School of Health and Allied Health Sciences Nursing Department Self-Directed Learning (Nur 146 - Clinical Area)

SCHOOL OF HEALTH AND ALLIED HEALTH SCIENCES
Nursing Department
SELF-DIRECTED LEARNING (NUR 146 - CLINICAL AREA)
Name: Cumayas, Divine Grace N. Group: _____ Date: 03/19/2021
I Define the following conditions:
1. Torticollis - is a problem involving the muscles of the neck that causes the
head to tilt down.
2. Craniosynostosis - is a birth defect in which one or more of the seams

(sutures) in a baby's skull close before the baby's brain has fully formed.
3. Achondroplasia - is a bone growth disorder that causes disproportionate

dwarfism.
4. Ankyloglossia - is a condition in which a child’s tongue remains attached to

the bottom of his or her mouth.
5. Pierre Robin Syndrome - is a rare congenital birth defect characterized by an

underdeveloped jaw, backward displacement of the tongue and upper airway
obstruction.
6. Esophageal Atresia - is a birth defect in which part of a baby's esophagus

(the tube that connects the mouth to the stomach) does not develop
properly.
7. Tracheoesophageal Fistula - is an abnormal connection between these two

tubes. As a result, swallowed liquids or food can be aspirated (inhaled) into
your child's lungs.
8. Omphalocele - is a birth defect of the abdominal (belly) wall. The infant's
intestines, liver, or other organs stick outside of the belly through the belly
button. The organs are covered in a thin, nearly transparent sac that hardly
ever is open or broken.
9. Gastroschisis - is a birth defect of the abdominal (belly) wall. The baby's

intestines are found outside of the baby's body, exiting through a hole beside
the belly button.
10. Meconium Ileus - is a condition where the content of the baby's bowel
(meconium) is extremely sticky and causes the bowel to be blocked at birth.
II. Answer the following:
1. Differentiate dislocation from subluxation.
Dislocation is the displacement of bones that form a joint. A joint is

where two or more bones meet. In a dislocation, the surfaces of the bones
that normally articulate with each other (i.e., join together to allow
movement) no longer line up correctly, and none of the joint surfaces are
touching. Subluxation is a partial dislocation, so some contact remains
between the joint surfaces.
2. Develop a teaching plan for parents to perform, a neurologic assessment on

a child discharged from the hospital in a spica cast.
The teaching plan for the parents to manage to perform when a child
in a spica cast is to keep the cast dry also the edges of the cast should be
padded as needed to prevent skin irritation. Make sure the child has enough
room in the cast. You should be able to put one finger between the child’s
skin and the cast around each thigh from the opening that is cut out in the
groin region.
3. Identify the major components of assessment when examining the infant for
a diaphragmatic hernia. What are the physiologic explanation for the positive
findings that you might find on assessment?
 Presence of a scaphoid abdomen, diminished breath sounds ipsilateral

to the side of the hernia, and displacement of the heart sounds
contralateral to the hernia.
 Chest x-ray shows visible bowel gas above the diaphragm
accompanied by a mediastinal shift.
Newborns with a diaphragmatic hernia will have respiratory

difficulty from the moment of birth, because at least one of the lobes
of their lungs cannot expand completely. Their abdomen generally
appears sunken because it is not as filled with intestine as in the
normal newborn. Breath sounds will be absent on the affected side of
the chest cavity. There may be cyanosis and intercostal or subcostal
retractions. These infants have a potential for developing persistent
pulmonary hypertension because blood cannot perfuse readily through
the unexpanded lung. This leads to right-to-left shunting through the
foramen ovale in the heart and also causes the ductus arteriosus to
remain patent.
4. Visit the physical therapy unit of SWU-MC, and identify the equipment used
for motor development by the patient in the hospital and by the patients who
visit for outpatient therapy.
 Pediatric Scooters - A pediatric scooter helps children develop

