Infectious Disease/Musculoskeletal Quiz

Question 1

______ are symptoms that occur between early manifestations of the disease and its overt clinical syndrome

Answer 1

Prodromal symptoms

Question 2

A ________is a disease caused by an infectious agent that is transmitted to a person by direct or indirect contact, vehicle or vector, or airborne route

Answer 2

communicable disease

Question 3

The ______ _______ is the interval occurring between the start of an infection and the appearance of symptoms. The patient is infected but does not know it yet.

Answer 3

incubation period

Question 4

The _______ _______ is a short interval in some diseases in which the patient starts to notice symptoms (such as rash, lesions erupting)

Answer 4

prodromal period

Question 5

What is the incubation period for varicella?

Answer 5

13-17 days (2-3 wks)

Question 6

When is chickenpox (varicella) contagious?

Answer 6

From 1-2 days before the onset of rash to 6 days after the first crop of vesicles–when crusts have formed

Question 7

What type of precautions are indicated during hospitalization of a child with chickenpox?

Answer 7

Strict isolation–>contact and droplet precautions–at home the child should be isolated until the vesicles have dried.

Question 8

What nursing care management can be done for a child with varicella?

Answer 8

baths and change clothes and linens daily; administer topical calamine lotion; keep child’s fingernails short and clean; apply mittens if child scratches. Child should be kept cool (may decrease number of lesions) Keep child occupied to lessen pruritus; avoid aspirin because of Reye syndrome.

Question 9

How is varicella treated?

Answer 9

Antiviral agent (acyclovir); varicella-zoster immune globulin; or IGIV. (Supportive: diphenhydramine–for itching; Acetaminophen for fever) Prevented with childhood immunization.

Question 10

What is the incubation period for measles?

Answer 10

10-20 days

Question 11

What are the signs and symptoms of measles?

Answer 11

Fever and malaise. 3 C’s–coryza (common cold), cough, conjunctivitis. Koplik’s spots–small red spots with a bluish white center and a red base>seen on buccal mucosa 2 days before rash

Question 12

Describe the rash associated with measles…

Answer 12

• Appears 3-4 days after the onset of prodromal stage
• Begins as erythematous maculopapular eruption on face and gradually spreads downward; more severe in earlier sites and less intense in the later sites; after 3-4 days, appears brownish and fine desquamation occurs over area of extensive involvement.

Question 13

How are measles treated?

Answer 13

• Bed rest during febrile period; antipyretics.
• antibiotics to prevent secondary bacterial infection in high-risk children
• airborne droplet precautions if child is hospitalized (isolation until 5th day of rash)

Question 14

What nursing management interventions are indicated when caring for a patient with measles?

Answer 14

• encourage rest during prodromal stage, provide quite activity
• dim lights if photophobia present; clean eyelids with warm saline–keep child from rubbing eyes
• use a cool mist vaporizer; protect skin around nares with layer of petrolatum; encourage PO fluids and soft bland foods
• keep skin clean, use tepid baths as necessary

Question 15

What do soft tissue injuries include?

Answer 15

injuries to muscles, ligaments, and tendons

EX: contusions, sprains, dislocations, strains

Question 16

Describe a contusion

Answer 16

(bruise)–damage to the soft tissue, subcutaneous structures, and muscle. -Tearing of these tissues and small blood vessels and the inflammatory response lead to hemorrhage, edema, and associated pain with mvmt.

Question 17

Describe a dislocation

Answer 17

-occurs when the force of stress on the ligament (which approximates long bones) is so great that it displaces the normal position of the opposing bone ends or the bone end to its socket.

Question 18

Describe a sprain

Answer 18

-occurs when trauma to a joint is so severe that a ligament is partially or completely torn or stretched by the force created as a joint is twisted or wrenched, often accompanied by damage to associated blood vessels, muscles, tendons, and nerves. (commonly ankles and knees)

Question 19

Describe a strain

Answer 19

-a microscopic tear to the musculotendinous unit and has features in common with sprains. (area is painful to touch and swollen)

Question 20

How are soft tissue injuries treated?

Answer 20

Rest:immobilization for torn ligaments, crutches to rest extremity
Ice: (immediately–but never for more than 30 mins at a time)
Compression:
Elevation:–point of injury should be kept several inches above heart level

Question 21

If a fracture does not produce a break in the skin, it is a _______ fracture

Answer 21

simple

Question 22

________ fractures are those with an open wound through which the bone protrudes.

Answer 22

Compound

Question 23

A fracture in which there are bone fragments that cause damage to other organs or tissues (e.g., liver, lung) is called a _____________

Answer 23

complicated fracture

Question 24

Pain, swelling, “hot spots”, and foul smelling (musty) odor are signs of _______ in a child with a cast.

Answer 24

infection

Question 25

How should a wet plaster cast be handled? What does it prevent?

Answer 25

with palms of the hands…prevents it from having pressure areas

Question 26

Nursing responsibilities for patients with traction include the following:

Answer 26

• neurovascular checks
• maintain alignment
• make sure weights are freely hanging
• provide skin care
• provide pain management
• prevent complications of immobility
• pin care w/skeletal tx

Question 27

_________ is a self-limiting disorder with aseptic necrosis of femoral head and has a peak @ 5-7yrs M>F; affecting more Caucasian>African American

Answer 27

Legg-Calve-Perthes Disease

Question 28

What are the assessment findings for Legg-Calve-Perthes Disease?

Answer 28

mild hip or thigh pain +limp, limited ROM, weakness–>has an insidious onset
-is aggravated with activity and relieved with rest

Question 29

What are the nursing interventions with Legg…

Answer 29

• dx w/ X-ray and MRI
• want to reduce inflammation and restore motion
• keep acetabulum and femur head in contact
• rest, with no weight bearing, use traction and abduction braces
• surgery is an option

Question 30

_____________ is when the upper femoral epiphysis slips from functional position; peaks @ rapid growth spurt (13-16 w/M; 11-14 w/F)

Answer 30

Slipped capitol femoral epiphysis (SCFE)

Question 31

What are the assessment findings for slipped capitol femoral epiphysis (SCFE) if it is gradual? If acute?

Answer 31

Gradual: persistent aching hip & thigh; limp; and limited ROM
Acute: sudden severe pain in hip & thigh; no weight bearing

Question 32

What are the nursing interventions for SCFE?

Answer 32

• strict bed rest & traction (Buck or Russell) until surgery

- May be on crutches, but not in wheelchair–>May increase slippage

Question 33

What is the post-op care for SCFE

Answer 33

-non-weight bearing, crutches while walking until pain free and increased ROM

Question 34

What teaching is important for SCFE?

Answer 34

• contact sports are restricted until growth is complete

- importance of compliance with followup visits and activity regimen

Question 35

______ is a deformity in which the foot is pointed downward (plantar flexed) and inward in varying degrees of severity

Answer 35

Talipes equinovarus (TEV)

Question 36

What is the goal of treatment for TEV

Answer 36

to achieve a painless plantigrade (ability to walk on the sole of the foot with the heel on the ground) and stable foot.

Question 37

How is talipes equinus treated?

Answer 37

• begins as soon as possible after birth
• manipulation and casting are performed weekly for 8-12 wks because of rapid growth of early infancy; a splint is then applied if casting and manipulation are successful
• surgical intervention may be necessary if normal alignment is not achieved by about 6-12 wks of age