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349 Peds Exam 4 > Chapter 29 The Child With Musculoskeletal Or Articular Dysfunction > Flashcards

Chapter 29 The Child With Musculoskeletal Or Articular Dysfunction Flashcards

1
Q

Which type of bone has the growth plates?

A

Long bone

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2
Q

Anytime there is a fracture in a growth plate, why are nurses so attentive with it?

A

Because it affects their growth

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3
Q

Anytime you have fracture or injuries what are you going to do?

A

Immobilize the child

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4
Q

What does Immobilized child mean?

A

When a child is simply put in a position where they do not move

Typically done to aid in the recovery of a bone injury

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5
Q

Why do we restrain a child?
Like what’s the number 1 reason?

A

Safety
Because we are trying to protect the child from further injuries to the current one, and or prevent future injuries

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6
Q

What’s the number one nursing consideration of restraining a child?

A

You must have an order and it must be updated

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7
Q

What’s the type of check we are going to be doing with these children in restrains?

A

Color
Movement
Sensation

CMS

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8
Q

What is a flexor restraint?

A

They prevent them from flexing

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9
Q

What is a procedural restraint?

A

A pupus

Looks like a burrito, like no other options

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10
Q

What is soft tissue injury? (4)

A

Contusions (bruise)
Dislocations
Sprains
Strains

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11
Q

What is a dislocation?

A

Displaced position of oppositing bone ends or bone end with socket

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12
Q

What is a sprain?

A

Partial or complete tear of ligament

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13
Q

What is a strain?
sTrain

A

Tear of musculotendinous unit

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14
Q

What’s the treatment for soft tissue injury? (4)

A

R
I
C
E

rest, ice, compression, elevation

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15
Q

For the elevation part of RICE in the treatment for any bone issue, what is the most important thing to note?

A

That the injury, like let’s say the leg
Is going to be elevated higher than the heart

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16
Q

How are we going to manage the ICE part in the RICE anagram for soft tissue injuries?

A

20mins
With a break in between each time
Don’t directly apply it on the skin

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17
Q

What does a fracture mean?

A

The breaking of a bone

  • resistance of bone against stress exerted yields to stress force
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18
Q

What’s our number one concern when regarding fractures?

A

Bone growth plate injuries
- which pretty prevents kids from growing

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19
Q

What is the main treatment behind fractures?

A

Immobilizing and promotion of RICE

then it will help with bone healing and remodeling

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20
Q

What two vitamins are so vital in healing a bone? And why do you think so?

A

Vitamin D - help the absorption of calcium

Calcium - literally help bone growth

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21
Q

What food would you suggest for fractures?

A

Daily products

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22
Q

What are the 4 types of fractures?

A

Compound-open
Complicated
Communited
Greenstick

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23
Q

What is a compound or open fracture?

A

Fractured bone protrudes through the skin

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24
Q

What is a complicated fracture?

