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Pediatrics > Exam 2 Musculoskeletal Disorders > Flashcards

Exam 2 Musculoskeletal Disorders Flashcards

1
Q

Physical Assessment: Look at

1) I____
2) In____ (S/S)
3) F_____ (2)
4) L___ (1)
5) G____ (looking for _____)

A

1) Injury (common injuries of small children)
2) Inflammation
3) Feet (Flat footed, Club feet)
4) Legs (Bowed Legs)
5) Gait (symmetry)

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2
Q

Flat feet are normal till age ____

Bowed legs normal till age ____

A

2

3

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3
Q

Palpate for

1) Full _____
2) ____ Tenderness - is indicative of _____

ALWAYS LOOK TO RULE OUT ______*

A

1) ROM
2) Point (fractures)

ABUSE!

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4
Q

Normal Findings

  • ____ ROM of (3) bilaterally
  • stable _____
  • No _____
  • No _____ to right ankle
A
  • ROM of hips, knees, ankles
  • Gait
  • Ataxia
  • Tenderness
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5
Q

Abnormal Findings

  • _____ to _____ aspect of right ankle
  • Pain with ______
  • Moderate ______
A
  • Tenderness, Lateral
  • Extension
  • Swelling
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6
Q

Soft Tissue Injury = (3)

A

Sprains, Strains, Contusions

no bony involvement

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7
Q

Sprains =

A

= Twisting of a joint, damage to ligaments

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8
Q

Strains =

A

= Tearing or pulling of muscle, may also effect tendons

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9
Q

Contusions =

A

= Bruises to the muscle (educate pt that they will change color)

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10
Q

Causes of Soft Tissue Injuries (3)

A

Falls, Athletics, Accidents

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11
Q

S/S of Soft Tissue Injury 5 __’s

A 
5 P's 
Pain
Pulses 
Pallor 
Paresthesia 
Paralysis
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12
Q

S/S of Soft Tissue Injuries by types

1) Sprain = REEHP
2) Strain = IE
3) Contusion = ID

A

1) Redness, Edema, Ecchymosis, Heat, Pain
2) Inflammation, Ecchymosis
3) Inflammation, Discoloration

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13
Q

Nursing Interventions for Soft Tissue Injuries

1) ______ to rule out fracture
2) _____*
3) What medication?
4) _____ therapy

A

1) X-Ray
2) RICE*
3) NSAIDS (motrin, advil)
4) Physical Therapy

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14
Q 
Rest = S\_\_\_\_, C\_\_\_\_, B\_\_\_\_
Ice = \_\_\_x/day, \_\_ min 
Compression = \_\_\_-bandage/s\_\_\_
Elevation = above the \_\_\_\_\_\_
A

Slings, Crutches, Bedrest
3 x/day, 20 min
Ace-bandage/Splint
Heart

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15
Q

Fractures =

A

Any break to the bone

accidental or non-accidental

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16
Q

S/S of Fracture

1) I_____
2) B_____
3) P______
4) ______ ROM
5) Non- ____ bearing

A

1) Inflammation
2) Bruising
3) Pallor
4) Limited ROM
5) Non-weight bearing (not willing to walk on it)

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17
Q

Assessment for Fractures

1) __-____
2) _____ (EBP transitioning to use this to check for fractures bc X-Ray has radiation)

A

1) X-Ray

2) US

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18
Q

Treatment for Fractures

1) C_____
2) C____ measures
3) Tr_____
4) ______ fixation devices
5) Te____

A

1) Casting
2) Comfort
3) Traction
4) External fixation devices
5) Teaching

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19
Q

Casting

  • Help keep ____/d____
  • Explain that it gets ___ when ____
  • May take time to ____
A
  • calm/distracting
  • warm when forming
  • dry
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20
Q 
Comfort Measure (1) 
Traction (1)
A

Sedation

Pulling

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21
Q

External fixation devices =

What is a complication of these devices?

A

= Bone screwed into external

Osteomyelitis (bone infection-higher risk for open fractures)

22
Q

Teaching

  • Do not ___ anything in the cast
  • ____ formation (on skin directly above fracture)
  • Check for ___ refill
A
  • Stick
  • Callus
  • Cap refill
23
Q

Club Foot =

A

Malalignment of feet, which resists being moved into proper alignment

24
Q

Causes of Club Foot (3)

A

Fetal Positioning
Intrauterine restriction (ex. multiple gestations)
Boys > Girls

25
Q

S/S of Club Foot

  • Appears _____
  • Unable to:
A
  • Abnormal

- Unable to return to proper alignment

26
Q

Assessment of Club Foot (2)

Treatment (3)

A
  • X-ray/Ultrasound

- Serial Casting (constant reapplication due to rapid growth), Surgery, Physical Therapy

27
Q

Developmental Dysplasia of the Hip =

A

Subluxation (slight misalignment) or complete dislocation of hip

28
Q

Causes of DDH (2)

A

Fetal Positioning

Girls > Boy

29
Q

Physical Appearance of DDH

Asymmetry of what 2 things

A
  • Asymmetry of thigh folds

- Asymmetry of femur lengths (knees up and see if one is higher)

30
Q

Tests for DDH (2)

