CONGENITAL AND CHRONIC DISORDERS

Question 1

What are clinical manifestations of scoliosis?

Answer 1

1. asymmetry in scapula, ribs, flanks, shoulders, and hips

2. improperly fitting clothing where one leg is shorter than the other

Question 2

what are nursing actions to perform with a child wearing a brace?

Answer 2

1. assess for skin breakdown around the brace

2. promote positive self image

Question 3

what is the purpose of a child with scoliosis wearing a brace?

Answer 3

wearing a brace helps slow progression of the curve sp

Question 4

what is a surgical intervention for scoliosis and what type of patients will get this procedure done?

Answer 4

spinal fusion with rod placement is a surgical intervention for scoliosis and used for patients with curvatures >45 degrees

Question 5

what are manifestations of developmental dysplasia of the hip in infants?

Answer 5

1. asymmetry of gluteal/ thigh folds
2. shortening of femur and widened perineum
3. positive ortolani test where hip is reduced by abduction
4. positive barlow test where hip is dislocated by adduction

Question 6

what are manifestations of developmental hip dysplasia in a child?

Answer 6

1. one leg is shorter than the other
2. positive trendelenburg sign where pelvis tilts downward while bearing weight on affected side
3. walking on toes on one foot and with a limp

Question 7

what can be given to a newborn if they have DDH?

Answer 7

pavlik harness can be given for the newborn for a total of 12 weeks

Question 8

what are education points on the pavlik harness?

Answer 8

1. straps should be checked every 1-2 weeks for adjustment
2. parents should not adjust straps, only the doctor can
3. avoid lotions and powders and gently massage skin under the straps

Question 9

when is the bryant traction used?

Answer 9

bryant traction is used when adduction contracture is present

Question 10

how does the patient lay with a bryant traction?

Answer 10

bryant traction is a skin traction in which hips are flexed at a 90 degree angle with buttocks raised off bed

Question 11

what are education points to teach a child who has a hip spica cast?

Answer 11

1. sponge baths to not get the cast wet

2. waterproof barrier around genital opening of spica cast to prevent soiling with urine and feces

Question 12

at what age is the hip spica cast placed?

Answer 12

at 6 months-2 years, surgical placement of hip spica cast is performed

Question 13

what are teaching points about prednisone?

Answer 13

1. administer with food
2. can cause osteoporosis, hyperglycemia, myopathy, PUD, infection, and suppression of adrenal glands
3. immunosuppressant used with many chronic disorders