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NUR 440 Exam 2 > Musculoskeletal & Infectious Disesae > Flashcards

Musculoskeletal & Infectious Disesae Flashcards

1
Q

Child Bone Development

A 
Around 300 bones
Large Cartilage components
Bones are more flexible! 
Sense periosteum
Open epiphyseal plate
Spine C shaped
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2
Q

Adult Bone Development

A

206 Bones
Bones are ossified
Bones more dense and rigid
Spine S- shaped

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3
Q

Factors in Bone Development

A

Genetics, Gender (girls at 12, boys at 14), weight bearing exercise, nutrition, environment, sleep- microtears repair during sleep
Vit D, Calcium
Milk 3, 8oz glasses a day

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4
Q

Musculoskeletal System Assessment

A 
History
Size and symmetry
Joint ROM
Gait- Limping is NEVER NORMAL! Toe walking
Muscle strength and tone equal
Developmental milestones
Nutrition
Pain
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5
Q

Diagnostic and Lab Tests

A

Xray- great diagnostic tool, Bone scan - stress fractures , CT, MRI, ultrasound, Bone marrow biposy, muscle biposy, serum enzymes

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6
Q

Nursing Diagnnosis Muscuoloskeletal Conditons

A

Self care deficit
Skin breakdown
Altered mobility, comfort

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7
Q

Congenital Club Foot Etiology

A

Unknown cause, abnormal intrauterine positioning, family hx

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8
Q

Congenital Club Foot Treatment

A

Non-operative serial casting ASAP after birth
Casting ever 1 to 2 weeks
Surgery may be required, following long cast and bracing

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9
Q

Congenital Club Foot Nursing Care

A

Long range planning for casting and appointments
Promotion of normal developmental needs
Cast care
Monitoring neuromuscular function
5 P’s : Pallor, Pain, Pulses, Peristia (numbness), Paralysis

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10
Q

Developmental Dysplasia of the Hip Etiology

A 
Rotate legs out, feel a clicking, pops in and out of the socket
Maternal hormones
Intrauterine positioning
Delivery Methods
Postnatal positioning
Genetic Factors
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11
Q

Developmental Dysplasia of the Hip Treatment

A

Pavlik Harness- newborn to 6 months
Spica Cast- 6 to 18 months
Closed surgical reduction with casting

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12
Q

Developmental Dysplasia of the Hip Nursing Care

A

Monitor skin breakdown
Teaching for parents and caregivers
Promotion of normal developmental activities
Is the harness on correctly? How will the child get home?

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13
Q

Bow Leg

A

Knees out
2inches
Should grow out of it at age 3

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14
Q

Knock Knee

A

Knees in
3 inches between feet
Should grow out of it at age 3

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15
Q

Legg- Calve- Perthes Disease

A

Most common in boys 4-8 years
Interruption of blood supply- coag disorder
Genetic and family history
Mild trauma to site

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16
Q

Legg- Calve- Perthes Disease Progression

A 
Pre-necrosis- insult to blood supply
Necrosis/ asymptomatic- 3-6 months
Re-vasularization- 1-4 years
Bones Healing- re-ossification
Remodeling- improved joint function
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17
Q

Legg- Calve- Perthes Disease Treatment

A

Bracing or traction

Surgery to release muscles, treat acetabulum or femur and restore range of motion

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18
Q

Legg- Calve- Perthes Disease Complications

A 
If left untreated:
Osteoarthritis
Hip Dysfunction
Shortened Height
Leg length discrepancy
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19
Q

Slipped Capital Femoral Epiphysis

A 
Typically 11-12 yo
Limping, hip pain, femur slips out of joint
Obesity
Recent growth spurt
Hypothyroidism
Hypogonadism
Can be acute or gradual
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20
Q

Slipped Capital Femoral Epiphysis Manifestations

A

Pain in affected hip or referred to knee

Change in hip range of motion

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21
Q

Slipped Capital Femoral Epiphysis Treatment

A

Surgical fixation of hip and bone graft

Then Spica Cast or Russell traction

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22
Q

Slipped Capital Femoral Epiphysis Nursing Care

A 
Pain management
Monitor for complications of immobility
Traction of cast care
Body image
Weight control
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23
Q