strength. They develop the ability they need to propel themselves
forward. This allows them to develop something called proprioceptive
strength and better neuromotor control.
 Gait Trainers - Gait trainers give independence to children who cannot
stand on their own otherwise. The trainers come with harnesses and
pelvic stabilizers for support.
 Turtle Therapy Systems - The Tumbleforms Turtle Therapy System is a
piece of equipment for pediatric physical therapy that accomplishes
just that. It has a rocking turtle dome, plus a padded scooter, and a
net swing.
 Positioning Wedges - A positioning wedge or therapy wedge is a
comfortable, practical tool. It helps children increase their tolerance of
a prone position. It can also be used to improve a child’s stability and
head control.
 Three-Wheel Tricycle Cruiser - The Mobo Triton Three Wheel Tricycle
Cruiser provides excellent cardio workouts. It builds stamina and is on
the lesser expensive end due to its simplicity. It has an adjustable
frame.
III. Case Study
Patrick is approximately 24 hours old. The doctors are implementing

test and procedures to determine whether his congenital neural tube
defect is a meningocele or myelomeningocele.
A. How does a meningocele different from myelomeningocele?
Myelomeningocele is the most serious type of spina bifida. With this

condition, a sac of fluid comes through an opening in the baby’s back. Part of
the spinal cord and nerves are in this sac and are damaged. This type of
spina bifida causes moderate to severe disabilities, such as problems
affecting how the person goes to the bathroom, loss of feeling in the person’s
legs or feet, and not being able to move the legs. With meningocele a sac of
fluid comes through an opening in the baby’s back. But, the spinal cord is not
in this sac. There is usually little or no nerve damage. This type of spina
bifida can cause minor disabilities.
B. What are the physical characteristics that Patrick would exhibit if diagnosed
with myelomeningocele?
With myelomeningocele, there's usually no skin covering, and the

spinal cord tissue is out in the open. Other symptoms of myelomeningocele
include: Weak leg muscles (in some cases, the infant can't move them at all)
Unusually shaped feet, uneven hips, or a curved spine (scoliosis)
C. Preoperatively, Patrick should be placed on what position?

Before surgery, Patrick should be kept prone and tension on the sac
minimized. Because the infant lies prone, no pressure is exerted on the sac
or repaired back defect. The hips are only slightly flexed, to decrease tension
on skin over the back.
D. The nurse should give special attention to Patrick’s elimination status. What
procedure might the nurse implement to aid in bladder elimination.
Clean intermittent catheterization: A procedure to empty the bladder

by inserting a soft, flexible tube called a catheter into the bladder to drain
the urine. This helps prevent infections, reduces bladder pressures, and helps
the child to become dry.

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SCHOOL OF HEALTH AND ALLIED HEALTH SCIENCES

SELF-DIRECTED LEARNING (NUR 146 - CLINICAL AREA)

Name: Cumayas, Divine Grace N. Group: _____ Date: 03/19/2021

I Define the following conditions:

2. Craniosynostosis - is a birth defect in which one or more of the seams

3. Achondroplasia - is a bone growth disorder that causes disproportionate

4. Ankyloglossia - is a condition in which a child’s tongue remains attached to

5. Pierre Robin Syndrome - is a rare congenital birth defect characterized by an

6. Esophageal Atresia - is a birth defect in which part of a baby's esophagus

7. Tracheoesophageal Fistula - is an abnormal connection between these two

9. Gastroschisis - is a birth defect of the abdominal (belly) wall. The baby's

II. Answer the following:

1. Differentiate dislocation from subluxation.

Dislocation is the displacement of bones that form a joint. A joint is

2. Develop a teaching plan for parents to perform, a neurologic assessment on

 Presence of a scaphoid abdomen, diminished breath sounds ipsilateral

Newborns with a diaphragmatic hernia will have respiratory

 Pediatric Scooters - A pediatric scooter helps children develop

III. Case Study

Patrick is approximately 24 hours old. The doctors are implementing

A. How does a meningocele different from myelomeningocele?

Myelomeningocele is the most serious type of spina bifida. With this

With myelomeningocele, there's usually no skin covering, and the

C. Preoperatively, Patrick should be placed on what position?

Clean intermittent catheterization: A procedure to empty the bladder

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