A

Bone fragments have damaged other organs or tissues

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25
What is comminuted fracture?
Small fragments of bone are broken from the fractured shaft and lie in the surrounding tissue
26
What is a greenstick fracture?
Compressed side of the bone bends but the tension side of the bone breaks, causing an imcomplete fracture
27
Buckle fracture - the bone is still intact however it’s more so like a little bump and got swollen Complete with periosteal hinge - bone is long gone but we still have a small piece of hinge hanging on the Complete fracture - completely snapped bone
28
What is a spiral fracture? What’s super important about this?
Can happen in long bone - needs to happen with great force - usually by parents hitting the kids or by trampolines
29
What is a cast?
Constructed from gauze strips and bandages impregnated with plaster of Paris or synthetic
30
Casts are usually ___ to body part
Molded
31
The biggest thing for cast is we need to be checking for what 3 things?
CMS color Movement Sensation
32
How can we assess for color? How can we assess for movement? How can we assess for sensation ?
Capillary refill & paleness Moving their fingers and hands Sharp & dull feelings ( they shouldn’t feel
33
What are the 5ps for cast care?
Pain Pulse Pallor Paresthesia Paralysis
34
This is very important to note If a patient were to get a fracture, let’s say the day before, they are going to develop swelling in 24-48 hours. Obviously we are going to monitor it, however why do you think we don’t put casts on these patients during the peak time of swelling?
Because we can cause compartment syndrome Which affects those 5 ps
35
What is compartment syndrome?
Medical emergency It’s soo much swelling that the skin starts to split What they do, cut the skin and release the pressure in the arm
36
Let’s say a patient is going to be placed into a sling, what is the vital thing to note when it comes to patients with a sling when regarding the healing process?
That their hand is above their elbow Remember, always elevate above the heart
37
How are we going to provide hygiene to these patients with casts?
Don’t get the cast wet! Remember don’t even put anything inside the cast either
38
Something I wanted to mention as well because I forgot What’s our number one worry with patients with a compound or open fracture?
Infection
39
Educate parents about itching How and what are we going to say?
Don’t put anything small in their arm I believe if I remember from patho, recommend the usage of like a hair dryer on cool
40
The child in traction What is a traction and the purpose behind it?
To position distal and proximal bone ends ( pulling two bones together by pulling in an opposite force ) To fatigue involved muscle and reduced spams To immobilize a fracture until healing is sufficient to permit casting or splinting To help prevent or improve contracture deformity
41
What’s our nursing action for traction?
Cleaning Noticing any redness, swelling or pus Avoiding infections Careful with weights
42
What are distraction? And why do we use it with kids?
To help promote healing and growth
43
What is an external fixation?
Process of separating opposing bone to encourage regeneration of new bone in the created space - can be used when limbs are unequal in length and new bone is needed to elongate the shorter limb Normally just helps kids move around
44
What is amputation?
The removal of a limb
45
What is a nursing care for amputation? (2)
Stump shaping for prosthetic fit Pain management ; phantom limb pain
46
What is congenital hip dysplasia? Normally found in which babies?
Usually a hip is out of socket Babies born breech
47
What are the clinical manifestation of development dysplasia of the hip? (3)
An additional gluteal / thigh fold One hip will move forward more / usually you’re gonna hear a click/clunk sound Asymmetry of thigh folds
48
What is a pavilk harness?
Holding a baby in a frog position By having the legs be spread out, allowing the hip to kinda stay in the socket - promoting hip statment
49
What is a spica cast? Biggest issue?
A big cast around the hips up to the chest Hygiene, because it only has one hole so trying to keep the skin clean is very tough
50
What other condition can use you hip spica cast other than the hip dysplasia?
Spiral fracture
51
What is congenital club foot, proper name?
Talipes equinovarus
52
What is congenital clubfoot?
Where the foot curves inside
53
What is the treatment or thought process behind clubfoot?
Since if you think about it, the foot is curved in, all the tendons are going to be tight So we need surgery to loosen it up, usually multiple surgeries early in life And then the cast molding each time to hold it in place and slowly reposition the foot
54
What is skeletal limb deficiency?
Underdevelopment of skeletal elements of extremities Reduction of malformation Varying degrees of functional capacity loss
55
An example of skeletal limb deficiency are like?
Extra digits Like polydactyly - Extra finger - extra toe
56
What is osteogenesis imperfecta?
Excessive fragility and bone defects
57
Notes classification of osteogenesis imperfecta Type 1 - most common and mildest Type 2 - most severe and lethal in infancy Type 3 - multiple fractures present at birth, short stature, severe bone deformity, disability Type 4 : similar to type 1, but more severe and short stature
58
Osteogenesis imperfecta What’s the main disease associated with this?
Brittle bone disease
59
When we think of brittle bone disease What is the anagram to remember?
Blue sclera Dental imperfections ( discolored and weak teeth ) Sensorineural hearing loss Multiple fracture BDSM
60
How do you get osteogenesis imperfecta?
Mutation in collagen
61
What is it Slipped capital femoral epiphysis? (SUFE) Happens mainly in who?
Spontaneous displacement of promixal femoral epiphysis posteriorly and inferiorly Adolescent because of rapid growth
62
What is the main clinical manifestation of SUFE?
Radiating pain from the hip down to the legs Remember the ball and socket in our hip, these kids are growing so much that the ball just popped out, and then proceeds to just go down instead - so when the ball goes down, think of how the ball started at the hip and rolls all the way down your leg
63
What is kyphosis?
Lateral convex angulation in curvature of thoracic spine “ Bow out to the king “
64
What is lordosis?
Lateral inward curve of cervical or lumbar curvature Like the pregnant body
65
What is idiopathic scoliosis?
This S curve of the spine
66
How are you going to assess a back a spine in a kid?
Stand straight Bend down forward
67
What is the main treatment for scoliosis?
A brace around the chest Nice and snug!
68
What is osteomyelitis?
Infection of the bone
69
What is the treatment of osteomyelitis? (2)
long term treatment of IV antibiotics Surgery
70
What is septic arthritis?
Inflammation - Bacterial infection in the joint
71
What is the clinical manifestion septic arthritis ? (3)
Swollen painful joint Limp Fevers
72
What is the diagnosis of septic arthritis?
You take fluid out of the joint And usually cloudy infection Tap the knee - usually micro can confirm the infection
73
What is skeletal tuberculosis?
TB goes into the bone
74
What is juvenile idiopathic arthritis?
Chronic childhood arthritis causing inflammation in joint synovium and surrounding tissue
75
What is the difference between rheumatoid arthritis vs arthritis
Older people - pain have end of the day - pain when using Joints a lot Rheumatoid - wake up in pain - as they get moving the joints, pain goes away
76
What’s the treatment of juvenile idiopathic arthritis?
Corticosteroids Helps with the inflammation
77
Classification of JIA systemic arthritis - involves one or more joints with at least 2 weeks of fever, rash, lymphadenopathy, hepatospelnomegaly, and serositis Oligoarthritis - one to four joints for the first 6 months Polyarthritis rheumatoid factor negative - five or more joints in the first 6 months with negative rheumatoid factor Polyarthritis rheumatoid factor positive - five or more joints in the first 6 months with positive rheumatoid factor
78
What is systemic Lupus erythematosus? Who may you not see this in?
Autoimmune disease which we attack the connective tissues and blood vessels In a baby, less likely because remember you need to have an immune system
79
What is the clinical manifestation of lupus? Main one!
Butterfly shaped rash!!! Mouth ulcers Fever Fatigue Chest pain Kidney disease Weight loss
80
Cutaneous lesions Lymphadenopathy Nausea, vomit, diarrhea, pain Generalized weakness, arthritis, joint pain and stiffness without deformity Forgetfulness Seizures Paralysis Pleurisy Pericarditis Proteinuria Reneal failure Also other symptoms of lupus
81
What’s the main treatment for lupus?
Steroids
82
What do you need to watch out for steroids?
Growth suppression

349 Peds Exam 4 (7 decks)

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