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VEEB > Care of the child Musculo-skeletal,Neuro,Sensory conditions > Flashcards

Care of the child Musculo-skeletal,Neuro,Sensory conditions Flashcards

1
Q

Osteomyelitis

A
  • inflammation of the bone
  • staph aureus
  • blood bone infection

s/s:

  • fever
  • pain
  • psuedoparalysis(afraid to move)

Diagnosis
-leukocylosis
-elevated esr
+ blood culture

Treatment/Nursing care

  • long term course of treatment(6-8weeks)
  • bedrest
  • iv antibiotics
  • analgesic
  • immobilization of limb
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2
Q

Duchenne Muscular Dystrophy(etiology)

A
  • Hereditary sex linked recessive
  • progressive neuromuscular disease, life expectancy, early 30s
  • fatty infiltration of muscle cells tissue breakdown
  • occur in males more

diagnosis:

  • H&P
  • serum enzymes
  • muscle biopsy
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3
Q

Duchenne Muscular Dystrophy(signs n symptoms)

A
  • incidious(comes on gradually)
  • delayed walking
  • decrease muscle strength
  • increasing clumsiness
  • lordosis(shoulders back,rounded abdomen)
  • gowers sign(large muscles break down first, cant stand up straight)
  • usually die from PNA, ulcer
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4
Q

Duchenne Muscular Dystrophy(Treatment/Nursing Care)

A
  • poor prognosis, no cure
  • life expectancy adolensence
  • depititating-crutches w/ bedridden
  • prevention of complication
  • skin care
  • PT/OT
  • emotional support
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5
Q

COXA-PLANA Disease aka LEGG-CALVE-PERTHES Disease(Etiology)

A
  • lack of circulation to femoral head
  • 4-8 years with limp cause unknown
  • trauma of synovities prior
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6
Q

COXA-PLANA Disease aka LEGG-CALVE-PERTHES Disease(nursing care/treatment)

A
  • Rest, allow child to repair itself
  • Bucks traction-puls in one place keeping in alignment
  • hip bracing
  • maintain ROM
  • limit activity during treatment
  • prognosis is good for hip degeneration in later years
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7
Q

Bone Tumors

A
  • Benign: causes deformity and pain

- malignant-development of abnormal cells

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8
Q

Bone Tumors(Ewing Sarcoma)

A
  • growth in marrow of the long bones
  • metastisis tp lungs and other bones

s/s: pain,possible mass at the site,possible fx
tx:chemo and radiation, good prognosis provided caught early

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9
Q

Bone Tumors(Osteosarcoma)

A

-primary malignant tumor of long bones
-metas to the lungs
s/s:pain,limited mobility,obvious tumor mass
TX:amputation and chemo
Nursing care: post op care,potential for infection,coping family support,phantom limb pain,prosthesis-P/T

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10
Q

Juvenilele Rheumatoid Arthritis(Stills Disease)(Etiology)

A

-most common form of arthritis
-systemtic fever x10days, invovle internal organs(liver,spleen enlargement)
-polyarticular=arthritis in 5 or more joints
-pauciarticular=arthritis in 4 or more joints
S/S:swollen joints,enlarged liver and spleen,anemeia,anorexia,rash,pericarditis,myocarditis,potential for
-uueitis=inflammation of anterior chamber of the eye, check eyes every year for blindness
Dx:ANA, no cure

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11
Q

Juvenilele Rheumatoid Arthritis(Stills Disease)(Treatment/nursing care)

A
  • no cure, treat symptoms
  • NSAIDs, ,anti-inflammatory-hepatoxcity,effect the Gi system, ROM exerxcies
  • prevent ankylosis(deformity of the joints)
  • PT/OT to decrease ankylosis
  • heat packs and warm showers-increase blood supply and decrease swelling
  • good nutrition
  • immunization delay because immunity decreased because of the use of corticorsteroids
  • prognosis: subsides over a few years
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12
Q

