Musculoskeletal

Question 1

the reason why kids sustain fractures

Answer 1

trauma (motor vehicle accidents)

Question 2

what fracture correlates to child abuse

Answer 2

spiral fractures

fractures in young infants

Question 3

1 sign of child abuse

Answer 3

inconsistency between history and physical findings

Question 4

what area on x-ray can determine child’s age

Answer 4

wrist

Question 5

if there is a fracture in the growth plate will it impact growth

Answer 5

yes

Question 6

most common pediatric fracture is known as a

Answer 6

green stick

Question 7

what is a green stick fracture

Answer 7

break into periosteum but not through the periosteum

Question 8

nursing interventions for assessing fractures with an immobilization device; distally

Answer 8

CMS (circulation, motor and sensation) - capillary refill, color, pulses

Question 9

should you take a child out of traction if you see any neurovascular impairment

Answer 9

no - call pediatric surgeon for evaluation

Question 10

which fracture places someone at greatest risk for infection

Answer 10

compound fracture (through the skin)

Question 11

types of fractures

Answer 11

transverse
simple
green stick
compound

Question 12

what is a transverse fracture

Answer 12

break completely across bone

Question 13

what is a simple fracture

Answer 13

break across

Question 14

what is a green-stick fracture

Answer 14

break is into the bone, but not through the bone

Question 15

what is a compound fracture

Answer 15

a bone that protrudes through the skin can lead to osteomylitis or infection of the bone

Question 16

what is comminuted fracture

Answer 16

bone is crushed

Question 17

trt for comminuted fracture

Answer 17

surgery to clean out fragmented pieces of bone, join two ends together

Question 18

what is an oblique fracture

Answer 18

angled break in the bone

Question 19

2 complications of fractures

Answer 19

delayed union - bone wont mend as easily

non-union - failure of two bone ends to fuse together

Question 20

how do we dx fractures

Answer 20

xray - look at continuity of the bone

Question 21

s/s of fractures

Answer 21

pain
swelling
deformity

Question 22

hip spica casts involve what body parts

Answer 22

part of torso and at least one extremity

Question 23

what are hip spica casts typically used for

Answer 23

someone with developmental hip dysplasia (first use brace)

Question 24

cast syndrome is also referred to as

Answer 24

superior mesenteric artery syndrome

Question 25

nursing care for pt in spica cast

Answer 25

monitor bowel movements
investigate signs of n/v
avoid gas producing foods

Question 26

what happens in cast syndrome

Answer 26

abdomen distends - pushes against cast, causing compression - tissue ischemia - necrosis - bowel perforation - peritonitis

Question 27

what nursing intervention would be recommended if cast syndrome was suspected

Answer 27

ng tube to decompress abdomen

Question 28

what is compartment syndrome

Answer 28

increased pressure of body part in cast

Question 29

what should a nurse do before applying cast

Answer 29

be sure to remove any icy/hot type creams before applying casting material; serious burns can occur

Question 30

talipes refers to what

Answer 30

club foot

Question 31

most common talipes

Answer 31

talipes equinovarus

Question 32

talipes equinovarus is remembered by this mnemonic

Answer 32

InAdEquate
Inversion of the foot
adduction and
equinus

Question 33

pseudo talipes is caused by

Answer 33

position in utero; foot appears like club foot but can be manipulated

Question 34

in true club foot you couldn’t put foot in ROM t or f

Answer 34

true

Question 35

can club foot be picked up by ultra sound in utero

Answer 35

yes

Question 36

nursing interventions for club foot

Answer 36

serial casting for several weeks/months

surgery between 4-12 mos

Question 37

when do we assess for dysplasia of the hip

Answer 37

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

Question 38

main therapy in preventing hip dislocation

Answer 38

keeping head of femur inside acetabulum

Question 39

in hip dysplasia the side effected will present with this

Answer 39

may present with asymmetry of skin fold

are knees horizontal

Question 40

nursing interventions for hip dysplasia

Answer 40

maintain hips in flexed position - keeps head of femur in acetabulum
use pavlik harness (worn 24 hrs/day) for a few months

Question 41

nurs dx for hip dysplasia

Answer 41

skin integrity r/t pavlik brace

Question 42

scoliosis occurs in this population most

Answer 42

girls aged 12-14

Question 43

what is scoliosis

Answer 43

lateral curvature of the spine - spine turn into “S”

Question 44

who typically picks up the presence of scoliosis

Answer 44

moms - skirts don’t hang evenly, jeans don’t fit right

Question 45

scoliosis occurs over a long period of time, t or f

Answer 45

true - not acute

Question 46

kids with CP often times present w/scoliosis t or f

Answer 46

true

Question 47

pain is a normal finding with scoliosis t or f

Answer 47

false

Question 48

**a scoliometer measures degree of curvature, trt measures

Answer 48

10 40 insertion of telescoping rods

Question 49

***pre/post-op nurs interventions for rod placement

Answer 49

log roll
on PCA IV opiods (day 1 - then PO)
teach deep breathing/coughing
catheter care
assess for cast syndrome