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peds 331 > musculoskeletal > Flashcards

musculoskeletal Flashcards

1
Q

development

A

mature at 17M and 2 years post menarche F
epiphysis plate = growth plate and growth
porous - flex and bend = incomplete breaks
thicker periosteum = heal quicker

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2
Q

casts purpose

A

immobilize affected part, usually fiberglass (palms only, no fingertips - pressure points), no fan or hairdryer to accelerate drying

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3
Q

casts pain

A

meds (range), no ibuprofen bc interferes with recovery
ice - itch, swell, pain
elevate
skin breakdown, 5 Ps (few fingers)

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4
Q

casts mobility

A

exercise non affected side, isometric on affected side
prevent foot drop, keep moving and active

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5
Q

casts healing

A

diet and fluids

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6
Q

casts - neurovascular

A

5 Ps (pain, paralysis, paresthesia, pulse, pallor)
elevate, tightness (few fingers)

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7
Q

casts - complications

A

keep heel off mattress, feel hot spots and tingling, wound drainage, skin break down (petal edges with moleskin)

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8
Q

casts - removal

A

scary - distract, headphones
explain and demonstrate on self, put vibrate on them to feel, cant cut skin
maybe restrain

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9
Q

traction

A

maintain correct balance, care of weights, skin inspections, pin care, neurovascular assess

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10
Q

DDH cm

A

hip out of socket
infant: asymmetry (gluteal folds, thigh fold, longer limb, more fat folds), limited abduction (clunk or clink, more ROM on 1 side, galleazzi sign (shorter femur), ortolani test (clink clunk)
older: trendelenberg, wadding gait, limp

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11
Q

DDH tm and nc

A

identify and treat early
hip in flexed abducted position to deepen socket

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12
Q

DDH tm 0-6 mo

A

pavlik harness - no thick diapers, check skin breakdown, always on except bath, creative holding, clothes under, no lotion or powder, massage under

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13
Q

DDH tm 6 -18 mo

A

pre op skin traction (3 week) - buck or russel, closed or open reduction under general anesthesia, hip spica cast 2-4 months until hip is stable

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14
Q

DDH tm older

A

surgical reduction

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15
Q

congenital clubfoot (talipes equinovarus) tm

A

serial casting q1-1.5 weeks (8-12 weeks), surgery for pins and tendons and casting 2-3 months
splint/brace after either

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16
Q

congenital clubfoot (talipes equinovarus) nc

A

injury r/t cast, fam help (defect)

17
Q

osteogenesis imperfecta cm

A

brittle bone disease (precollegen issue)
often confused with abuse
bone fragility and deformity, poor growth, bruising and recurrent epistaxis, blue sclerae, hearing loss, thin skin, diaphoresis and teeth discolor, mild hyperpyrexia, normal intelligence
decrease fractures in adolescence

18
Q

osteogenesis imperfecta tm

A

support: prevent break, muscle weak, osteoporosis, malalignment
brace, swim, traction, moderate activities, rods with bone, activity non contact, pt, splint, pamidronate med - bone healing and decreased bone reabsorption

19
Q

osteogenesis imperfecta nc

A

handle carefully, teach limitations to increase g+d, family support

20
Q

legg calve parthes cm

A

insidious, pain always, limp and trend
decreased ROM, history of trauma

21
Q

legg calve parthes tm

A

diagnose with radiography
hips abducted and off feet (maybe) - for months
or sx

22
Q

legg calve parthes nc

A

teach (care at home), diversional activites (industry), return to school, long treatment (adherence)

23
Q

scoliosis cm

A

structural v funcitonal
lateral curve, asymmetric hip and shoulder, unequal scapula prominences and ribs, asymmetry of abd skinfolds

24
Q

scoliosis tm - mild

A

<20
observe, eval q 3-12 months

25
Q

scoliosis tm mod

A

20-40
brace until no more bone growth (skin breakdown, body image, wear 23 hours a day)

26
Q

scoliosis tm - severe

A

> 40 spinal fusion

27
Q

spinal fusion nc

A

preop: hospital for weeks for traction, lots of labs, and x rays, skin assess (bacne), educate - PCA, log roll, IS (breathing is hard bc pain)
post op: vs (htn), wound, circulation, 5Ps; IS q2hr, logroll q2 (flat), PCA, PT asap, indep, fam involve

28
Q

juvenille idiopathic arthritis nc

A

paui - eye doctor q 6 months (uveitis)

29
Q

juvenile idiopathic cm

A

fever, rash, pericarditis, morning stiff, joint swell, warm joint, pain, malaise, anorexia, decreased ROM, eye issues

30
Q

juvenile idiopathic tm

A

decrease inflam, and ROM
heat and exercise, prevent deformity (PT/Ot, ROM), relieve s (pain), swim, play

31
Q

osteomyelitis cm

A

vaccine
(bone infection)
appear ill, bone pain, wont walk/move, fever, irritable, malaise, decreased appetite

32
Q

osteomyelitis tm

A

IV abx 3-4 weeks, then oral, heat
bed rest
sx drainage of abscess

33
Q

osteomyelitis nc

A

supportive, pain, PICC line care, cast care, nutrition (increase protein and calories), diversional activities

peds 331 (28 decks)

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