What safety instruction should a nurse teach a 10-year-old child with diminished sensation in the legs because of cerebral palsy?

Appeared in: AIIMS Delhi NO - 2017

Explanation

The primary risk for a patient with diminished sensation in the legs is injury from sources they cannot feel, such as extreme temperatures.
Hot bathwater can cause severe scalds and burns before the child is even aware of the danger.
Teaching the child or caregiver to always test the water temperature with a body part that has normal sensation (like an elbow or hand) or a thermometer is a critical and direct preventive measure.
This instruction empowers the patient and family to proactively manage a significant environmental risk.

Option B: Tightening brace straps 'securely' is dangerous for someone with diminished sensation. It can lead to pressure ulcers or impaired circulation, which the child would not be able to feel.
Option C: While repositioning is important for preventing pressure sores in immobile individuals, waking a 10-year-old child twice during the night is disruptive and may not be the highest priority. The immediate risk of acute injury from external hazards like heat is more pressing.
Option D: This describes incorrect and unsafe crutch-walking technique. Looking down at the feet compromises balance and prevents the user from seeing obstacles, increasing the risk of falls.

Clinical Relevance

Nursing practice connection: Use the key finding related to Safety instructions for a pediatric patient with sensory deficits due to cerebral palsy to guide bedside assessment, documentation, and the next nursing action.
Patient and family education is a cornerstone of nursing care, especially for chronic conditions like cerebral palsy. Empowering them with safety knowledge prevents complications and hospitalizations.
Nurses must perform thorough risk assessments for all patients, identifying specific vulnerabilities like sensory deficits and implementing tailored safety plans.
What if the child also had a significant cognitive impairment? The safety instruction would remain the same, but the teaching would be directed exclusively to the caregivers, who would bear full responsibility for implementing the safety check.

How to Approach the Question

First, identify the core clinical problem in the question stem: the patient is a 10-year-old with 'diminished sensation in the legs'.
Next, determine the primary risk associated with this problem. Diminished sensation means the inability to feel pain, pressure, or temperature.
Evaluate each option based on how it addresses this primary risk.
Option A (testing water temp) directly prevents burns, a major risk of sensory loss.
Option B (tightening braces) increases the risk of pressure injury, which is the opposite of a safety instruction.
Option C (turning at night) addresses pressure, but is less of an immediate safety priority than preventing burns and is disruptive.

Concept Tested & Keywords

Concept Tested: Safety instructions for a pediatric patient with sensory deficits due to cerebral palsy.
Stem keywords: safety instruction, 10-year-old child, diminished sensation, legs, cerebral palsy
Lead-in keywords: What
Clinical cues: The patient's diminished sensation is the key clinical detail, as it directly relates to the risk of unfelt injury.

QcsCKic_voilrM5Nk9Y_3D

E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 190-192

Practise the full AIIMS Delhi NO - 2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.