Scoliosis

A

Congenital, idiopathic, acquired
Truncal asymmetry, uneven shoulders, uneven hips, one sided rib hump, prominent scapula, hip and back pain, extreme fatigue, dyspnea with exertion

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24
Q

Scoliosis Treatment

A

Mild: 10-20 degree curve, physical therapy to improve posture and muscle strength and tone
Moderate: 20-40 degrees, Bracing to maintain current level of curve, does not reduce
Severe: >40 degrees, spinal fusion with segmental instrumentation

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25
Muscular Dystrophy- Duchenne's
``` Genetic Autosomal recessive Lower extremities weakness Gower Sign- Standing up abnornamlly Toe- walking Tripping, Limping Enlarged calves Progress to complete immobility, respiratory difficulty and failure, cardiomyopthy, fractures and chronic disability Eventually wheelchair ----- death ```
26
Muscular Dystrophy- Duchenne's Treatment
Supportive and Palliative Care Minimize family dysfunction Maximize function and quality of life Infection prevention, skin care, respiratory and nutritional support, PT and OT, parent support
27
Plastic Deformation Fracture
Bending of the bone
28
Buckel/ Torus Fracture
??
29
Greenstick Fracture
Most common | Not all the way through
30
Complete Fracture
Complete break
31
Common Fracture Sites
Radius, Clavicle, Femur
32
Fracture Nursing Care
``` 8 week recovery 5 P Check Monitor for compartment syndrome Pain management Infection control and asepsis Monitor neurovasular status Cast Care Activity restriction ```
33
Osteomyelitis
Infection of the bone Long bone of lower extremity is most common Can spread to soft tissue
34
Osteomyelitis Manifestations
Pain, edema, decreased mobility, fever, redness surrounding affected area
35
Osteomyelitis Treatment
IV antibiotics 3-6 weeks | PICC Line
36
Nursing Role in Immunization
``` Reduce transmission of infections Educate parents Screen for eligibility Promote and provide immunizations Reduce pain and anxiety with administration Monitor for side effects ```
37
Safe Administration of Immunizations
``` 22-25 g needle 5/8 in for newborns 1 in for 2-12 months 1 & 1/4 in Toddler MAX 1cc ```
38
Varicella Complications
Prevent with vaccine! | Complications: cellultis, pneumonia, sepsis, meningitis, reye's syndrome, can be fatal!
39
Varicella Vaccine
Subcut Live virus 12-15 months AND 4-6 years Do not give to immunosuppressed or allergic to neomycin or gelatin Childbearing age girls avoid pregnancy for 3 months
40
Diphtheria Infection
Bacterial Cough, stidor, nosiey breathing, bluish white gry covering oropharynx, tonsils, soft, hard palate, severe sore throat, enlarged cervial lymph nodes
41
Diphtheria Infection Complications
Endotoxins can cause myocarditis Guillian Barre! Severe Respiratory distress *Last seen in 2003*
42
Diphtheria Infection Vaccine
Inactivated | Given with DTAP, 5 doses
43
Haemophilus Influenza Type B Infection
Bacterial Manifestations specific for target site Complications: meningitis, epiglottis, sinusitis, pneumonia, cellulitis and death in young infants Vaccine: Inactivated, 4 doses
44
Influenza A/B Viral Infection
Chills, cough, runny nose, sore throat, malasise, aches, HA, nausea, Anorexia, vomittingm diarrhea, abdominal pain, croup
45
Influenza A/B Viral Infection Complications
Ear infection, exacerbation of lung disorders, pneumonia, myostitis, myocarditis, Guillian Barre
46
Influenza A/B Viral Infection Vaccine
``` Inactivated for all ages Live for 2 and older Yearly after 6 months 1st time <9 yo, 2 doses 4-6 weeks apart 80% effective ```
47
