Author Question: The nurse is discussing genetic referral with the parents of children being seen in the pediatric ... (Read 113 times)

storky111 · **on:** Jun 28, 2018

The nurse is discussing genetic referral with the parents of children being seen in the pediatric clinic. The child who would benefit from a genetic referral is the child whose family has a history of:

1. Prominent epicanthal folds, resonant lungs, or absent tinnitus in Asian families.
2. Broad face, lower-extremity lichenification, or spider angiomas.
3. Normocephalic head, euthyroid, or five digits per extremity.
4. Cleft lip and/or cleft palate, diaphragmatic hernia, or cataract.

Question 2

A child is admitted to the PICU following an accident. The nurse is speaking with the parents regarding preparing siblings to visit. What should the nurse include in the conversation with the parents? Select all that apply.

1. Describe how the sibling looks.
2. Describe in detail what the siblings should expect to see.
3. Describe the hospital environment.
4. Use a doll to show injuries.
5. Discourage the siblings from visiting.

joanwhite · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

4
Rationale 1: The trait of prominent epicanthal folds is a cultural variation in Asian families. Resonant lungs and the absence of ringing in the ears are normal findings.
Rationale 2: A broad face is likely to be a family trait. Lichenification is thickening of the skin often due to chronic irritation. Spider angiomas are a common, benign skin lesion.
Rationale 3: A normocephalic head, euthyroid, and five digits per extremity are normal findings.
Rationale 4: Cleft lip and/or cleft palate, diaphragmatic hernia, or cataract may have a genetic basis, and the family may benefit from a genetic referral.
Global Rationale:

Answer to Question 2

1, 3, 4

Rationale:
1. Before the visit, talk with the siblings about what to expect, and describe how their sibling will look.
2. Inform siblings about ill siblings using language and concepts appropriate to their ages and developmental tasks.
3. Describe the hospital environment, including equipment, sounds, and smells.
4. Using a doll, drawing pictures, or showing an actual picture of the child can help prepare the siblings.
5. Siblings should be allowed to visit. Such a visit should be encouraged if the child could potentially die.