Musculoskeletal

Question 1

leading cause of death in children older than one year

Answer 1

trauma

Question 2

assessing LOC using AVPU method

Answer 2

A- child is alert
V- child responds to verbal stimulus
P- child responds to painful stimuli
U- child is unresponsive

Question 3

manual traction

Answer 3

applied to the body part by a hand

Question 4

skin traction

Answer 4

pulling mechanism is attached to skin, indirectly applying pressure to skeletal structure

Question 5

skeletal traction

Answer 5

applied directly to a bone by a pin, wire, or tongs

Question 6

nursing care with traction

Answer 6

never released by nurse
carefull assessment
pin site care
pain management 
educate for discharge

Question 7

amputation post op care

Answer 7

elevate stump for 24 hours, then natural position
child should be turned side to side and front to back
child should lay prone for at least a few hours a day

Question 8

complete v incomplete fracture

Answer 8

complete: fracture fragments are separated
incomplete: fracture fragments are still attached

Question 9

simple v compound fracture fracture

Answer 9

simple: no break in skin
compound: break in skin; bone sticks out of skin

Question 10

complicated v comminuted fracture

Answer 10

complicated: fragments that cause damage to surrounding organs / tissues
comminuted: fragments remain in surrounding tissue

Question 11

transverse, oblique, spiral fracture

Answer 11

T: crosswise, right angle to long axis of bone
O: slanting but straight
S: slanting / circular

Question 12

buckle fracture

Answer 12

produced by compression of the bone

Question 13

greenstick fracture

Answer 13

bone is angulated beyond limits of bending

looks like a broken stick

Question 14

plastic deformation

Answer 14

when bone is bent but not borken

Question 15

epiphyseal injury

Answer 15

injury involving the growth plate

its the weakest point of long bones

Question 16

salter-harris classification

Answer 16

S- separated growth plate
A- above growth plate
L- below growth plate
T- through growth plate
ER- eraser of growth plate (its squished between two bones)

Question 17

symptoms of epiphyseal injuries

Answer 17

generalize swelling
pain / tender
diminished functional use
bruising, severe muscle rigidity, crepitus

Question 18

assessing the 5 P’s

Answer 18

Pain
Pallor
Pulse
Parasthesia
Paralysis

Question 19

contusion

Answer 19

damage to soft tissue
escape of blood into tissues
ecchymosis, swelling, pain, disability, crush injuries

Question 20

dislocation

Answer 20

force of stress disrupts normal position of bone / socket

pain inc. with passive / active ROM

nursemaids elbow = most common (pulling on arm to catch / lift a child)

Question 21

sprain

Answer 21

causes ligament to be stretched; partially or completely torn
- occurs suddenly
joint laxaty= indicator of severity

onset of swelling w/ disability

Question 22

strain

Answer 22

microscopic tear
common to sprain
no joint laxity
over time rather than suddenly

Question 23

stress fracture

Answer 23

repeated muscle contraction in repetitive weight bearing sports

tibial = most common

sharp, persistent, progressive pain

Treatment = rest, alteration of activity, PT, NSAIDS

Question 24

heat cramps

Answer 24

cause = sodium depletion
occurs in legs, child sweats profusely
treatment = replace electrolytes

Question 25

heat exhaustion

Answer 25

cause = excessive loss of fluids
gradual onset
head, fatigue, dizzy, anxiety, maybe disoriented,

Treatment = move to cool environment, provide rest / fluids

Question 26

heat stroke

Answer 26

failure of normal thermoregulatory mechanism

onset = rapid headache, weakness, disoriented
then = confusion, agitation, lethargy, temp > 104

treatment = cool child with wet towels and pants, transport to hospital

Question 27

skeletal limb deficiency

Answer 27

congenital: genetical / environment causes / meds in utero

treatment t- prosthetic devices

Question 28

developmental dysplasia of hip

Answer 28

ortolani / Barlow tests: most reliable until 4 weeks of age;

galeazzi sign: shorter thigh on affected side

trendelenberg sign: child stands on one leg on affected side, normal side tilts down

newborn -6 months = pavlik harness
6+ monts = surgery

Question 29

lego-calve perches disease

Answer 29

femoral head changes shape and no longer fits into acetabulum

cause unknown; involves disturbed circulation to femoral head

T= therapy, rest, activity restriction, NSAIDs

Question 30

slipped capital femoral epiphysis (SCFE)

Answer 30

spontaneous displacement of proximal femoral epiphysis in posterior / inferior direction

separation at growth plate before or during puberty (accelerated growth)

Tx= keep head of femur in acetabellum, rest, surgery

Question 31

club foot

Answer 31

congenital deformity caused by shortened achilles, causes feet to turn in and under

could be caused by abnormal position in utero

t= serial casting to correct for 5-8 weeks
night time bracing 3-5 years

Question 32

osteomyelitis

Answer 32

causes

• exogenous: infectious agent invades bone (penetrating wound, open fracture, contamination during surgery, or burn
• hematogenous: preexisting infection spreads to bone

S/S- abrupt fever, severe pain, irritable, tender, leukocytosis, bone cultures

T= antibiotics, bed rest, immobility of limb, pain meds

Question 33

osteogenesis imperfecta

Answer 33

most common osteoporosis in kids
excessive fractures / bone deformity
autosomal dominant
blue sclerae, heading loss, dentinogenesis

T= biphosphonate therapy; bracing / splints / prevent fractures

Question 34

juvenile idiopathic arthritis

Answer 34

negative rheumatoid factor chronic inflammation of synovium, destruction of cartilage
T= relieve symptoms, OT,PT, splinting devices, NSAIDS corticosteroids, DMARDS

Question 35

systemic lupus erythmatosus

Answer 35

autoimmune disease of connective tissues / blood vessels

diagnostic criteria (need at least 4): butterfly rash, discoid rash, photosensitivity, arthritis, serositis, proteinuria

T= meds, anti-inflammatory, corticosteroids, immunosuppressive agents, avoid sun