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NCLEX > Ch 44: Peds Musculoskeletal > Flashcards

Ch 44: Peds Musculoskeletal Flashcards

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1
Q

Developmental Dysplasia of the Hip

A

head of the femur is seated improperly in the acetabulum of the pelvis

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2
Q

Acetabular Dysplasia (preluxation) (DDoH)

A

mildest form
neither subluxation nor dislocation
delay in acetabular development occurs
femoral head remains in acetabulum

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3
Q

Subluxation (DDoH)

A

incomplete dislocation of the hip
femoral head remains in acetabulum
stretched capsule and ligamentum teres causes head of the femur to be partially displaced

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4
Q

dislocation (DDoH)

A

femoral head loses contact with acetabulum and is displaced posteriorly and superiorly over fibrocartilaginous rim
ligamentum teres is elongated and taut

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5
Q

Galeazzi’s sign, Allis’ sign

A

shortening of the limb on the affected side (DDoH)

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6
Q

Ortolani’s test (DDoH)

A

meaneuver is a test to assess for hip instability. examiner abducts the thigh and applies gentle pressureforward over the greater trochanter. a “clunking” sensation indicated a dislocated femoral head moving into the acetabulum.

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7
Q

Barlow’s test (DDoH)

A

examiner adducts the hips and applies gentle pressure down and back with the thumbs. in hip dysplasia, the examiner can feel the femoral head move out of the acetabulum.

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8
Q

Trendelenburg’s sign (DDoH)

A

child stands on one foot and then the other foot, holding onto a support and bearing weight on the affected hip; the pelvis tilts downward on the normal side instead of upward, as it would with normal stability.

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9
Q

Pavlik harness

A

DDoH: birth to 6 mo

worn continuously until ~3-6mo

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10
Q

hip spica cast

A

DDoH: 6-18 mo
following reduction under general anesthesia
worn for 2-4 mo until hip is stable
then flexion abduction brace for ~3mo

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11
Q

CF: talipes varus

A

inversion or bending inward

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12
Q

CF: talipes valgus

A

eversion or bending outward

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13
Q

CF: talipes equinus

A

plantar flexion in which the toes are lower than the heel

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14
Q

CF: talipes calcaneus

A

dorsiflexion in which the toes are higher than the heel

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15
Q

clubfoot treatment

A

manipulation an dcasting are performed weekly for about 8-12 wks
splint is then applied if casting and manipulation are succesful
surgical intervention may be necessary if normal alignment is not achieved by ~6-12 wks of age

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16
Q

Adam’s test

A

(scoliosis)
asymmetry of the ribs and flanks is noted when the child bends forward at the waist and hangs the arms down toward the feet

17
Q

scoliosis post op

A

monitor for superior mesenteric artery syndrome:

caused by mechanical changes in the position of the child’s abdominal contents during surgery

18
Q

superior mesenteric artery syndrome symptoms

A

emesis and abdominal distention similar to what occurs with intestinal obstruction or paralytic ileus

19
Q

Marfan Syndrome

A

disorder of connective tissue that affects the skeletal system, CV system, eyes, and skin

20
Q

Marfan Syndrome caused by -

A

defects in the fibrillin -1 gene, which serves as a building block for elastic tissue in the body.
disorder may be inherited.
no cure.

21
Q

Marfan Syndrome symptoms

A

tall and thin body structure: slender fingers, long arms and legs, curvature of spine
visual problems
cardiac problems

22
Q

Juvenile Idiopathic Arthritis meds

A 
NSAIDS
Methotrexate
Corticosteroids
Tumor Necrosis Factor Receptor Inhibitors
Slower Acting Antirheumatic Drugs
23
Q

(JIA meds) NSAIDS

A

first meds used

GI irritation and easy bruising

24
Q

(JIA meds) Methotrexate

A

used is NSAIDS ineffective

CBC and LFTs monitored closely

25
Q

(JIA meds) Corticosteroids

A

potent immunosuppressives used for life threatenign complication, incapacitating arthritis, and uveitis. Lowest possible dose admin-ed. Prolonged use = Cushing’s syn, osteoporosis, up infection risk, glucose intolerance, hypokalemia, cataracts, growth suppression.

26
Q

(JIA meds) Tumor Necrosis Factor Receptor Inhibitors

A

Etanercept (Enbrel)
Infliximab (Remicade)
adverse effects: allergic rxn at inj site, up risk for infection, demyelinating disease, pancytopenia

27
Q

(JIA meds) Slower Acting Antirheumatic Drugs

A 
usually prescribed in combo w/ NSAIDS
Sulfasalazine *Azulfidine)
hydroxychloroquine (Plaquenil)
gold sodium thiomalate (Myochrysine)
penicillamine
28
Q

Priority Nursing Actions of Extremity Fracture

A
  1. Assess extent of injury and immobilize
  2. compound fracture - cover wound w/ sterile dressing
  3. elevate the injured extremity
  4. apply cold to injured area
  5. monitor neurovascular status
  6. transport to nearest ED
29
Q

five “P’s” of fracture assessment

A 
pain and point of tenderness
pulses distal to fracture site
pallor
paresthesia (sensation distal to the fracture)
paralysis (mvmt distal to site)
30
Q

Russell skin traction

A

stabilizes a femur fracture pre op
double pull (knee and foot) using a knee sling
similar to Buck’s traction

31
Q

Balanced suspension

A

skin or skeletal traction

approximates fracture of femur, tibia, or fibula

32
Q

90 degree 90 degree traction

A

lower leg supported by boot cast or calf sling
skeletal Steinmann pin or Kirschner wire is placed in distal fragment of femur
allows 90 degree flexion at hip and knee

33
Q

simple fracture

A

fracture of the bone across its entire shaft w/ some possible displacement but w/o breaking the skin

34
Q

greenstick fracture

A

incomplete fracture that occurs through only a part of the cross section of the bone; one side of the bone is fractured and the other side is bent.

35
Q

comminuted fracture

A

complete fracture across the shaft of the bone w/ splintering of the bone fragments.

36
Q

compound fracture

A

aka open / complex fracture

the skin or mucous membrane has been broken and the wound extends to the depth of the fractured bone.

37
Q

JIA

A

a complication of JIA is iridocyclitis (uveatis)
JIA most often occurs before the age of 16
JIA is twice as likely to occur in girls than in boys
clinical manifestations of JIA include morning stiffness and painful, stiff, swollen joints

38
Q

spiral fracture

A

a fracture that has a twisted or circular break.
affects the length rather than the width.
seen frequently in child abuse.

NCLEX (15 decks)

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