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WCF > Care for Child w/MSK Condition & Maltreatment > Flashcards

Care for Child w/MSK Condition & Maltreatment Flashcards

1
Q

Several different methods to immobilize an extermity

A

Splinting Devices
Boots
Casts
Skin traction
Skeletal traction
Distraction devices

Splinting devices and boots can be done in outpatient setting or ER; easily removed

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2
Q

6 P’s of Neurovascular Assessment

A

Pain unrelieved by narcotics
Pallor
Paralysis
Paresthesia
Pulselessness
Poikilothermia

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3
Q

Main principles of traction is to

A

reduce dislocations and immobilize fractures

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4
Q

Skin traction

A

Force is applied over a large area of skin (DDH, femur fractures)

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5
Q

Skeletal traction

A

Force is applied directly to the bone (pin or wire, often for multiple injuries sustained)

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6
Q

What head shape abnormality?

Most often positional (Back to Sleep)
Cranial sutures are overriding
Facial abnormalities
Treated with corrective helmet

A

Plagiocephaly

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7
Q

What head shape abnormality?

Premature fusion of one or more of the cranial sutures
Most need craniotomy

A

Craniosynostosis

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8
Q

Common foot deformity diagnosed in newborns

May be associated with spina bifida or other anomalies, can be idiopathic

A

CONGENITAL TALIPES EQUINOVARUS (CLUBFOOT)

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9
Q

S/sx of clubfoot

A

Foot is:
Plantar-flexed
Inverted heel
Adducted forefoot
Rigid and cannot be manipulated into a neutral position

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10
Q

Risk factors for clubfoot

A

maternal obesity, maternal smoking, amniocentesis before 20 weeks, CVS

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11
Q

Treatment for clubfoot

A

-Serial casting
Provide cast care education, ADL’s- bathing, diapering

-Severe cases of clubfoot may require surgery
Post-op care & monitoring

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12
Q

Abnormal development of the hip (subluxation or dislocation of acetabulum)

Can result in abnormal gait, decreased strength, and hip & knee joint disease if untreated

A

DEVELOPMENTAL DYSPLASIA OF THE HIP (DDH)

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13
Q

S/sx of DDH

A

+ Ortolani or Barlow sign (first 3 months of age)
+ Galeazzi sign
Unequal gluteal folds
In older children, + Galeazzi, unequal leg length

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14
Q

Treatment for DDH

A

-Abduction brace (Pavlik harness 23 hours a day)
-If Pavlik fails, closed reduction and hip spica casting
-If after 18 months, open reduction and hip reconstruction

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15
Q

interrupted blood supply to the femoral head  avascular necrosis of femoral head

Can be genetic or environmental

A

LEGG-CALVE-PERTHES DISEASE

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16
Q

S/sx of Legg-Calve-Perthes disease

A

-Hip or knee soreness or stiffness
-Pain that increases with activity and decreases with rest
-Painful limp
-Quadriceps muscle atrophy
-Joint dysfunction
-Limited ROM

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17
Q

Capital femoral epiphysis (top of femur) slips through epiphysis (growth plate) in a posterior direction

Cause unknown, genetic/obesity
8-15 years old

Treated with surgery (pinning)

A

SLIPPED Femoral Capital Epiphysis (SCFE)

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18
Q

S/sx of Slipped Femoral Capital Epiphysis

A

Pain in groin or referred pain to thigh or knee
Pain during internal rotation of hip
Hip does not fully rotate externally
Abduction is Limited
Affected leg may be shorter in moderate or severe slip

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19
Q

Sprains and strains are

A

soft tissue injuries

20
Q

Connect muscle to bone

A

tendons

21
Q

Connect bone to bone

A

ligaments

22
Q

Sprain stretches or incomplete tears of a __________.

Causing Pain, Swelling, Bruising, Instability, & Loss of ability to move and use joint

A

ligament

23
Q

__________ or muscles are stretched in a strain.

Causing Pain, Swelling, Limited motion, Muscle spasms, Muscle weakness, & Cramping

A

tendons

24
Q

Patellar ligament irritation at the prominence of the tibial tubercle
Overuse in active school age children or adolescents

S/sx: pain below kneecap, pain when squatting or extending knee against resistance

A

Osgood-Schlatter Disease

25
Q

What is it: Bone undergoes more stress than it can absorb

Cause: Most common are falls, MVA’s & bicycle accidents

S/S: Pain, swelling around area, immovable limb

Diagnosed w/ imaging

A

Fractures

26
Q

How are fractures treated?

