Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Module 5 (Pediatrics) > Musculoskeletal Dysfunction > Flashcards

Musculoskeletal Dysfunction Flashcards

1
Q

Frctures

A

the resistance between bone yielding to applied stress
- break in the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common site of childhood fractures?

A

distal forearm (radius, ulna, or both)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Children are at high risk for fractures due to

A

high activity levels
immature bones
- brace themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Children have a faster

A

remodeling/healing
Younger the child the shorter amount of remodeling time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fractures in infancy are rare and warrant

A

further investgation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If you wait to go to ER after a break, then what will happen?

A

the bone will remodel itself and not heal correctly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What fracture can stop the bone from growing and create a more complex treatment?

A

growth plate fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Factors affecting remodeling

A

age (younger = faster healing)
location (growth plate = complex/stop growing)
degree of deformity (complex to simple crack)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dx of Fractures

A

X-ray
If still showing s/s = CT/MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the different types of fractures?

A

Plastic Deformation (bend)
Buckle (torus)
Greenstick
Complete
Spiral
Growth Plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Plastic Deformation

A

bend
- not a break
- MALLEABLE BONES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Children have malleable bones. To what degree does the bone been but not break?

A

45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Buckle fracture

A
  • torus
  • pulled/raised in the fx site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Greenstick fracture

A

broke but not all the way through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Spiral fracture

A

twisting force
- sports with a plant and twist
- child abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Growth plate fracture

A

Epiphysis - end of the long bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Assessment of Fx

A

general swelling
pain/tenderness/numb
deformity
low functional use guarding
Ecchymosis
Rigid muscles/spasms
Crepitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why is it important to make a splint for the affected fractured bone?

A

Muscular rigidity is a s/s of a fracture and will affect/move the bone out of place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Crepitation

A

bones scraping together with bubbling under the skin
- careful not to cause damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the initial priority nursing actions of a child extremity fracture in order?

A
  • calm/reassure
  • Assess the extent (mech of injury)
  • Peripheral neurovascular assessment (6Ps)
    ~ only move distal (as little as possible)
  • If compound, then cover with sterile dressing
  • Immobilize (sling/immobilizer)
  • RICE
    ~ Elevate/Isolate
    ~ Apply cold
  • Cont. monitor neovascular status
  • Apply traction if circulatory compromise is present
  • Transport to ER
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Neurovascular Assessment

A

Pallor
Pulse
Pain
Poikilothermia - temperature
Parenthesis - numbness (only move phalanges)
Paralysis - no mvmt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If the circulatory compromise is present with the fracture, then apply

A

traction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

T/F: Do not try to reduce or press on the fracture.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the different types of casting materials?

A

plaster
synthetic (fiberglass)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Casts are used to

A

immobilize the bone and joint after fx
- fx of hip/knee requires spica cast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the advantages of plaster casts?

A
  • molded closely to body part
  • smooth exterior
  • cheap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the disadvantages of plaster casts?

A
  • take 10-72 hours to dry
  • heavy
  • not water resistant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the advantages of synthetic casts?

A
  • lightweight
  • dry quickly (5-20 minutes)
  • Can be used with a water-resistant liner
  • colors and prints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the disadvantages of synthetic casts?

A
  • can not molded close to the body
  • rough
  • expensive $$$$$$$$
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The fracture should be in a splint until

A

the swelling has gone down
then cast is placed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

During the application of casts, what are the developmental considerations for children?

A

Preschoolers have a fear of body mutilation
- use transition objects
Interactions to calm down
Distractions for cleaning the areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the process of putting on a cast material?
Have abrasions?

A

If abrasions/altered skin = stocking net for liner
cotton wrap for comfort
casting material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When HCP applies the cast material they will

A

mold material to limb
- ensuring smooth cast edge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

If they are applying a synthetic cast material, what does the HCP need to ensure?

A

smooth edges with stocking net outside of the edge OR petal the edge with water adhesive tape
- due to the synthetic edge being rough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What should the nurse teach the parent and child considering cast care?

