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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 childā€™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

A

True

24
Q

Nursing care for casts

A 
Neurovascular assessment
Prevent edema
Prevent hidden infections
Pain control
Prevent damage of cast 
ADLs 
Education
25
Q

Talipes equinovarus

A

Club foot (obvious deformity noted at birth)

26
Q

InADEquate mnemonic

A

Inversion
Adduction
Equinus

27
Q

Talipes equinovarus (club foot) involves

A

Both bony structures and soft tissue

28
Q

With club foot the entire foot is pointing downward.

T or F

A

True

29
Q

Treatment for club foot

A 
Serial casting (often weekly)
Surgery at 4-6 mos if full correction is not achieved with casting
30
Q

Nursing diagnosis for children with club foot

A

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
Q

What is hip dysplasia

A

Abnormality in the development of the proximal femur, acetabulum, or both

32
Q

Hip dysplasia risk factors

A

Breech presentation
Large infant size
First-born females w/ history of a close relative with condition

33
Q

Assessment for hip dysplasia

A 
Barlow- femur appears shorter on the side of dislocation 
Limited abduction on affected side
Uneven skin folds
Trendelemburg sign
Ortalani "clunk"
34
Q

Types of hip dysplasia

A

Partial dislocation

Complete dislocation

35
Q

s/s of hip dysplasia

A

Head of femur lies outside the acetabulum
Positive ortolani maneuver
Asymmetrical lower extremity skin folds
Discrepancy in limb length

36
Q

Assessment for DDH

A

Barlow maneuver
Ortolani maneuver
Assess skin folds for asymmetry

37
Q

Newborn-

6 mos

A

**will watch and wait-may resolve on its own

Pavlik harness or other abduction methods

38
Q

Interventions for DDH

A 
Early detection
Maintain hips in flexed position
Traction to stretch muscles 
Pavlik harness
Hip surgery
39
Q

Intervention s for older children

A

Surgical correction

Casting (hip spica cast)

40
Q

Pavlik harness

A 
Continuous use 23hrs a day
strap position (mark on straps)
41
Q

Skin care when using harness

A

Undershirt/long socks
Clothing under harness
Inspect skin for any breakdown

42
Q

Hip dysplasia Nursing diagnosis

A

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
Q

What is scoliosis

A

Lateral Curvature of the spine

44
Q

Cause of scoliosis

A

Idiopathic (unknown)

Usually associated with rotary deformity & kyphosis

45
Q

When does the curvature occur

A

Around age 10

46
Q

S/s of scoliosis

A

Spinal ā€œSā€ 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
Q

Mild scoliosis

A

Strengthening and stretching

48
Q

20-40 degree back curve treatment

A

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
Q

Surgery when curve is

A

> 40 degrees: many procedures
Spinal alignment
Fusion with bone chips
Rod placed

50
Q

When does child wear brace

A

At night

51
Q

Children with scoliosis and a brace are at risk for impaired skin integrity.
T or F

A

True

Skin care, hygiene, and brace over at shirt are very important

52
Q

If pain a normal finding w/ scoliosis

A

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
Q

Nursing care of children w/ scoliosis

A

Examine skin for signs of irritation from brace
Cotton shirts should be worn under brace
Daily hygiene followed by thorough drying
Encourage compliance

54
Q

RN care S/P surgery

A

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
Q

Musculoskeletal differences in children

A 
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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