A

Closed reduction
Open reduction (surgery)- pins, screws, plates, rods
Elevate & cold packs

27
Q

What it is: Non-painful lateral curvature of the spine.

Types:
C-curve: laterally in one direction
S-Curve: two opposite directions

Diagnosed initially with Adam’s position or the bend over test. Then, radiography at Cobb’s angle.

A

Scoliosis

28
Q

S/sx of scoliosis

A

Unequal shoulder heights
Scapular prominences and heights
Rib prominences
Chest asymmetry
Unequal leg length

29
Q

Treatment for scoliosis

A

Back Brace
-Brace worn 23 hours a day
-Skin care and monitoring
-PT

Halo Traction
-Will sometimes use before surgery

Spinal Surgery: Spinal Fusion, may delay to prevent issues with spinal growth, necessary if pulmonary function is compromised

30
Q

Bacterial Infection of the bone and tissues around the bone and bone marrow. Infection spreads to ends of bones and can destroy epiphyseal plate.

Causes:
Open fracture or blunt trauma
Penetration of skin
Septic joint
Infected wound
Bacterial infection in body

A

Osteomyelitis

31
Q

S/sx of Osteomyelitis

A

Pain
Fever
Irritability
Soft tissue swelling, redness, warmth, pain

32
Q

How is osteomyelitis treated?

A

w/ antibiotics

33
Q

Connective tissue disorder which can cause fractures with minimal or no trauma (decrease in synthesis of collagen)

A

Osteogenesis Imperfecta

AKA brittle bones disease

34
Q

Blue sclera, deformed teeth, brittle bones

A

osteogenesis imperfecta

35
Q

Group of muscle disorders that cause the gradual wasting and degeneration of symmetrical groups of skeletal muscle

A

MUSCULAR DYSTROPHIES

36
Q

What are the three types of MD?

A

3 Types:
Duchenne’s (most common)
Congenital myotonic dystrophy
Facioscapulohumeral MD

37
Q

Symptoms appear after child can walk (3-7 years of age)
Waddling, wide-based gait
Calf muscles become weak and hypertrophied
Leg, Pelvis, arm, shoulder, and cardiac muscles weak and hypertrophied
Gower’s maneuver to rise from floor

A

Duchenne’s MD

38
Q

Risk factors for abuse

A

-Children < 1
-Children with disabilities/chronic illness
-Single parents
-Low socioeconomic level
-Caregivers with: Mental Illness, Substance use, Strict ideas of discipline, hx of generational abuse, &Marital discord

39
Q

-Intentional injuries
-Injuries are inconsistent with story: Bruises, Burns, Fractures, &Changes in behavior

A

Physical abuse

40
Q

-Any behavior, attitude, or failure to provide emotional or physical care
-Impairs a child’s socio-emotional development, mental health, and sense of self-worth

A

Emotional abuse

41
Q

-Any sexually related act involving adult and a child
-Violation of bodily privacy
-Exposing to adult sexuality
-Exploiting through child pornography or prostitution
-Electronic sexual luring
-UTIs, changes in behavior, regression, running away, abnormal knowledge of sex

A

Sexual abuse

42
Q

-Most common yet most difficult to prove
-Seen in families with mental illness and/or substance abuse

A

Neglect

43
Q

Retinal hemorrhage can lead to

A

blindness

44
Q

-Caregiver fabricates signs and symptoms of illness in child
-Child may undergo needless and painful procedures and treatments
-10% of cases may be fatal to the child
-Difficult to prove

A

Munchausen Syndrome by Proxy (MSBP)

45
Q

Munchausen Syndrome by Proxy (MSBP) Perpetrators will

A

-Gain support of the health care team through skilled deceit, leading professionals to believe they are a devoted, loving caregiver.
-Doctor shops & hospital jumps so that tracking the child’s true medical history is virtually impossible
-Typically, the mother
-Often work in health care
-Reporting of signs and symptoms occurring only in the presence of the parent
-Reports that illness is unresponsive to treatments
-Marital discord is often present
-May have other children with complicated medical histories

46
Q

Common Presentations and Methods of Deception of Munchausen Syndrome by Proxy

A

Apnea- suffocation, drugs, poisoning
Seizures- drugs, poisoning, asphyxiation
Vomiting- poisoning w/drugs that initiate vomiting
Diarrhea- poisoning w/drugs such as laxatives, mineral oil, or salt

WCF (12 decks)

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