Rubeola (Hard Measles)
Rash starts 2-4 days after prodromal period Begins on face and spreads to trunk and extremities Symptoms lasts 4-7 days Generalized Malaise, fatigue, lymphadenopathy, anorexia, cough Lesions can erupt on mucus membranes in mouth
48
Rubeola (Hard Measles) Complications
Ear infection, pneumonia, encephalitis, bronchitis, death | The younger the more at risk
49
Rubeola (Hard Measles) Vaccine
Subcut Live, given with MMR 2 doses Egg allergy= observe 90 minutes after injection Avoid pregnancy for 4 weeks post immunization
50
Parotitis (Mumps)
Bilateral or unilateral parotid gland swelling, peaking by the third day Meningeal irritation: stiff neck, HA and photophobia Can be confused with cellulitis
51
Parotitis (Mumps) Complications
Orchitis, inflammation of the epididymis, scrotal swelling, pancreatitis, glomerulonephritis, myocarditis, hearing impairment, cerebellar, ataxia
52
Parotitis (Mumps) Vaccine
Subcut Live Given with Measles and MMR 2 doses
53
Pertussis
Bacterial infection Prodomal Stage 1- nasal congestion, runny nose, low grade fever, mild non-productive cough for 2 weeks Paroxymal Stage 2- severe cough at night, thick mucus plugs, whooping sound after breathing, periods of hypoxai and apnea- 6 weeks Convalescent Stage 3- Paroxysms gradually subsitde
54
Pertussis Vaccine
DTAP and TDAP with Diptheria and tetanus 5 doses Encouraged to get TDAP when tetanus booster
55
Poliomyelitis
Viral Infection Prodromal: Fever, HA, back ache, vomitting and sore throat Manifestations: Affects CNS, vomitting, sore throat, stiff neck, progressive weakness, meningeal irritation, respiratory tract muscle weakness, paralysis
56
Poliomyelitis Complications
Permanent motor paralysis, respiratory arrest, myocardial failure, aseptic meningitis, post polio syndrome
57
Poliomyelitis Vaccine
Subcut or IM 4 doses Contraindicated in pregnancy, children with hypersensitivity to neomycin, streptomycin or polymyxin B
58
Rotavirus
Viral Infection Watery diarrhea 1-2 days, following fever and vomiting 10-20 stools a day, symptoms can last 3-8 days Complications: dehydration, electrolyte imbalance, death in some cases Vaccine: Oral, Live, 3 doses
59
Rubella
Viral Infection Prodomal: 1-5 days before rash, low grade fever, HA, malaise, sore throat, anorexia, pinpoint lesions on soft palate, generalized lympthadenopathy, 7 days before rash appears
60
Rubella Clinical Manifestations
Pink, non-confluent, maculopapular rash on the face | Rash progresses to neck, trunk and legs
61
Rubella Complications
Dangerous to pregnant women
62
Rubella Vaccine
Subcut Live 2 doses
63
Tetanus
``` Bacterial Infection Stiffness of the neck and jaw Painful facial spasms, HA, difficulty chewing and swallowing Prolonged and painful muscle spasms Suffocation from respiratory spasms Increased oral secretions ```
64
Tetanus Complications
Laryngospam, respiratory distress, death
65
Tetanus Vaccine
5 doses | Booster every 10 years
66
Erythema Infectiosum 5th Disease
``` Viral Infection Fiery-red rash on cheeks Later a lacy, erythmatous maculopapualr rash on trunk and limbs Circumoral pallor Rash lasting up to 3 weeks No vaccine ```
67
Lyme Disease
Bacterial Infection | Prodromal: malaise, fatigue, HA, stiff neck, milk fever, and muscle and joint aches
68
Lyme Disease Manifestations
1-4 months later, multiple erythema migran, cranial nerve palsy, HA, meningitis, fatigue Arthritis months later
69
Lyme Disease Complications
Neuro deficits- Bell's palsy, encephalopathy, optic neuropathy, peripheral nerve disorders

NUR 440 Exam 2 (4 decks)

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