A

dry inside out
- do not dry with a heat lamp or hair dryer
**Reposition wet cast with palm
Elevate on a soft surface
Ice for pain/swelling w/ barrier to keep dry
Assessments of infection and 6Ps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

The cast dries from

A

inside out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

The cast should be repositioned with

A

palms
- if finger then skin breakdown can occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

S/S of infection in a cast

A

fever
pain
increase swelling
redness
odor
drainage
HEAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are alterations to casts?

A

Windows
- assess area and hygiene
- surgical site/diaper change
- Spiga Cast
Bivalve
- cut in half to loosen top portion held with ace wrap
- assess the surgical sites or swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What should you constantly check for and tell children about cast protocol?

A

NO objects/toys/food in the cast
Nothing inside to itch
NO moisture (cover with a plastic bag)
- Call HCP if gets wet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

The cast is removed with a

A

cast cutter/saw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What should you do for the atraumatic care of a cast saw?

A
  • the cast is now a part of them if younger
  • preschoolers might not use the arm altogether
  • call it cast removal tool, tickle, no harm to skin only
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Education of Cast removal
- appearance and skin care

A

skinnier =
muscle atrophy
funky odor with no judgment
dead skin buildup
If they do not slough off then do not peel,
Skin Care = regular baths and will fall off normally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

After taking the cast off, what should you do if the skin does not slough off?

A

let it go normally
DO NOT PEEL!
- Normal showering and cleaning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Education of returning to activity after a cast

A

minor = full activity to the amount of time inside cast
Ex) 1 month in cast = 1 month till activity
- No football, rollerblading, or bike riding till after
- Not normally PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What joint mobility exercise after cast material?

A

stiff is normal due to no usage
muscle and mobility will increase over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the developmental activities used in cast removal?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Traction purpose

A

CIRCULATORY COMPROMISE
realign bone
immobilize
fatigue muscle to reduce spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Skin Traction is applied to

A

directly to the skin surface and indirectly to the skeletal structures
- pulling force is weights (bandage, boot, sling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Skeletal Traction is applied to

A

DIRECTLY INSIDE the distal bone with pins/wires/tongs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Traction type is dependent on:

A

Fracture
- severity, degree of misplacement, other structures involved (tearing)
- child’s age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Buck Extension/Traction

A

short term immobilization
leg extended position
boot appliance to traction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Buck Traction is used on these musculoskeletal disorders?

A

dislocated hips
Legg-Calvé-Perthes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Do not remove the traction without

A

HCP orders
- only double-check wts with ropes and pulleys in place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Bryant Traction does what

A

immobilizes both lower extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Bryant Traction is used in what musculoskeletal disorders?

A

fractured femur
developmental dysplasia
of the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Bryant Traction flexes the legs at what angles?

A

90 degrees at the hips ONLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

With Braynt Traction, the butt should be

A

raised slightly off the bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are the different types of skin traction?

A

Buck and Bryant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Skeletal Traction allows for what compared to skin traction

A

longer traction time and heavier weights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Skin Traction holds weights less than

A

25 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Skeletal Traction holds weights

A

25-45 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Skeletal Traction Types

A

90-90 Traction
Halo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

90-90 Traction is used for

A

bone realignment with calves in boots/slings
- Hip (butt off the bed) and Knees at 90 degrees
- Steinmann pin or Kirschner wire in the distal fragment of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Monitor for what with pin care of skeletal traction?

A

increase infection s/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Halos are used for

A

displaced/fx vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Halos are

A

steel halo attached with four screws into outer skull
- rigid bars connect to vest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Halos allow for

A

greater mobility of the body while avoiding cervical spinal motion**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

With Halos, what are the scheduled assessments?

A

Neuro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Assessments of Traction devices

A

6 Ps
Turning if not in 90-90 or Bryants)
- skin integrity (no pressure points, wrinkles)
Body alignment (butt off bed)
Pin sites need to be clean/dry
Position bandages, frames, and splints, boots
Ropes/pulley/weights
Bed Position from HCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What should be used in tractions to prevent muscle spasms?

A

analgesic/muscle relaxants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What psychological needs should be addressed for children with traction?

A

allow for friends and stimulation
siblings do not touch weights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Osteomyelitis

A

Infection within the bone, usually caused by bacteria introduced by trauma or surgery,
by direct extension from a nearby infection or via the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the most common bacteria in osteomyelitis?

