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Mgmt of child > Musculoskeletal ppt > Flashcards

Musculoskeletal ppt Flashcards

1
Q

1 injury in children

A

Motor vehicle accidents

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2
Q

Fracture that has a high incidence with abuse

A

Spiral fracture

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3
Q

Sensation

A

Can the child feel touch on affected extremity

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4
Q

Motion

A

Can the child move fingers or toes below area of injury/nerve injury

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5
Q

Temperature

A

Is the extremity warm or cool to touch

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6
Q

Capillary refill assessment

A

Sluggish capillary refill may signal poor circulation

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7
Q

Color assessment

A

Note color of extremity and compare with unaffected limb

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8
Q

Pulse assessment

A

Asses distal to injury or cast

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9
Q

1 fracture in children

A

Green stick (bone is more pliable)

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10
Q

Neurovascular impairment

A

Restriction of circulation and nerve function from injury or immobilization device

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11
Q

Neurovascular assessment

A 
Sensation
Motion 
Temperature 
Capillary refill
Color 
Pulses
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12
Q

Types of fractures

A 
Transverse 
Simple 
Green stick 
Compound 
Comminuted
Spiral 
Oblique
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13
Q

Oblique fracture

A

On an angle

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14
Q

Compound fracture

A

Through the skin (increased risk for infection-osteomyelitis)

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15
Q

Comminuted

A

Crushed bone

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16
Q

Simple fracture

A

Small break in bone

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17
Q

Green stick fracture

A

Through periosteum but not completely through

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18
Q

Neurovascular impairment r/t cast

A

Relieve pressure by splinting cast or loosening restrictive bandage (notify physician)

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19
Q

Childs bones are less dense and more porous than adult bones, therefore they are not as strong and fracture easily.

T or F

A

True

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20
Q

Common place for injury in a child

A

Growth plate or epiphyseal plate fracture

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21
Q

Growth plate injury can lead to

A

Improper growth if not treated correctly

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22
Q

Periosteum of child’s bone

A

Thicker and AIDS in rapid healing

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23
Q

Adolescents that limit their intake of calories and calcium are at risk for stress fractures.
T or F

24
Q

Nursing care for casts

A 
Neurovascular assessment
Prevent edema
Prevent hidden infections
Pain control
Prevent damage of cast 
ADLs 
Education
25
Talipes equinovarus
Club foot (obvious deformity noted at birth)
26
InADEquate mnemonic
Inversion Adduction Equinus
27
Talipes equinovarus (club foot) involves
Both bony structures and soft tissue
28
With club foot the entire foot is pointing downward. | T or F
True
29
Treatment for club foot
``` Serial casting (often weekly) Surgery at 4-6 mos if full correction is not achieved with casting ```
30
Nursing diagnosis for children with club foot
Impaired mobility related to casts Altered parenting related to emotional reaction following birth b/c of defects Risk for skin integrity r/t cast Knowledge deficit: cast care & home care
31
What is hip dysplasia
Abnormality in the development of the proximal femur, acetabulum, or both
32
Hip dysplasia risk factors
Breech presentation Large infant size First-born females w/ history of a close relative with condition
33
Assessment for hip dysplasia
``` Barlow- femur appears shorter on the side of dislocation Limited abduction on affected side Uneven skin folds Trendelemburg sign Ortalani "clunk" ```
34
Types of hip dysplasia
Partial dislocation | Complete dislocation
35
s/s of hip dysplasia
Head of femur lies outside the acetabulum Positive ortolani maneuver Asymmetrical lower extremity skin folds Discrepancy in limb length
36
Assessment for DDH
Barlow maneuver Ortolani maneuver Assess skin folds for asymmetry
37
Newborn- | 6 mos
**will watch and wait-may resolve on its own | Pavlik harness or other abduction methods
38
Interventions for DDH
``` Early detection Maintain hips in flexed position Traction to stretch muscles Pavlik harness Hip surgery ```
39
Intervention s for older children
Surgical correction | Casting (hip spica cast)
40
Pavlik harness
``` Continuous use 23hrs a day strap position (mark on straps) ```
41
Skin care when using harness
Undershirt/long socks Clothing under harness Inspect skin for any breakdown
42
Hip dysplasia Nursing diagnosis
Knowledge deficit regarding care of harness or cast Impaired physical mobility Risk for impaired skin integrity Altered skin perfusion r/t cast or braces Risk for altered growth and development r/t limited mobility
43
What is scoliosis
Lateral Curvature of the spine
44
Cause of scoliosis
Idiopathic (unknown) | Usually associated with rotary deformity & kyphosis
45
When does the curvature occur
Around age 10
46
S/s of scoliosis
Spinal "S" curve Pain is NOT a normal finding for idiopathic scoliosis Often see an uneven hemline of skirts on girls Uneven hips Rub hump when bending over w/ arms hanging Asymmetric shoulder, scapula height
47
Mild scoliosis
Strengthening and stretching
48
20-40 degree back curve treatment
Bracing and exercise (Boston brace, Milwaukee brace-plastic & metal device with neck ring (less common) TLSO- custom molded plastic orthotic device Worn 16-23 hrs a day
49
Surgery when curve is
>40 degrees: many procedures Spinal alignment Fusion with bone chips Rod placed
50
When does child wear brace
At night
51
Children with scoliosis and a brace are at risk for impaired skin integrity. T or F
True | Skin care, hygiene, and brace over at shirt are very important
52
If pain a normal finding w/ scoliosis
No, pain is not a normal finding for idiopathic scoliosis, and the presence of their symptom could be signaling an underlying condition such as a tumor of the spinal cord
53
Nursing care of children w/ scoliosis
Examine skin for signs of irritation from brace Cotton shirts should be worn under brace Daily hygiene followed by thorough drying Encourage compliance
54
RN care S/P surgery
Special bed may be ordered(Stryker frame) Maintain proper body alignment-avoid twisting movements Log roll when moving child Encourage child to perform leg exexercises Walk slow w/ aid of a safety belt Administer opioids pcs until pain can be controlled without them Catheter care-urinary retention is common Assess for cast syndrome (poor circulation to gut and intestines)
55
Musculoskeletal differences in children
``` Epiphyseal growth plate present Bones are growing/heal faster Bones are more pliable Periosteum thicker and more active Abundant blood supply to bone The younger the child the faster the healing ```

Mgmt of child (5 decks)

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