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Peds exam 2 > Muscle > Flashcards

Muscle Flashcards

1
Q

what are some difference in infants when considering bone growth

A

not fully ossified at birth, make the infants bones more flexible, increased bone healing

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2
Q

what is an infant muscle development

A

full range of motion, normal muscle tone, deep tendon reflexes present, 25% of total body weight is muscle

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3
Q

what helps an adolescents muscle development

A

hormones assist in muscle development, they grow rapidly

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4
Q

when does the neural tube start to change and what into

A

at 3-4 weeks it begins to differentiate into brain and spinal cord - puts premature infants at a higher risk for neural tube defects

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5
Q

why do you have to support an infants head

A

because the spine is very mobile especially the cervical spine

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6
Q

when and how does myleinization happen

A

progresses and complete by 2 years of age, proceeds in head to toe (cephalocaudal)

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7
Q

what are the normal findings of an infants legs and feet

A

legs have a bowed appearance, toes fold inward- straighten out by 2

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8
Q

why is hemoglobin/hematocrit important for CBC when looking a muscle development

A

shows where the RBC are created - bone marrow in the long bones

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9
Q

how is a radiography complete and what is it for

A

two views obtained AP and lateral, detects fractures and other anomalies

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10
Q

what are the nursing considerations for a radiography

A

calm the child, is there is trauma make sure the cervical spine remains immobilized

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11
Q

what is a bone biopsy

A

a procedure where a small sample of the bone is taken from the body

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12
Q

what are the considerations for a bone biopsy

A

very painful, informed consent is needed, child is sedated, frequently check post-procedure for pain

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13
Q

how does a CT work

A

Non-invasive x-ray study that looks at tissue density and structures. can be used with dye

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14
Q

what are the considerations for a CT

A

can be lengthy, assess for allergies if dye is being used (iodine or shellfish), encourage fluids after if contrast is used to flush it out

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15
Q

how does an MRI work

A

doesnt require contrast, uses bodys own composition of hydrogen atoms to capture imaging, can assess for inflammation, congenital abnormalities, neural tube defects, hard and soft tissue and bone marrow

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16
Q

what are some considerations for a MRI

A

remove metal objects from child, child cannot move during scan so sedation might be needed, can be scary for the child

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17
Q

how is congenital clubfoot managed

A

begins at birth, serial casting every 2 weeks, may require corrective shoes/braces, if severe surgery might be needed

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18
Q

what are the ss of congenital clubfoot

A

resembles a golf club, inability to move it into correct position (it will just go back), inversion (turned in) or eversion (turned out)

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19
Q

what are some teaching and interventions for congenital clubfoot

A

encourage parent to hold the infant, neurovascular checks, skin integrity, cast care

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20
Q

what is development dysplasia of the hip : acetabular dysplasia

A

shallow ir sloping displacement

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21
Q

what is development dysplasia of the hip : sublaxation

A

partial disloaction

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22
Q

what is development dysplasia of the hip : dislocation

A

total dislocation - no contact

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23
Q

what are the ss of development dysplasia of the hip

A

asymmetrical folds on posterior thigh, limited hip abduction, shortening of femur, positive ortalani test, positive barlow test

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24
Q

what is a positive ortalani test

A

put the infant supine and flex the knees 90 degrees at the hip, grasp inner part of thigh and abduct the hips, while applying upward pressure, listen for sounds a clunk sound suggest development hip dysplasia

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25
Q

what is a positive barlow test

A

the infant in supine, grasp inner thighs, adduct the thighs while applying outward and downward pressure, feel or listen for a clunk

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26
Q

what are some interventions and teaching for developmental dysplasia of the hip

A

encourage parents to hold child, palvilk harness is the most common, bryant traction, hip spica cast

27
Q

what is the nursing care for a hip spica cast

A

make sure the cast area is clean and dry, preventing cast from getting soiled from diaper changing- skin care is very important

28
Q

what is leg calve perthes disease

A

avascular necrosis of femoral head, boys 4-8 years old

29
Q

what is revascularization in leg calve perthes disease and when does it happen

A

can occur as blood vessels develop, phase is 18-24 months during this time the bone is soft and at risk to fracture during this phase

30
Q

what are the interventions and teaching for leg calce perthes disease

A

maintain shape of femoral head, anti-inflammatories, limit activity, bracing, casting, traction, serial x-rays, no contact sports, promotion of swimming/bicycling to promote mobility of unaffected body part

31
Q

what are the ss of leg calve perthes disease

A

painless limp, mild hip pain, limited ROM, shortening of affected leg, muscle wasting because they arent using the affected leg as much