A

Staph. aureus

75
Q

Osteomyelitlis is most commonly seen in

A

long bones (arm and leg)

76
Q

Osteomyelitis occurs in children

A

boys younger than 10

77
Q

Osteomyelitis assessment

A

Pain increase with limb use
- guard not use limb
HIGH Fever
- malaise
irritable
erythema (bruising)
decrease mvmt
edema
warmth

78
Q

Osteomyelitis Dx

A

Culture
CBC
X-Ray (2-3 weeks till seen)
Bone scan/CT/MRI
Bone bx (last resort with s/s)

79
Q

What is seen on labs for osteomyelitis/

A

WBC high
CRP high
ESR high

80
Q

What are some nursing interventions for osteomyelitis? (assessments, medications, mobility)

A

6 Ps
IV Antibiotics up to 6 weeks (Central/PICC)
Non-opioid for mild to moderate pain
Opioid for severe pain
Rest/comfort
NWB
Nutrition
Possible surgery for I&D if high labs
Psych needs

81
Q

If you need to reposition an osteomyelitis pt then

A

slow and caution infected area

82
Q

What nutritonal considerations should an osteomyelitis patient eat?

A

high in protein to help healing

83
Q

What labs need to be watched for with IV antibiotics for fast, high, and continuous doses?

A

liver
renal

84
Q

Legg-Calve-Perthes Disease is the

A

avascular necrosis of the femoral head
- cause unknown
- blood supply stops to the femoral head and dies
- BUT spontaneously returns and heals

85
Q

Legg-Calve-Perthes is common in

A

2-12 y/o
boys 4-8 y/o

86
Q

Legg-Calve-Perthes is located at the

A

femoral capital epiphysis
-flattens upper part of head

87
Q

Legg-Calve-Perthes Assessment

A

limp
slow pain
joint stiff with limited ROM

88
Q

Legg-Calve-Perthes Dx

A

H&P limited
Xray - defect of hip
**MRI - definitive shows osteonecrosis

89
Q

Legg-Calve-Perthes has what type of onset

A

slow - don’t know when it happened

90
Q

Initial Interventions of Legg-Calve-Perthes

A

rest/activity restrictions
reduce inflammation and irritability of the hip
limited/NWB
- Crutches (wheelchair if too young)
- PT
- Buck’s traction
Parent’s choice on Tx

91
Q

Legg-Calve-Perthes Conservative Tx

A

abduction brace, cast, harness sling
lasts 2-4 years

92
Q

Legg-Calve-Perthes Severe Tx

A

Surgical reconstruction and containment
hip replacement (3-4 months back to normal)
- might not want surgery due to infection complication

93
Q

What are the conservative braces put on patients with Legg-Calve-Perthes?

A

Scottish Rite Orthoses - Frankenstein walk
Spica Cast with Hip Abductor - older
- esp after surgery

94
Q

Legg-Calve-Perthes Prognosis

A

self-limiting
Outcome influenced by early tx and age
Possible long-term complications
- older more prone to osteoarthritis

95
Q

Idiopathic Scoliosis

A

abnormal lateral curvature of the spine 10 degrees or more
- C or S curve

96
Q

Scoliosis is more common in

A

girls
- 2-3% adolescent population

97
Q

Scoliosis is usually dx during

A

adolescent growth spurt

98
Q

Visual Assessment of Scoliosis

A

One shoulder higher than the other
One shoulder protrudes or higher
One hip higher
Space of the arms from body
Lean to one side
Head not center above the pelvis

99
Q

What is the dx spinal screening for scoliosis?

A

Forward Bend Test
Scoliometer

100
Q

If the scoliometer is greater than _____ degrees tilt then HCP

A

7 degrees

101
Q

Dx of Scoliosis includes

A

Scoliometer - Forward Bend Tilt
Cobb Method
MRI

102
Q

Cobb Method

A

angle of the curve of the Xray to determine interventions

103
Q

MRI for Scoliosis

A

find spinal abnormalities/compression of the spine from tumor or defect

104
Q

Postural variation is what degree of scoliosis?

A

< 10

105
Q

The mild curve is what degree of scoliosis?