A normal hip would test negative for these maneuvers

A

Barlow’s = push knees in and back to feel hip come out (a clunk)

Ortalani’s = after hips go out, push knees out and hips should go back in

31
Q

Assessment of DDH

1) Based on ____ exam
2) Radiology tests (2)

A

1) Screening

2) X-Ray/Ultrasound

32
Q

Treatment for DDH (2*)

A

Pavlik harness*

Spica Casting*

33
Q

Pavlik Harness =

  • should only be used if baby is how old?
  • No l___/p___
  • Frequent visits for ____
  • They should be in the harness how long each day?
A

= keeps legs abducted to keep trochanter in the acetabulum

  • less than 6 months old
  • no lotion/powder
  • adjustments (do not let parents adjust!)
  • 24/7, with 1 hour off to shower
34
Q

Spica Casting =

  • should be used if baby is how old? or if what fails?
A

= covers from armpits around chest to ankles

  • older than 6 months, or if harness fails
35
Q

Legg Calve Perthes =

Cause =

A

= necrosis of femur and at times, acetabulum; blood supply returns but damage to bone is done

= Blood does not go to the head of the femur (and sometimes the acetabulum)

36
Q

S/S of Legg-Calve-Perthes

1) P____
2) L_____ (that worsens with ___)

A

1) Pain

2) Limp (worsens with activity)

37
Q

Assessment of Legg-Calve-Perthes

1) __-___/___ scan/M___
2) ____ diagnosis is key

A

1) X-Ray/Bone scane/MRI
(MRI to see how far its progressed, one appears necrotic/broken down)

2) Early diagnosis is key

38
Q

Treatment fo Legg-Calve-Perthes

  • What medication?
  • _____ bearing
  • _____ extension to _____ (assess 5 P’s)
A
  • NSAID’s
  • NON-weight bearing (crutches)
  • Buck extension to immobilize
39
Q

Slipped Capital Femoral Epiphysis =

A

= Head of femur separated from the rest of the femur at the growth plate

40
Q

Causes of Slipped Capital Femoral Epiphysis

1) ____weight
2) T_____ (at ___ ___)

A

1) Overweight

2) Teenagers (at growth spurt)

41
Q

S/S of SCFE

1) Hip ______
2) Painful ____
3) L____
4) _____ hip flexion
5) Pain increases when toes turned _____
6) Position of comfort =

A

1) tenderness
2) ROM
3) Limp
4) decreased
5) inward
6) external rotation of affected leg

42
Q

Assessment of SCFE

1) History suggests - ____ pre-teen
2) _____ definitive

A

1) Obese preteen

2) X-ray

43
Q

Treatment for SCFE

1) _____ immediately
2) _______ of the joint

A

1) Surgery (don’t want to delay growth)

2) Immobilization

44
Q

Scoliosis =

More common in girls or boys?
Happens during when?

A

= Lateral curvature and rotation of the spine

Girls > Boys
During pubertal growth

45
Q

S/S of Scoliosis

  • uneven ____
  • one scapula/clavicle ____ than the other
  • Hip/rib ______
  • Severe = ____/____ compromise
  • Back ____
A
  • posture
  • higher
  • asymmetry
  • cardiac/respiratory
  • pain
46
Q

Assessment of Scoliosis

1) How to screen?
2) Monitor ___ ____ during exam

Treatment

1) is based on ___ and c_____
2) Bracing = is it a cure?
3) S_____

A

1) Tell pt to bend over at hips and touch toes
2) physical appearance

1) age, curvature
2) NOT curative, help prevent worsening
3) surgery

47
Q

Duchenne Muscular Dystrophy =

Cause = ______*
Greater in boys or girls?

A

= Progressive loss of function due to muscular loss (but not cognition)

Hereditary*
Boys > Girls bc X linked

48
Q

S/S of Duchenne Muscular Dystrophy

1) Initially growth/development is?
2) What age do they start to lose function that was previously attained?
3) What type of functions do they start to lose first?
4) ____ sign* develops (what is it?)
5) What will they need by teenage years?

A

1) normal
2) 3 yo
3) small functions -> gross motor
4) Gower’s* (get up like an old man)
5) wheelchair

49
Q

Assessment of Duchenne Muscular Dystrophy

  • Monitor using ____ tools
  • ____* tests bc its ______

Treatment of Duchenne Muscular Dystrophy

  • Is there a cure?
  • Preserve _____, vital ____ function, and _____ as long as possible
A
  • screening
  • DNA* bc its hereditary
  • NO cure
  • ambulation, organ function, independence
50
Q

Osteomyelitis =

Caused by =

A

= Bacterial infection in the bone

= introduced via a skin break or the vascular system

51
Q

S/S of Osteomyelitis

1) F_____
2) C_____ a lot
3) R_____, W____, S_____, P_____
4) L______

Looks _____

A

1) Fever
2) Crying
3) Redness, warmth, swelling, pain
4) Limping

Cellulitic

52
Q

Nursing Interventions for Osteomyelitis

1) Draw ____
2) Hang _____* as ordered
3) Prep for _____ PRN
4) Prep for scans (4)

A

1) Labs
2) Antibiotics*
3) Surgery
4) X-ray, MRI, CT, bone scans

Pediatrics (16 decks)

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