A school nurse is performing scoliosis screenings.
The nurse should recognize which of the following clinical manifestations as an indication of scoliosis?
Uneven shoulder and pelvic heights.
Exaggerated curvature of the sacrum.
Limited range-of-motion of the hips.
Mild pain in the hip region.
The Correct Answer is A
Choice A rationale:
"Uneven shoulder and pelvic heights." This is the correct answer. Uneven shoulder and pelvic heights, along with an asymmetrical appearance of the spine when viewed from the back, are clinical manifestations of scoliosis. Scoliosis is a sideways curvature of the spine that often develops during the growth spurt before puberty. Screening for scoliosis typically involves assessing the alignment of the spine and looking for these asymmetries.
Choice B rationale:
Exaggerated curvature of the sacrum is not a typical sign of scoliosis. Scoliosis primarily affects the upper back and can cause a side-to-side curvature of the spine, not the sacrum.
Choice C rationale:
Limited range-of-motion of the hips is not a specific indicator of scoliosis. Restricted hip movement might suggest other musculoskeletal issues but is not directly related to scoliosis.
Choice D rationale:
Mild pain in the hip region is not a characteristic symptom of scoliosis. While scoliosis can cause discomfort, it typically manifests as back pain, not specifically in the hip region. Pain symptoms can vary widely among individuals and might not be present in all cases of scoliosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Answer is: a. "The estimated blood loss was 250 milliliters."
Explanation: Including the estimated blood loss during the procedure in the hand-off report is relevant information that impacts the patient's care and helps the receiving nurse assess the patient's condition and monitor for complications.
Choice b. is wrong because the client has been transferred to the PACU, it is implied that the intubation has been removed. The focus should be on the patient's current condition and any potential complications related to the procedure.
Choice c. is wrong because the client's role as a member of the board of directors does not directly affect their medical care. Nurses should maintain patient confidentiality and only discuss relevant information regarding the patient's health status.
Choice d. is wrong because the number of sponges used during the procedure is not essential information to include in the hand-off report. The focus should be on the patient's current condition and any potential complications.
Correct Answer is B
Explanation
The correct answer is Choice b: New onset of hearing loss.
Gentamicin, a potent aminoglycoside antibiotic, is renowned for its propensity to cause ototoxicity, particularly manifesting as new-onset hearing loss. Ototoxicity refers to damage to the inner ear structures responsible for hearing and balance, primarily the cochlea and vestibular apparatus. The mechanism of gentamicin-induced ototoxicity involves its accumulation in the endolymphatic fluid of the inner ear, leading to direct toxicity to the sensory hair cells and subsequent hearing impairment.
Manifestations of gentamicin-induced ototoxicity can vary, ranging from subtle high-frequency hearing loss to profound sensorineural deafness. Patients may experience tinnitus (ringing in the ears), difficulty hearing in noisy environments, and imbalance or vertigo. Notably, gentamicin-induced hearing loss is often irreversible and may progress even after discontinuation of the medication.
Now, let's delve into the rationales for the other choices:
Choice a: Hypotension Gentamicin administration is not typically associated with hypotension. However, systemic side effects such as nephrotoxicity and neurotoxicity can occur, particularly with prolonged or high-dose therapy. Nephrotoxicity may manifest as acute kidney injury, characterized by a rise in serum creatinine and blood urea nitrogen levels, oliguria, and fluid-electrolyte imbalances. Neurotoxicity, on the other hand, can lead to symptoms like muscle weakness, paresthesia, and confusion. Monitoring of blood pressure is essential in patients receiving gentamicin, but hypotension is not a direct adverse effect of the medication.
Choice c: Hyperthermia Gentamicin therapy is aimed at treating bacterial infections, such as pyelonephritis, and does not typically induce hyperthermia. Pyelonephritis itself is associated with fever, chills, and flank pain due to the inflammatory response to the urinary tract infection. Administration of gentamicin aims to eradicate the causative bacteria and resolve the underlying infection, which should, in turn, alleviate fever. However, persistent or worsening fever despite antibiotic therapy may indicate treatment failure or the presence of complicating factors, warranting further evaluation and management.
Choice d: Slurred speech Slurred speech is not a recognized adverse effect of gentamicin. Instead, it may suggest central nervous system involvement, such as cerebrovascular accidents (strokes), intoxication, or neurological disorders affecting speech production. Gentamicin primarily exerts its toxic effects on the inner ear structures, leading to auditory dysfunction rather than impairments in speech articulation. Therefore, the presence of slurred speech would prompt an assessment for alternative etiologies unrelated to gentamicin therapy.
In conclusion, while gentamicin is an effective antibiotic for treating infections, it carries the risk of ototoxicity, particularly manifested as new-onset hearing loss. Careful monitoring for this adverse effect is crucial to promptly identify and manage potential complications.
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