Musculoskeletal disorders - exam 3 Flashcards
Is it normal for children to have flat-footed feet?
yes, normal until age 2
is it normal for a child to be bow-legged?
yes, normal until age 3
3 examples of soft tissue injuries
sprain, strains, contusions
What is a sprain?
- twisting of a joint
- damage to the LIGAMENTS (stretched or torn by force of a twisted joint)
What is a strain?
- tearing or pulling of muscle
- may also effect TENDONS
What is a contusion?
bruises to the muscle (i.e. from being punched)
Signs and Sx of soft tissue injury AND fractures (5 P’s)
- Pain
- pulses
- pallor
- paresthesia (tingling, burning)
- paralysis (ability to move)
Signs and Sx of a SPRAIN
- **EDEMA
- pain
- heat
- redness
- ecchymosis
Signs and Sx of a STRAIN
- inflammation
- ecchymosis (bruising)
Signs and Sx of a CONTUSION
- inflammation
- discoloration
Nursing interventions of soft tissue injury
- assessment: need X-ray to r/o fracture
- Treat: RICE (whether it’s fractured or not)
- -rest: slings, crutches, bedrest
- -Ice: 3-5 times per day; 20 min application (should be iced immediately!)
- -compression: ace-bandage/splint
- -elevation: above heart
- NSAIDS as ordered
- PT: prescribed exercises (only if absolutely necessary)
What is a fracture
ANY type of break in the bone
Signs and Sx of a fracture
- inflammation
- bruising
- pallor
- limited ROM
- non-weight bearing
- point tenderness is more indicative of a fracture
How to diagnose fractures
-Assessment (x-ray and ultrasound)
Nursing interventions for fractures
- casting
- -help keep calm/distract
- -rest w/ elevation of cast recommended
- -move joints above and below casted joints
- comfort measures: sedation, ice to relieve itching
- traction: pulling (physically moving bone back)
- external fixation devices
- teaching
- -don’t stick anything in cast
- -check for cap refill, feeling, sensation, movements
- -rapidity of healing is inversely related to child’s age
- -check for tightnes/weakness/contractures in uninvolved joints and mscles
Club foot definition:
malalignment of feet which resists being moved into proper alignment (feet are turned inward)
Pathophysiology of a club foot
- fetal positioning (e.g. seen more in twins/triplets)
- intrauterine restriction
- boys>girls
Treatment of club foot
- serial casting (1st treatment choice)
- -needs constant reapplication d/t rapid growth
- surgery (not always required)
- physical therapy