Musculoskeletal Flashcards
the reason why kids sustain fractures
trauma (motor vehicle accidents)
what fracture correlates to child abuse
spiral fractures
fractures in young infants
1 sign of child abuse
inconsistency between history and physical findings
what area on x-ray can determine child’s age
wrist
if there is a fracture in the growth plate will it impact growth
yes
most common pediatric fracture is known as a
green stick
what is a green stick fracture
break into periosteum but not through the periosteum
nursing interventions for assessing fractures with an immobilization device; distally
CMS (circulation, motor and sensation) - capillary refill, color, pulses
should you take a child out of traction if you see any neurovascular impairment
no - call pediatric surgeon for evaluation
which fracture places someone at greatest risk for infection
compound fracture (through the skin)
types of fractures
transverse
simple
green stick
compound
what is a transverse fracture
break completely across bone
what is a simple fracture
break across
what is a green-stick fracture
break is into the bone, but not through the bone
what is a compound fracture
a bone that protrudes through the skin can lead to osteomylitis or infection of the bone
what is comminuted fracture
bone is crushed
trt for comminuted fracture
surgery to clean out fragmented pieces of bone, join two ends together
what is an oblique fracture
angled break in the bone
2 complications of fractures
delayed union - bone wont mend as easily
non-union - failure of two bone ends to fuse together
how do we dx fractures
xray - look at continuity of the bone
s/s of fractures
pain
swelling
deformity
hip spica casts involve what body parts
part of torso and at least one extremity
what are hip spica casts typically used for
someone with developmental hip dysplasia (first use brace)
cast syndrome is also referred to as
superior mesenteric artery syndrome
nursing care for pt in spica cast
monitor bowel movements
investigate signs of n/v
avoid gas producing foods
what happens in cast syndrome
abdomen distends - pushes against cast, causing compression - tissue ischemia - necrosis - bowel perforation - peritonitis
what nursing intervention would be recommended if cast syndrome was suspected
ng tube to decompress abdomen
what is compartment syndrome
increased pressure of body part in cast
what should a nurse do before applying cast
be sure to remove any icy/hot type creams before applying casting material; serious burns can occur
talipes refers to what
club foot
most common talipes
talipes equinovarus
talipes equinovarus is remembered by this mnemonic
InAdEquate
Inversion of the foot
adduction and
equinus
pseudo talipes is caused by
position in utero; foot appears like club foot but can be manipulated
in true club foot you couldn’t put foot in ROM t or f
true
can club foot be picked up by ultra sound in utero
yes
nursing interventions for club foot
serial casting for several weeks/months
surgery between 4-12 mos
when do we assess for dysplasia of the hip
in the nursery - ortolani maneuver
the earlier the hip instability is picked up the better the prognosis
re-screen every well child visit in infancy
if palpate a thud, as hip slips out, notify physician
main therapy in preventing hip dislocation
keeping head of femur inside acetabulum
in hip dysplasia the side effected will present with this
may present with asymmetry of skin fold
are knees horizontal
nursing interventions for hip dysplasia
maintain hips in flexed position - keeps head of femur in acetabulum
use pavlik harness (worn 24 hrs/day) for a few months
nurs dx for hip dysplasia
skin integrity r/t pavlik brace
scoliosis occurs in this population most
girls aged 12-14
what is scoliosis
lateral curvature of the spine - spine turn into “S”
who typically picks up the presence of scoliosis
moms - skirts don’t hang evenly, jeans don’t fit right
scoliosis occurs over a long period of time, t or f
true - not acute
kids with CP often times present w/scoliosis t or f
true
pain is a normal finding with scoliosis t or f
false
**a scoliometer measures degree of curvature, trt measures
10 40 insertion of telescoping rods
***pre/post-op nurs interventions for rod placement
log roll on PCA IV opiods (day 1 - then PO) teach deep breathing/coughing catheter care assess for cast syndrome