A

10-25 degrees

106
Q

The moderate curve is what degree of scoliosis?

A

25-45 degree

107
Q

The severe curve is what degree of scoliosis?

A

> 45

108
Q

Postural variation interventions

A

eval at routine well checkups
Xrays until skeletal maturity

109
Q

Mild Curvature of the spine interventions

A

observe and HCP evaluation every 3-6 months

110
Q

Moderate Curvature of the Spine Interventions

A

Bracing Tx
Corrective forces and release the load

111
Q

Severe Curvature of the Spine Interventions

A

surgery recommended, rods and bone grafts to correct curve

112
Q

Scoliosis Braces are used in

A

moderate curves

113
Q

Scoliosis Braces are used for how long per day

A

16-23 hours
- gradually wean off until night time

114
Q

What should be under the braces of scoliosis

A

soft cotton underneath
no lotion/creams to promote skin intergrity

115
Q

Braces are not a cure but

A

prevent worsening

116
Q

Adolescents will usually be ____________ due to scoliosis braces themselves

A

noncompliant

117
Q

What are the different types of scoliosis braces?

A

Boston (low profile and plastic component)
Milwaukee (bulkier)

118
Q

The boston brace are used in curves in what area

A

lumbar or thoracic-lumbar area
- low profile
-plastic and customized

119
Q

Milwaukee Braces are used on what part of the spine

A

older bulky
HIgher in thoracic or cervical spine

120
Q

Scoliosis Education

A

Promotion of positive body image
Skin assessment/care
Compliance (16-23 hours)
PT/exercise (cont exercise and abd muscles for strengthening of cure

121
Q

For severe curvature what is used for tx

A

internal fixation surgery (rods, hooks, and wires)
- “growing” rods pull apart so no new surgery
-Lifetime

122
Q

Goal of scoliosis surgery is to

A

maximal correct to scoliosis and max mobility

123
Q

Post-Op Interventions of Scoliosis Surgery

A

neuro assess
log roll
skin integrity with care
IV hydration and meds
Opioid analgesics for severe and PCA
Assist with amputation (progressive) asap
Develop and Psycho needs

124
Q

What should you watch for during amputation after scoliosis surgery?

A

gait
constipation(pain meds)
low BP (opioids)
- sit up slowly
ICS, TCDB, ambulation, BM (if no ileus and pain meds)

125
Q

Developmental Dysplasia of the Hip (DDH)

A

abnormal development of the hip that may develop during fetal life, infancy, or childhood; in these disorders, the head of the femur is seated improperly in the acetabulum
- unknown cause

126
Q

DDH is more common in

A

1st born
females
family hx
breech delivery
Large birth weight
oligohydramnios

127
Q

What are the different degrees of DDH

A

Dysplasia
Subluxation
Dislocation

128
Q

DDH Assessment when

A

newborn 8-12 weeks

129
Q

DDH Assessment as a newborn have which tests

A

Positive Barlow test
Positive Ortolani test

130
Q

Barlow Test

A

adducting the thigh
+ = palpable “clunk” of femoral head dislocating from acetabulum

131
Q

Ortholani Test

A

Abducted while lifting leg forward
+ = Palpable “clunk” as dislocated femoral head reduces into the acetabulum

132
Q

The Barlow and Ortholani test MUST be performed by who

A

experienced HCP
- if too vigorous in the 1st 2 days of life - persistent dislocation

133
Q

If the infant is older than 7 weeks of age, what do the results show

A

no + result even if they have DDH

134
Q

DDH Infants Assessment

A

limited abduction of hips
asymmetry of gluteal and thigh folds
+ Galeazzi (Allis) sign
leg length difference

135
Q

Galeazzi (Allis) sign

A

shortness of the femur with the hips and knees flexed
laying down

136
Q

Older Infants and CHildren Assessment of DDH

A

+ Trendelenburg sign
leg length difference
telescoping mobility joint
Lordosis and waddling gait

137
Q

Waddling gait from DDH means

A

bilateral dislocations

138
Q

Trendelenburg sign

A

child stands on one foot at a time
- weight is on the affected hip
- pelvis tilts downward on normal side instead of up

139
Q

Dx of DDH

A

Physical
Xray (>4months)
Ultrasound (2 weeks - 4 months)

140
Q

Xray for dx DDH is unreliable if under

A

4 months old

141
Q

If the baby is younger than 6 months old what are the treatments for DDH?

