final exam Flashcards
Know pediatric fracture considerations, what do we care about in kids’ vs adults?
- Pediatric patients are at risk for epiphyseal injuries
- These are dangerous injuries because they can interfere
with bone growth at the site - These injuries are classified using the Salter-Harris
classification system.
Salter Harris fracture classification – what is it? What are the 5 stages?
used to stage epiphysis injuries
stage 1: through growth plate
stage 2:through growth plate and metaphysis
stage 3: through growth plate and epiphysis
stage 4: through all 3 elements
stage 5: crush injury to growth plate
What are the 5 P’s of fracture presentation?
Pain and point of tenderness
* Pulse–distal to the fracture site
* Pallor
* Paresthesia–sensation distal to the fracture
site
* Paralysis–movement distal to the fracture site
Fracture assessment & care along with nursing considerations
immediate neurovascular
assessment
* PMS, cap refill
* Effective pain management
* Diagnostics
* Treatment
* Reduction: realign misplaced bones
* Immobilization: allowing healing to
occur
What things should we be teaching families about cast care?
Plaster Cast
* Up to 2 days to dry
* Do not speed drying with heat or
fans
* Teach patient to elevate extremity
* Avoid putting anything inside the cast
* Careful handling of wet cast
* Perform frequent neurovascular
assessment and teach family to do
the same
* Capillary refill, color, warmth,
movement, sensation
* Keep edges clean, dry, smooth
What is scoliosis? When do we screen for it? What things do we look for when screening for it? How is it managed?
Lateral S/C shape curve to spine > 10 degrees + rot deformity of spine/ribs; congenital or can dev w multiple causes typically idiopathic, MC spinal deformity
Signs - Noticeable post pre adolescent growth spurt
Trunk asymm
Uneven shoulder/hip ht
One sided rib hump
Prominent scapula
Dx:
Lat curve
Axial rot
Skeletal maturity
Standing radiographs
Mgmt:
Mild 10-20% -> strength/stretching
Mod 20-40% -> brace
Severe 40-50% -> surgery/spinal fusion
What is Slipped Capital Femoral Epiphysis (SCFE)? What age group is it common in? What are the signs and symptoms?
Femur head sep @ epiphysis + slips backwards w potential or complete dislocation
Common - teens, males, overwt/obese
s/sx - acute/chr hip, thigh, knee pain; limited IR + obligated ER hip; AP XR - ice cream slipping off cone
What is Legg-Calves Perthes disease? What age group is it common in? What are the signs and symptoms?
Femoral epiphysis - temporary interruption in blood supply → bone necrosis + subsequent repair
Common - males, 4-8y
s/sx - hip pain on aff side (radiate to knee), leg length discrepancy or limp, IR + abd aff leg
MRI + XR
Tx - maintain femoralhead in acetabulum, restore ROM, (activity restriction, PT, brace)
Primary vs Secondary Lesions – what are there, how do we know the difference, examples of each
Primary - previously healthy skin
Macules, papules, patches, tumors, nodules, vesicles
Secondary - from changes in primary lesions
Crusts, scales, keloids, erosions, ulcers
Drug rxn, bacteria, virus, fungus, infestations
Tinea Infections – know the different ones, how they are treated, nursing considerations associated with treatment
Tinea Capitis (Scalp)
* Scaly pustular bald areas with indistinct
margins; may appear as with yellow, greasy
scales
Tx: ketoconazole shampoo 2–3
times weekly,Oral griseofulvin for 8–12 weeks
Tinea Corporis (Trunk)
* Pink, scaly circular patch with an expanding
border
Tx: Topical cream (e.g., clotrimazole, miconazole,
ketoconazole) if 12 years and older twice a day for
4–6 weeks
Lice – know the treatment, special considerations with treatment, nursing considerations
pediculicides, removal of nits, home cleaning
* Preventing spread and recurrence
Scabies – Mode of transmission, treatment & management, nursing consideration
HIGHLY contagious infestation caused by the scabies mite
* Spread through skin to skin contact and sexual contact
Tx: Household cleaning of all linen,
carpets, stuffed animals,
clothing
* Treat all family members with
5% permetherin cream and
antihistamines
Impetigo - Mode of transmission, treatment & management, nursing consideration
Minor skin injuries, insect bites, dermatitis provide portal for the
highly infectious agent
Treatment: mupirocin (topical) and/or erythromycin (oral)
* Nursing considerations:
* Wash crusts off TID with warm, soapy washcloth
* Apply topicals after cleaning and leave open to air, may bleed.
* Fingernails kept clean and short
* Child should bath and sleep alone
* HANDWASHING
Understand the different types of conjunctivitis
1.Chemical
- Splash injuries
- Foreign Body
2. Bacterial
3. Viral
4. Allergic
The major difference between bacterial and viral conjunctivitis is that bacterial conjunctivitis
has a purulent discharge that may result in crusting, whereas the discharge from viral
conjunctivitis is serous (watery). Allergic conjunctivitis produces watery to thick drainage
and is characterized by itching and usually bilateral in nature.
Understand the cause of periorbital cellulitis and the s/s
Periorbital cellulitis is a bacterial infection of the
eyelid and surrounding tissues.
Typical causitive agent is staphylococcus or
streptococcus
S/S: swollen, tender, red or purple eyelids with
restricted, painful movement of the area around
the eye, and fever
What is strabismus?
Disorder in which the eyes don’t look in exactly the same direction at the same time.
What is retinopathy of prematurity
an eye disease that can happen in babies who are premature (born early) — or who weigh less than 3 pounds at birth. ROP happens when abnormal blood vessels grow in the retina
What is otitis media? What are the symptoms of otitis media? Treatment? Possible nursing dx and interventions?
Otitis media is an inflammation of the middle ear.The tympanic membrane and fluid behind it become infected
Breastfeeding has been shown to be effective in preventing OM
Tx:Teach use of antibiotic therapy
2. Pain relief
3. Follow up medical care
4. Prevention-second hand smoke
5. Holding infants to feed
6. Limit use of pacifier
When are tympanostomy tubes placed? What care is required?
Recurrent otitis media or effusion
ENT referral for possible tympanostomy tube placement
What is otitis externa? What typically causes it?
Inflammation of the skin and soft tissue of the ear canal
Occasionally called “Swimmer’s Ear”
Can also be caused by placing things into the ear
What is proper nursing care of epistaxis? What is the most common cause?
Have the child sit upright, tilt the head forward, squeeze the nares just below the nasal bone and hold for 10-15 minutes.
If bleeding does not resolve a cotton ball may be inserted either plainly or soaked in epinephrine, thrombin or lidocaine.
The most common cause is from nose picking, foreign bodies, or dry air. Though it may also occur from allergies,
infections, or forceful coughing.