32
Q

what is osteogenesis imperfecta

A

genetic bone disorder, results in low bone mass, increased fragility of bones and other connective tissue problems,

33
Q

what is classification I osteogenesis imperfecta

A

mild form, 50% of all cases, blue sclera, hearing loss, frequent shoulder/elbow dislocations, after growth complete fractures diminishes, gross motor skill delays

34
Q

what is classification II osteogenesis imperfecta

A

most severe form, lethal die within fist year of life, low birth weight, short limbs, small chest, soft skull, dark blue/gray sclera

35
Q

what is classification III osteogenesis imperfecta

A

most severe nonleathal, sclera white to blue, fractures in utero, results in significant diability, marked short stature

36
Q

what is classification IV osteogenesis imperfecta

A

moderately severe, sclera light blue then lighten to white in teens, fragile bones, may present at birth with in utero fractures or bowing of lower long bones

37
Q

what are the interventions for osteogenesis imperfecta

A

minimize fractures, maintain mobility, fracture care, PT and OT, braces, splints, severe cases may require surgical insertion of steel rods into long bones

38
Q

what is pamidronate (bisphosphonate) med used for

A

used to increase bone mineral density, given at 4 month intervals, causes a decrease in serum calcium level (bc increase in phosphate decreases calcium)

39
Q

what is scoliosis

A

lateral curvature of the spine exceeding 10 degrees, congenital or idiopathic (most often), early screening and detection are key

40
Q

what are the interventions for scoliosis

A

prevent further curvature (brace/surgery), treatment based on age, serial examinations to monitor progression, curvature greater then 25-45 degrees bracing is needed, braces depend on location and severity of the curve

41
Q

what are some surgical interventions for scoliosis

A

insertion of rods and bone grafting or partial fusion with many of corrective surgeries

42
Q

what is the physical assessment of scoliosis

A

asymmetry of shoulders and hips,

43
Q

what is the education for scoliosis

A

compliance with bracing, educate family on putting on and taking off brace, promote positive body image,

44
Q

What are the common sites for fractures

A

forearm and the wrist

45
Q

what fractures can occur at birth

A

midclavicular, humerus, femur fractures

46
Q

where is the most vulnerable portion of the childs bones

A

ephiseal plate - frequently the site of injury

47
Q

what is a buckle fracture

A

not complete- the bone is broken but still connected

48
Q

what is a green stick fracture

A

pulled and twisted - most indicative of abuse

49
Q

Bc child bone are more flexible what does that mean about fractures

A

it takes alot of force to break their bones, but they heal quicker

50
Q

what are some interventions for fractures

A

casting to provide comfort and allow for activity, manual traction may be required for disabled fractures, severe fractures may require traction for a period of time followed by casting, cold therapy, tetanus vaccine ( if no booster in last 5 years), cast care, discourage risky behavior

51
Q

how is an assessment performed for a fracture

A

palpate the joint or injured part - tenderness could indicate a fracture, x-ray will confirm fracture diagnosis

52
Q

what is the education and interventions for casts

A

used for fracture reduction, dislocations or correct a deformity, must do neurovascular checks

53
Q

what is the nursing care for traction

A

frequent neurovascular checks (q4), prevent infection, provide pin site care - chlorhexidine or alcohol with non shedding material

54
Q

where is compartment syndrome normally seen

A

commonly seen in traumatic long bone fractures or crushing injuries

55
Q

what is the nursing care for compartment syndrome

A

frequent neurovascular checks, monitor urinary output, fasciotomy may be required

56
Q

what are the 4 Ps of neurovascular checks

A

pain, pallor, pulses, paresthesia

57
Q

what is osteomyelitis

A

bacterial infection of the bone and soft tissues, inflammatory response,

58
Q

what are the interventions for osteomyelitis

A

aspirate for culture and sensitivity, 4-6 week antibiotic, pain, bed rest,

59
Q

what is the assessment of osteomyelitis

A

pain, fever, ss of worsening infection, redness, edema, warmth, tenderness

60
Q

what kind of pain is helped with acetaminophen

A

mild-moderate pain, most often combined with narcotic such as codeine for increased effect

61
Q

what are the considerations for narcotic analgesics

A

assess pain location/quality/intensity/duration, assess respiratory rate and periodically after, monitor sedation level,

62
Q

what are some side effects of narcotic analgesics

A

nausea, vomiting, constipation, pupil constriction

63
Q

what are the considerations for NSAIDs

A

for mild-moderate pain, administer with water or food to decrease GI upset

64
Q

what are the side effects for NSAIDs

A

nausea, vomiting, diarrhea, constipation

Peds exam 2 (8 decks)

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