Health Promotion and Maintenance Q 141
A toddler has recently been diagnosed with cerebral palsy. Which of the following information should the nurse provide to the parents? Note: More than one answer may be correct. Select all that apply.
A. Regular developmental screening is important to avoid secondary developmental delays.
B. Cerebral palsy is caused by injury to the upper motor neurons and results in motor dysfunction, as well as possible ocular and speech difficulties.
C. Developmental milestones may be slightly delayed but usually will require no additional intervention.
D. Parent support groups are helpful for sharing strategies and managing health care issues. E. Outdoor activities are prohibited for the child.
E. Outdoor activities are prohibited for the child.
Correct Answer: A, B & D.
Delayed developmental milestones are characteristic of cerebral palsy, so regular screening and intervention is essential. Because of injury to upper motor neurons, children may have ocular and speech difficulties. Parent support groups help families to share and cope.
Option A: Encourage age-related play and other activities that strengthen gross and fine motor development, sensory and cognitive development such as letting the child put green balls on the left basket and red balls on the right. These activities enhance growth and development and provide needed stimulation for the child.
Option B: Learn patient needs and pay attention to nonverbal cues. The nurse should set aside enough time to attend to all of the details of patient care. Care measures may take longer to complete in the presence of a communication deficit. Provide an alternative means of communication. Alternative forms such as flashcards, whiteboards, hand signs, or a picture board allow the client to express oneself if speaking is difficult to obtain.
Option C: Physical therapy and other interventions can minimize the extent of the delay in developmental milestones. Facilitate activities in using fine and gross motor skills (such as giving a ball on hand to encourage throwing, holding a spoon). Perform range-of-motion exercises every 4 hours for the child unable to move body parts. Children with cerebral palsy have a decreased range of motion (ROM) due to limited mobility and the presence of spasticity. ROM exercises promote movement and minimize the risk of contractures.
Option D: Encourage the parent to express the impact of their child’s condition on the family. Assess the coping ability of the family. This will determine how much support and guidance the family may need. Educate the family on different skills needed to manage the child’s care (such as physical rehabilitation, proper nutrition, medication administration, ROM exercises, seizure management).
Option E: Outdoor activities, such as bird watching, playing in the playground, or amusement park rides, are not prohibited for the child with cerebral palsy. Most of the activities of daily living and play exercises hasten physical development. Helps the parents to vent their feelings/concerns.