Exam Flashcards
4 functions of skin
Provide sensory input
Provide protection
Thermoregulation
Warning system for danger
primary lesions
-skin changes produced by a causative factor
-Macules, papules, vesicles, patches, bullae, plaque, wheals, nodules, pustules, cysts
secondary lesions
-Changes that result from alteration in the primary lesions, such as those caused by rubbing, scratching, medication, or involution and healing
-Crust, keloid, scar, fissure, excoriation, scale
superficial burn
-Erythema, pain, heals 5-10 days, no scar
-Eg. sunburn
partial thickness burn
-Epidermis and dermis
-Painful, moist, red, blister
-Heal in 14-21 days, scarring
-Wound is extremely sensitive
full thickness burn
-Extend into subcutaneous tissue
-Nerve endings, sweat glands, hair follicles are destroyed
-Dry leathery appearance (deep red, white, black, brown)
-Loss of sensation (no pain)
Full-thickness + underlying tissue burn
Muscle, fascia, bone, ligaments, tendons
severity of burn injury
-Major burn injury: treat in specialized burn centre
-Moderate burn injury: treat in hospital with expertise in burn treatment
-Minor burn injury: treat in outpatient setting
acute phase of burn
-First 24-48 hours
-Treatment of burn shock and management of pulmonary status
-Check peripheral pulses of burned extremity every hour
management and rehab stage of burn
Completion of resuscitation through wound coverage
Preventing infection, closing the wound
The major musculoskeletal consequences of immobilization
-Significant decrease in muscle size (atrophy), strength, and endurance
-Bone demineralization leading to osteoporosis → fractures
-Contractures and decreased joint mobility
Psychological effects of immobility
-Diminished environmental stimuli
-Altered perception of self and environment
-Increased feelings of frustration and helplessness
-Depression, anger, protest, aggressive behaviour
-Developmental regression
contusion
-Bruise
-Damage to soft tissue, subcutaneous structures, and muscle
-Escape of blood into tissues which causes ecchymosis
-Swelling, pain, disability
-Crush injuries (slam fingers in door, contact sports, etc)
dislocations
-Occur when force of stress on ligament is sufficient to displace normal position of opposing bone ends or bone ends to socket
-Pain increases with active or passive movement of the affected extremity.
-May be an obvious deformity
-Subluxation or partial dislocation of radial head (pulled elbow) is common in kids under 5
-Should reset asap
sprains
-Trauma to a joint from where the ligament is partially or completely torn or stretched by force
-May have associated damage to blood vessels, muscles, tendons, and nerves
-Grading (1, 2, 3)
-Rapid onset of swelling with disability, pain
strain
-A microscopic tear to musculotendinous unit
-Similar to sprain
-Swollen, painful to touch
-Generally incurred over time
types of fractures
-Complete: fracture fragments are separated
-Incomplete: fragments remain attached
-Simple or closed: no break in the skin
-Open or compound: Fractured bone protrudes through the skin
-Complicated: Bone fragments have damaged other organs or tissues
-Comminuted: Small fragments of bone are broken from fractured shaft and lie in surrounding tissue
PRICE
P - Protection
R - Rest the injured part
I - Ice immediately (maximum 20 minutes at a time)
C - Compression with wet elastic bandage
E - Elevation of the extremity (several inches above the heart)
Immobilization and support (casts or splints as appropriate to injury)
growth plate injuries
-The weakest point of long bones is the cartilage growth plate (epiphyseal plate).
-Frequent site of damage during trauma
-May affect future bone growth
Bone healing and remodelling
-Bone healing and remodelling
-Newborn period: 2 to 3 weeks
-Early childhood: 4 weeks
-Later childhood: 6 to 8 weeks
-Adolescence: 8 to 12 weeks
compartment syndrome - 6 Ps
-Pain: Severe pain that is not relieved by analgesics or elevation of the limb, movement that increases pain
-Pulselessness: Inability to palpate a pulse distal to the fracture or compartment
-Pallor: Pale appearing skin, poor perfusion, capillary refill greater than 3 seconds
-Paresthesia: Tingling or burning sensations
-Paralysis: Inability to move extremity or digits
-Pressure: Involved limb or digits may feel tense and warm; skin is tight, shiny; pressure within the compartment is elevated
The main purposes of the traction
-Fatigue muscle to reduce spasm for realignment
-Align bone fragments
-Immobilize fracture until realignment is achieved
-To help prevent or improve contracture deformity
-To provide immobilization of specific areas of the body
-To reduce muscle spasms (rare in children)
manual traction
Applied to the body part by the hands placed distal to the fracture site. Manual traction may be provided during application of a cast but more commonly when a closed reduction is performed.
skin traction
Applied directly to the skin surface and indirectly to the skeletal structures. The pulling mechanism is attached to the skin with adhesive material or an elastic bandage. Both types are applied over soft, foam-backed traction straps to distribute the traction pull.
skeletal traction
Applied directly to the skeletal structure by a pin, wire, or tongs inserted into or through the diameter of the bone distal to the fracture.
distraction
-Process of separating opposing bone to encourage regeneration of new bone in created space
-Can be used when limbs are unequal in length and new bone is needed to elongate shorter limb
-External fixation device commonly used
Nursing care:
-Teach family: good hand hygiene, pin care, including observation for infection and loosening of the pins
-Use of crutches
amputation - stump hygiene
soap-and-water washing every day and checking for skin irritation, breakdown, or infection
When is the optimum time for the child to be fitted with a prosthetic device?
When the infant begins sitting up and can maintain balance
Signs of hyperglycemia
Lethargic, confusion, thirst, weakness, N/V, abdo pain, flushed, signs of dehydration, kussmaul’s respirations, fruity breath, diminished reflexes, polyuria, blurred vision
Signs of hypoglycemia
Labile, irritable, nervous, difficulty concentrating, speaking, focusing, shaky feeling, headache, dizziness, pallor, sweating, tachycardia, palpitations, tremors, dilated pupils, diplopia
