Pediatric Nursing Demystified

Difficulty climbing and running.

Gowers sign where the child uses upper body to move from a prone to

upright position

Posture changes.

Scapular flaring due to weakened thoracic muscles.

Muscle atrophy.

Contractures.

Test Results

 Electromyography (EMG): Decreased electrical impulses in muscles.

Serum creatine kinase: Increase indicates early sign of muscular dystrophy.

Nerve conduction velocity: Abnormal nerve response to electrical stimulus.

Muscle biopsy: Identifies degenerative muscle fibers, fat, and connective

tissues.

Treatment

There is no cure for Duchenne muscular dystrophy.

Provide physical therapy to help maintain muscle tone.

Provide occupational therapy to help the child master the skills of inde-

pendent living when possible.

Treatment is focused on treating complications of Duchenne muscular

dystrophy such as trauma and infection.

Surgery for contractures.

Nursing Intervention

Prevent infection.

Monitor vital signs.

Provide a balanced diet to prevent obesity.

Perform range-of-motion exercises.

Change position every 2 hours.

Arrange for a social worker to help the family deal with the challenges

that face the child and the family.

Guillain-Barré Syndrome

What Went Wrong?

Guillain-Barré syndrome is an acute, progressive autoimmune condition that

affects the peripheral nerves. Symptoms occur as the myelin surrounding the

axon on the peripheral nerves is damaged from the autoimmune effect. The

disease typically follows a viral infection, surgery, other acute illness, or

immunization by a couple of weeks.

Ascending Guillain-Barré exhibits muscle weakness and/or paralysis that

begins in the distal lower extremities and travels upward. Patient may also

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CHAPTER 10/ Neurologic Conditions^221