Question

An infant is brought to the emergency department by parents who report that the baby’s fontanels seem to be bulging outward. What action by the healthcare provider is most appropriate?

When are childhood cancers most often … ?

The student wants to know how the clinical manifestations and onset of juvenile idiopathic arthritis (JIA) differ from those of rheumatoid arthritis (RA) in adults. What answer by the healthcare professional is best?

An infant has been … with intussusception and the student asks the healthcare professional to explain the condition. What explanation by the professional is most accurate?

A patient is in status epilepticus. In addition to giving medication to stop the seizures, what would the healthcare professional place highest priority on?

A child has osteosarcoma and the healthcare team is assessing for metastases. What diagnostic study would be the priority?

Answer 1

1.

The fontanelles should feel firm and very slightly curved inward to the touch. When the infant is crying, lying down, or vomiting, the fontanelles may look like bulgedThis is known as a bulging fontanel and may be a sign of brain swelling or fluid build up in the brain...A bulging fontanel is an emergency. It can be a sign of pressure rising inside the skull which may result in damage to the baby’s developing brain. childlexperiencing this symptom, seek medical attention immediately.

2.rheumatoid a and rheumatoid arthritis?

JIA is a group of chronic arthritis disorders affecting children (you can read about the different types of JIA here). RA is a single condition. Many people with JIA find that symptoms subside as they age, while adults usually have life-long RA symptomsArthritis causes joint swelling (inflammation) and joint stiffness.   

JIA may affect a child’s bone development and overall growth, whereas RA does not affect growth and development because the disease impacts adults.

3

Intussusception is a life-threatening illness and occurs when a portion of the intestine folds like a telescope, with one segment slipping inside another segment. This causes an obstruction, preventing the passage of food that is being digested through the intestine.Intussusception is the most common cause of intestinal obstruction in children between the ages of three months and six years.

4A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes is called status epilepticus. This is a medical emergency that may lead to permanent brain damage or death..children, the main cause of status epilepticus is an infection with a fever. In adults, the common causes include: Stroke.

administer liquids or foods until the person is fully conscious. attempt to give oral medications during the seizure. administer oxygen or CPR during the seizure.

How to help during a seizure

Protect the person from injury. Keep him or her from falling if you can, or try to guide the person gently to the floor. ...

Do not force anything, including your fingers, into the person's mouth.

Do not try to hold down the person. This can cause injury, such as a dislocated shoulder.

The benzodiazepines most commonly used to treat status epilepticus are diazepam (Valium), lorazepam (Ativan), and midazolam .

5.Osteosarcoma is the most common type of bone cancer in children and teens. This cancer arises most often in the wide ends of long bones, such as the femur and tibia in the upper and lower leg, and the humerus in the upper arm.

Pain in the affected bone (usually around the knee or in the upper arm) is the most common symptom of osteosarcoma. At first, the pain might not be constant and might be worse at night. The pain often increases with activity and might result in a limp if the tumor is in a leg bone.

Diagnosis _magnetic resonance imaging (MRI) of the primary tumor, computed tomography (CT) scan of the chest and bone scan.

Treatment_Osteosarcoma is often treated with a combination of therapies that can include surgery, chemotherapy and radiation therapy. Most patients with high grade tumors receive about three months of chemotherapy, known as neo-adjuvant therapy, before surgery.