A

Pavlik harness

142
Q

Pavlik Harness

A

maintains flexion and abduction of hip
worn cont. (full-time) for 6-12 weeks

143
Q

Pavlik Harness Education for Parents

A

fit of harness and skin care
hold infant with harness - development
involve infant in activities with others

144
Q

The Infant should go to the HCP to adjust the brace and assess progress through Ultrasound every

A

2-3 weeks

145
Q

The infant can wear what under the harness?

A

cotton onesie
- leg warmer socks

146
Q

The Pavlik harness should be taken off for

A

bath and check for skin at this time
- no lotions or powders

147
Q

The infant with a Pavlik harness should get a gentle massage

A

2-3 x a day

148
Q

Where does a diaper go on a Pavlik harness?

A

under

149
Q

What interventions should happen for a 6-24-month-old infant with DDH?

A

Bryant’s traction (skin)
- BUTT OFF BED
surgical reduction (open vs. closed)
- reduce hip joint
spica cast (12 weeks)
- after surgery
flexion-abduction brace until fully healed

150
Q

What interventions should happen for a > 24-month-old infant with DDH?

A

open reduction
spica cast (after surgery)
flexion-abduction brace (if needed)

151
Q

At the age of 4 y/o, what is the prognosis of DDH?

A

surgery is difficult
after 6 impossible due to severe shortening and contracture of the muscle

152
Q

talipes equinovarus

A

Clubfoot

153
Q

Clubfoot

A

complex deformity of the ankle and foot that may be unilateral or bilateral

154
Q

Clubfoot risk

A

increased risk with family history
- no amniotic fluid
more common in boys

155
Q

Clubfoot Dx at

A

birth
in prenatal Ultrasounds

156
Q

Assessment of Clubfoot on the affected foot

A

pointed downward and inward
may be smaller and shorter
Calf** may appear thinner
may have deep crease on the bottom of foot

157
Q

What is the non-surgical interventions for Clubfoot

A

Ponseti method

158
Q

The Ponseti Method is

A

serial casting for 6 - 10 weeks (5-6 casts)
weekly gentle manipulation and stretching
Achilles tenotomy, possibly, at the conclusion of serial casting process
the final cast is placed and on for 3 weeks
then removable orthotic device “boots and bar”
3-4 years 23 hours till only at naps and bedtime

159
Q

In the Ponseti Method, the final cast is placed on the

A

3 weeks

160
Q

In the Ponseti Method, the baby will wear the orthotic boot and bar for how long?

A

3-4 years 23 hours a day till only at sleep times

161
Q

If the ponseti method is unsuccessful, then

A

surgery is an option

162
Q

Juvenile Idiopathic Arthritis

A

Autoimmune inflammatory disease affecting the joints and other tissues, such as articular cartilage
unknown cause

163
Q

Juvenile Idiopathic Arthritis has

A

no cure tx is supportive
- aggressive and can go into remission

164
Q

Juvenile Idiopathic Arthritis is more common in

A

girls

165
Q

Juvenile Idiopathic Arthritis Assessment in affected joints

A

Swelling
Stiffness
Pain
Limited ROM
Generalized symptoms of fever, malaise, rash
Periods of exacerbations (flares) and remissions
Uvelitis

166
Q

What joints are usually affected in Juvenile Idiopathic Arthritis?

A

large joints
-shoulder and hips

167
Q

Uveitis

A

risk IM inflammation and can cause blindness

168
Q

Juvenile Idiopathic Arthritis is usually dx before

A

16 y/o

169
Q

Juvenile Idiopathic Arthritis is dx through tests

A

no definitive tests
- cont arthritic pain in 1+ joints for > 6 weeks
Repetitive fever up to 103
Rash on legs, arms, and trunk
Elevated ESR
Leukocytosis with exacerbations

170
Q

Juvenile Idiopathic Arthritis Xrays show

A

soft tissue edema and joint space widening
- increased synovial fluid in joint

171
Q

What are the nursing interventions for Juvenile Idiopathic Arthritis?