Scoliosis(Etiology)

A
  • curvture of the spine
  • common in females

Functional:poor posture, no treatment
Structural:congenital,neuromuscular,diopathic(just happens we dont know)

Screening:pt. bends over feel spine
Dx: X-ray

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13
Q

Scoliosis(Treatment & Nursing care)

A

-curves under 20degrees=observation,good posture,backpack safety
-curves 20-40degrees=boston brace,milwaukee brace,daily exercise
-curves greater than 40degrees=harrington rods,spinal fusion
patient education:
-wear brace 23 hrs a day
-tee shirt under brace(skin integrity)
-body image in adolescents
-surgery:pre-op teaching,post op care, potential for constipation,log rolls,physical therapy,going to be immobile after surgery,dehersereanants after surgery because skin tight in the back, physical therapy

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14
Q

Hydrocephalus(etiology)

A
  • excessive fluid in head around the brain
  • increase CSF in ventricles of the brain
  • increase intracranial pressure
  • increase head circumference
  • congenital or acquired
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15
Q

Hydrcephalus(Sign and symptoms)

A
  • lethargy
  • shrill cry,poor muscle tone,poor appetite
  • seizures
  • bulging fontanels
  • increase head circumfeence
  • seperated cranial sutures(increase fluid pushed them apart)
  • getting sun eyes
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16
Q

Hydrcephalus(assessment)

A
  • head circumference
  • transillumnation
  • MRI,cat scan
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17
Q

Hydrcephalus(treatment)

A

-ventriculo-peritoneal shunt

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18
Q

Hydrcephalus(pre-op care prior to shunt placement)

A
  • Temp and Pulse q2h
  • support head
  • quiet feeding/quiet environment,prone to vomitting and seizures
  • check fontanels
  • monitor head circumference
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19
Q

Hydrcephalus(post-op care vp shunt)

A
  • position baby on unoperative side
  • initally flat then gradually increase HOB
  • observe signs of malfunction
  • monitor fontanels,sunken or bulging,adjust position
  • observe for s/s of infection,possible menigitis/peritonitis
  • skin care
  • nutrition and emotional support
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20
Q

Hydrcephalus(parent teaching for VP shunt)

A
  • recognize signs of increase intercranial pressure,malfunction,infection
  • importance of the flu care and need for shunt revision
  • safety-child may have tendency to be unbalanced
  • early intervention: PT/OT/SPEECH
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21
Q

Spina Bifida(etiology)

A
  • congenital embryonic neutal tube defect
  • imperfect closure of spinal vertebrae

prenatal diagnosis

  • alfa-fetal protein(AFP) level at 3-15weeks
  • amniocentesis is indicated
  • folic acid decreases incidence
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22
Q

Spina Bifida(2 types)

A
  1. Spina bifida Occulta

2. Spina Bifida Cystica

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23
Q

Spina Bifida Occulta

A

-minor varistion, opening in spinal column small and no protrusion of structures

s/s: -tuft of hair or small dimple

  - occurs at L1 or S1
  - no treatment unless symptomatic
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24
Q

Spina Bifida Cystica

A
  • Meningocele: cyst containing meninges and CSF
  • size varies
  • usually no neuromuscular symptoms
  • surgery needed

Myelomeningocele

  • defect in bony canal meninges csf. and spinal cord
  • S/S:
  • visible sac
  • B&B control poor
  • leg paralysis
  • hydrocephalus
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25
Q

Tx of Spina Bifidas

A
  • intra-uterine surgery
  • c-section and surgery within 24hrs
  • repairs defect
  • prevents hydrocephalus
  • latex free environment
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26
Q

Nursing care Spina Bifida

A

Pre-OP

  • moist saline dressing
  • assesment of sack
  • avoid pressure on sac
  • neuro assessment
  • skinn care(no diapering)
  • help promotoe parent-infant relationship

Post-Op

  • observe dressing
  • monitor for ICP, VS,for infection,for leakage
  • parent teaching/expectations
  • intelligence/learning ability not effected
  • independence is compromised
  • long term family goals
  • focus on childs accomplishments
  • catherization procedures
  • bowel control
  • precautions of latex allergic reaction
  • observe for s/s of complication of immobility
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27
Q

Reyes Syndrome

A
  • viral infection
  • hepatopathy: ammonia level, bleeding
  • encephalopathy
  • no aspirin
  • neuro checks
  • HIB vaccine
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28
Q

Meningitis(etiology)

A
  • inflammation of the meninges
  • may be viral or bacterial
  • peak incidence 6 to 12 months
  • droplet infection/resp infection
  • HIB vaccine useful to decrease risk
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29
Q

Meningitis(s/s)

A
  • severe headache
  • stiff neck
  • irritability
  • fever
  • restlessness
  • petechiae
  • vomiting
  • nuchal rigidity
30
Q

Lumbar puncture

A
  • small amount of CSF is extracted

- CSF should be clear

31
Q

Lumbar puncture(nursing care)

A
  • place child in lateral position
  • hold neck and thighs to make a curve in spine
  • talk quietly to child for reassurance
  • quiet environment
  • iv fluids and iv antibiotics
  • anticonvulsants
  • comfort and safety measures post LP
  • resp isolation-72 ABX
  • monitor iv fluids I/O
  • observe for signs of increase ICP
  • neuro checks
  • tylenol for fever
  • immunizations
32
Q

Encephalitis(defintion)

A
  • inflammation of the brain

- usually viral

33
Q

Encephalitis(s/s)

A
  • headaches
  • drowsiness
  • change in mental status
  • coma
  • seizures
34
Q

Encephalitis(Tx)

A
  • supportive care
  • oxygen
  • sedatives
  • antipyretics
  • iv fluids
  • antibiotics
35
Q

Encephalitis(nursing care)

A
  • neuro check
  • v/s
  • i&o
  • T&P
36
Q

Brain turmors

A

-2nd common childhood cancer
-s/s depend on site
-treatment: radiation,surgery,chemotherapy
nursing care:monitor vs,observe for increase ICP,emotional support

37
Q

Neuroblastoma(eitology)

A
  • develops in utero
  • adrneal gland
  • abdominal mass
  • HTN-tachycardia
  • resp depression
38
Q

Neuroblastoma(Dx)

A
  • palpated mass in abdomen
  • ct scan
  • biopsy
39
Q

Neuroblastoma(Tx)

A
  • surgery
  • chemo
  • radiation
40
Q

Neuroblastoma(nursing care)

A
  • poor prognosis, due to metastasis before discovery

- emotional support

41
Q

Mental retardation

A
  • below average mental functioning
  • deficit in adaptive behavior
  • onset before 18
  • 3 components: memory,mood,language
  • early intervention
  • emphasize strengths
  • family support
  • AHRC
42
Q

Downs Syndrome(Trisomy 21)

A

mild-severe mental retardation

-

43
Q

Downs Syndrome(Trisomy 21)(S/S)

A
  • small head
  • round face
  • flat nose
  • protruding tongue
  • close set eyes
  • simian crease
  • short thick hands: congenital heart defects
  • family counseling
  • strive to potential
  • self-actualization
44
Q

Head Injuries(etiology)

A
  • concussion/skull fx

- shaken baby syndrome

45
Q

Head Injuries(s/s)

A
  • increased ICP
  • headache
  • hypoxia
  • change of LOC
46
Q

Head Injuries(nursing care)

A
  • observe for LOC- wake child if neccessary
  • monitor for ICP
  • observe for posturing
  • decerebrate=all 4 limbs extended, hands flexed back
  • decorticate=arms wrist fingers flexed up
47
Q

Decerebrate

A

all 4 limbs extended, hands flexed back

48
Q

Decorticate

A

arms wrist fingers flexed up

49
Q

Otitis Media(etiology)

A
  • inflammation of middle ear due 2 upper resp infection
  • communicable disease complication
  • haemophilius influenzae
  • baby w/ bottle in bed
  • second hand smoke
50
Q

Otitis Media(s/s)

A
  • pain in ear, pulling on ear
  • irritability
  • diminished hearing
  • fever
  • headache
  • vomit and diarrhea
  • potential for rupture of eardrum
51
Q

Otitis Media(Tx)

A
  • broad spectrum antibiotic if throat culture positive
  • analgesics
  • ear drops
  • under 3yrs: pinna down n back
  • over 3yrs-inna up an back
  • no cotton in ears
  • myringotomy
52
Q

Otitis Media(Nursing care)

A
  • meds as ordered-Ax and tylenol
  • no cotton in ear
  • place child on affected side if drum is ruptures
  • cold compress for pain relief
  • check temp
  • avoid water in ears
53
Q

Hearing Impairment(etiology)

A
  • prenatal viral infection or german measels
  • acquired deafness: measles, mumps, meningitis exposure to loud noise
  • temporary due to wax build up
  • chronic ear infections
  • neurological deficit
54
Q

Astigmitism

A
  • irregular shaped cornea or lense
  • causes blurring vision
  • treated with corrective lenses
55
Q

Amblyopia

A
  • lazy eye
  • decrease muscle
  • vision reduction
  • patch good eye(unpatch 2hrs/24)
  • can occur up to 9yrs of age
56
Q

Strabismus

A
  • cross eyes-unable to focus both eyes at same time
  • move head instead of just eyes
  • glasses
  • patch unaffected eye
  • vision therapy
57
Q

conjuctivitis

A
  • conjuctiva inflamed
  • redness,drainage
  • transferable
  • treated with eye drops or ointment
  • handwashing
  • keeping person items seperate
58
Q

hyphema

A

etiology: bleeding into the anterior chamber of the eye usually cause by blunt or penetrating trauma
- tx: both eyes are patched, cbr to prvent increase intracranial pressure and allows the re-absorption of the blood

59
Q

cataracts

A
  • opaque lens
  • congenital
  • hereditary
  • non-hereditary
  • surgery
60
Q

Retinoblastoma(etiology)

A
  • malignant tumor

- chromosome 13

61
Q

Retinoblastoma(s/s)

A
  • yellow/white reflex

- cats eye

62
Q

Retinoblastoma(tx)

A
  • cyrosurgery-freezing by laser
  • photocoagulation-destroys blood vessels by laser
  • enucleation-removal of eye
  • chemotherapy
63
Q

Retinoblastoma(Nursing Care)

A
  • pressure dressing
  • elbow restraints
  • eye prothesis
  • emotional support
64
Q

Cerebral Palsy(etiology)

A
  • anoxia at bitrth(lack of o2 to brain)
  • prenatal
  • preinatal
  • non pregressive
  • intelligence not necessarily affected
  • person responsible for american disability act had cp
65
Q

Cerebral Palsy(nursing care)

A
  • early intervention
  • Rom
  • socializaiton
  • family support
66
Q

Seizures(etiology)

A
  • altered neurological impulse causing rapid muscle contraction
  • causes unknown, fever, trauma,brain tumor
  • tonic-clonic(gran mal)
  • aura
  • tonic/clonic
  • postictal lethary
67
Q

Status epilepticus

A
  • prolonged seizures

- sudden stopping of medication

68
Q

Epilepsy

A

-chronica medical condition causeing seizures

69
Q

Absence(petit mal)

A

-twiching , facial tics,blinking of eyes

70
Q

Febrile

A
  • most common

- caused by rapidly increasing temp

71
Q

myoclonic

A

-sligh short lasting seizures

72
Q

infantile spasms

A
  • seen in premies with under developed nerous systems

- child is very jumpy and twitching

VEEB (25 decks)

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