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Maternal Nursing > Musculoskeletal Disorders > Flashcards

Musculoskeletal Disorders Flashcards

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1
Q

What is the most severe and common type of muscular dystrophy?

A

Duchenne muscular dystrophy

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2
Q

What is absent in the muscle of children with Duchenne Muscular Dystrophy?

A

Dystrophin

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3
Q

What is Dystrophin?

A

A protein product in skeletal muscle that helps the muscles contract and stay toned.

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4
Q

What is pseudohypertrophy?

A

Muscular englargement caused by fatty infiltration.

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5
Q

What occurs as DMD progresses?

A

Muscular atrophy.

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6
Q

When do symptoms of DMD generally occur age wise?

A

3-7 years

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7
Q

What is the progression of DMD?

A

Weakness to abnormal gait to paralysis

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8
Q

What generally happens by 12 years old to patients with DMD?

A

They can be wheelchair or bed bound because they have contractures and deformities of small and large joints.

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9
Q

What are some clinical manifestations of DMD?

A

Waddling, Lordosis, faling, gower sign, pseudohypertrophy, atrophy in later stages, cognitive impairment, contractures, obesity

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10
Q

What is the prognosis of DMD?

A

Death from respiratory tract infection or cardiac failure- very difficult diagnosis

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11
Q

How is DMD diagnosed?

A

by blood polymerase chain reaction for dystrophin gene mutation, EMG, and CPK levels, and muscle biopsys

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12
Q

How can DMD be diagnosed prenatally?

A

If another child has had this problem it can be Dx-ed at 12 weeks

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13
Q

What is an EMG test?

A

electromyography- painful test that tests for muscle activity in each muscle.

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14
Q

Why are CPK levels high in DMD patients in the first two years of life?

A

because as the muscle is damages, it elevates CPK

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15
Q

What is the treatment of DMD?

A

Corticosteroids, PT, Respiratory therapy, bracing, surgery

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16
Q

What are some nursing care techniques with DMD patients?

A

Supportive care to PT and family, Assess systems, promote self care, educate, provide resources.

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17
Q

What is Osteogenesis Imperfecta (OI)?

A

Brittle bone disease- an autosomal dominate disease with 6 types.

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18
Q

What are the 6 types of OI?

A

Mild, lethal, severe, mild to moderate, similar to IV, DX by bone biopsy

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19
Q

What are clinical manifestations of OI?

A

Increase fractures, fractures at birth, deformities, small stature, blue sclerae, decrease hearing

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20
Q

What is the treatment for OI?

A

Supportive; light weight braces, rehab therapy, surgery to correct fractures, biophosphate therapy to promote bone density

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21
Q

What is the nursing care for OI?

A

Be careful and treat fragily, educate parents.

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22
Q

What is Legg-Calve Perthes Disease?

A

Aseptic necrosis of the femoral head because it is depleted of vascularization.

23
Q

When does legg-calve perthes disease affect children age wise?

A

2-12 years

24
Q

What are the 4 stages of legg-calves perthes disease?

A

Necrosis, revascularization, re-ossification, regenerative

25
Q

What are clinical manifestations of legg-calves perthes disease?

A

hip pain, soreness, stiffness, limp, symptoms worsen in morning and night, decrease ROM

26
Q

What can you see on an X-ray or MRI of a patient with legg-calves perthes disease?

A

osteonecrosis.

27
Q

What is the goal of treatment for legg-calves perthes disease?

A

to restore ROM, decrease pain, prevent epiphyseal collapse, decrease necrosis

28
Q

How is legg-calves perthes disease treated?

A

abductor casts (hips apart), brace, traction, surgery to put head back in socket if neccessary

29
Q

What is the prognosis of Legg-Calves Perthes disease?

A

Depends if there is an early diagnosis and interventions

30
Q

What is compartmental syndrome?

A

When the tissue around a cast swells because the cast is too tight- look for cold, white extremities

31
Q

What is Slipped Capital Femoral Epiphysis (SCFE)?

A

Spontaneous displacement of the proximal femoral epiphysis- head of femur slips out

32
Q

What is SCFE associated with?

A

accelerated bone growth and obesity.

33
Q

What is the etiology of SCFE?

A

Endocrine disorders, renal osteodystrophy, and radiotherapy.

34
Q

What are clinical manifestations of SCFE?

A

Limping on the affected side, pain, decreased ROM, shortening of LE

35
Q

How is SCFE diagnosed?

A

Clinical symptoms and confirmed with X-ray

36
Q

How is SCFE treated?

A

Non-weight bearing (crutches/wheelchair), bedrest with traction, surgery.

37
Q

What are some complications of SCFE?

A

Avascular necrosis- breakdown of bones, and Chondrolysis- joint is lost

38
Q

What is scoliosis?

A

Complex spinal deformities with a lateral curvature, spinal rotation that leads to rib asymmetry, and thoracic hypokyphosis.

39
Q

What are the age classifications for scoliosis?

A

Congenital, infantile, juvenile, adolescent.

40
Q

What are some clinical manifestations of scoliosis?

A

Adams test, scoliometer, Risser scale, tanner maturity rating

41
Q

What is the Adams test for scoliosis?

A

Bending over and lookingat the shoulders and hips.

42
Q

What is a scoliometer?

A

Looking at trunkal rotation.

43
Q

What is an X-ray with Cobb Technique?

A

An X ray looking at the degree of curvature.

44
Q

What is the Risser Scale with scoliosis?

A

Looking at how fast the child is growing

45
Q

What is the tanner maturity scale with scoliosis?

A

Looking at the progression of the curvature.

46
Q

What are some nursing assessments for scoliosis?

A

Assess asymmetry between shoulders and hip alignment, Adams test, accurate height measurements

47
Q

What degree of scoliosis is not threatening?

A

less than 10

48
Q

Which degree of scoliosis indicates mild scoliosis?

A

20 degrees or less

49
Q

Which degree of scoliosis indicates a progressive scoliosis that needs intervention?

A

greater than 30

50
Q

Which degree of scoliosis indicates a need for surgical intervention?

A

45-55 degrees

51
Q

What is the goal of surgical intervention in scoliosis?

A

To realign and straighten the spine through internal fixation and instrumentation, also to stabilize through spinal fusion.

52
Q

What is pre-op care for scoliosis patients?

A

Teach, labs, Xrays, marking, degrees

53
Q

What is post-op care for scoliosis patients?

A

bedrest, log roll, assess resp. status, bowel sounds, pain, and promote self care.

Maternal Nursing (22 decks)

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