A

control pain
- NSAIDs, Methotrexate, Corticosteroids
Preserve joint function and deformity
Normal G&D (peer groups)

172
Q

What NSAIDs are Rx for Juvenile Idiopathic Arthritis?

A

naproxen, ibuprofen
-take with food

173
Q

Methotrexate is used when

A

NSAIDs fail or in combination with NSAIDs
- liver function test

174
Q

What corticosteroid type is used for Juvenile Idiopathic Arthritis?

A

eyedrop strong inflammation
- prevent IM uvelitis
- lowest dose for short amount of time

175
Q

To preserve joint function in an Juvenile Idiopathic Arthritis the patient should

A

Maintain normal activities, strength training, PT, pool exercise is great for them (freedom of movement), warm packs/baths for pain and stiffness,

176
Q

Physiologic Effects of an Immobilized Child

A

decrease in muscle size, strength, and endurance
bone demineralization leading to osteoporosis
contractures and decreased joint mobility

177
Q

Psychologic Effects of an Immobilized Child

A

decreased ability to respond to anxiety status quo
decreased sensory input
feeling of isolation, boredom, helplessness
potential for sluggish intellect & decreased communication – if out of school for a long time
may react with aggression, submission, passiveness, or anger
possible depression related to ability to function or change in body image

178
Q

What nursing interventions should there be for the immobilized child?

A

Skin Care, hydration
DVT prevention
Encourage high protein, high-calorie foods
Adequate hydration for opioids
Upright position frequently unless contraindicated
For lungs
Transport outside room when possible
Allow to wear own clothes
Allow to participate in own care
Frequent visits from family and friends

179
Q

D/C Planning for an Immobile Child

A

Case management and child life
Home health care - PT and more resources otside
Durable medical supply
Respite care for parents with chronic
Emotional, spiritual, and financial support

180
Q

A young girl has just injured her ankle at school. In addition to calling the child’s parents, which is an immediate action by the school nurse?

A. Apply ice.

B. Encourage child to assume a position of comfort.

C. Obtain parental permission for administration of acetaminophen or aspirin.

D. Observe for edema and discoloration.

A

A. Apply ice.

The application of ice can reduce the severity of the injury.

181
Q

Which is an advantage to using a fiberglass cast instead of a plaster of Paris cast?

A. Dries rapidly

B. Smooth exterior

C. Molds closely to body parts

D. Cost effective

A

A. Dries rapidly

A synthetic casting material dries in 5 to 30 minutes as compared with a plaster cast, which takes 10 to 72 hours to dry. Synthetic casts are more expensive and have a rough exterior, which may scratch surfaces. Plaster casts mold closer to body parts.

182
Q

A neonate is born with bilateral mild talipes equinovarus (clubfoot). When the parents ask the nurse how this will be corrected, the nurse would give which explanation?

A. Children outgrow this condition when they learn to walk.

B. Traction is tried first.

C. Frequent, serial casting is tried first.

D. Surgical intervention is needed.

A

C. Frequent, serial casting is tried first.

183
Q

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome? (Select all that apply.)
Select all that apply.

A. Severe pain not relieved by analgesics

B. Inability to move extremity

C. Palpable distal pulse

D. Capillary refill to extremity less than 3 seconds

E. Tingling of extremity

A

A. Severe pain not relieved by analgesics

B. Inability to move extremity

E. Tingling of extremity

Severe pain not relieved by analgesics Indications of compartment syndrome are severe pain not relieved by analgesics, tingling of extremity, and inability to move extremity. A palpable distal pulse and capillary refill to the extremity less than 3 seconds are expected findings.

Inability to move extremity Indications of compartment syndrome are severe pain not relieved by analgesics, tingling of extremity, and inability to move extremity. A palpable distal pulse and capillary refill to the extremity less than 3 seconds are expected findings.

Tingling of extremity Indications of compartment syndrome are severe pain not relieved by analgesics, tingling of extremity, and inability to move extremity. A palpable distal pulse and capillary refill to the extremity less than 3 seconds are expected findings.

Module 5 (Pediatrics) (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions