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Pediatrics > Neuromusculoskeletal Issues > Flashcards

Neuromusculoskeletal Issues Flashcards

1
Q

[Blank] are the leading cause of death in children 1-19 years.

A

Unintentional injuries

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2
Q

Causes of immobilization

A

congenital defects
prolonged ventilation and sedation
surgical or traction

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3
Q

muscular effects of immobilization

A

loss of joint mobility
atrophy
decreased muscle strength

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4
Q

skeletal effects of immobilization

A

bone demineralization
unbalanced calcium

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5
Q

cardio effects of immobilization

A

orthostatic intolerance
increased workload of heart
clots

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6
Q

Respiratory effects of immobilization

A

decreased respiratory effort
reduction in movement of secretions

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7
Q

G.I. effects of immobilization

A

decreased mobility of the bowel
risk for aspiration

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8
Q

Renal effects of immobilization

A

hypercalcemia because renal is designed to function in an upright position
urinary retention
impaired ureteral peristalsis
difficulty voiding

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9
Q

Metabolism effects of immobilization

A

decreased metabolic rate
decreased production of stress hormones

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10
Q

Integumentary effects of immobilization

A

decreased circulation and pressure
risk for ischemia and damage

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11
Q

Neurosensory effects of immobilization

A

loss of innervation
range of motion
effects of improper positions
nerve tissue damage

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12
Q

Nursing care management for immobilization

A

physical assessment
wheelchairs, canes
ROM

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13
Q

one thing you have to do for a single spica cast?

A

note diaper to maintain dryness

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14
Q

Nursing care for amputation

A

assessment
positioning
pain management
elastic bandaging

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15
Q

what is the most frequently broken bone in children?

A

clavicle

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16
Q

comminuted fracture

A

small fragments of bone are broken and lie in surrounding tissues

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17
Q

greenstick fracture

A

compressed side of bone bends but tension side of bone breaks

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18
Q

Manifestations of fracture

A

generalized swelling
pain and tenderness
diminished functional use

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19
Q

Five Ps of fracture assessment

A

Pain and point of tenderness
Pulselessness
Pallor
Paresthesia (sensation distal to the fracture)
Paralysis (movement distal to fracture site)

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20
Q

Nursing management for fractures

A

alleviate pressure on nerves
pain management
palpate of cast for hot spots
pulses, skin color, temperature

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21
Q

Fracture complications

A

circulatory impairment
nerve compression syndromes
compartment syndrome
physeal damage

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22
Q

what is compartment syndrome?

A

when pressure within close space compromises circulation to muscle and nerves due to tight casts

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23
Q

Osteomyelitis

A

infection of the bone secondary to blood stream infection

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24
Q

Ankle-foot orthosis usage

A

used to prevent foot drop due to bedrest, trauma, or paralysis

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25
Q

Knee-ankle-foot orthosis usage

A

prevent buckling of the knee and to support extremity when there is paralysis

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26
Q

Hip-knee-ankle-foot usage

A

to provide various types of control for the knee and ankle joints

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27
Q

Stages of bone healing

A

1.) hematoma formation
2.) cellular proliferation
3.) callus formation
4.) ossification
5.) consolidation and remodeling

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28
Q

P.E should be suspected in a child with a hx of what?

A

recent surgery, major trauma, prolonged immobilization

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29
Q

Sign of P.E.

A

sudden chest pain and dyspnea

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30
Q

Osgood-Schlatter Disease

A

due to over usage of limb
ligaments tear away from the tibial shaft

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31
Q

Torticollis “wry neck”

A

limited neck motion

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32
Q

nursing care of child with pavlik harness

A

check skin 2-4 times a day
massage to stimulate circulation
avoid lotions and powders
place diaper under straps

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33
Q

Legg-Calve-Perthes disease

A

Avascular necrosis of femoral head

34
Q

Therapeutic management for legg-calve-perthes disease

A

rest and activity restriction
give NSAIDs
physical therapy to restore ROM
possible surgery

35
Q

Two types of osteomyelitis

A

exogenous
hematogenous

36
Q

Exogenous osteomyelitis

A

infectious agent invades the bone after open fracture or penetrating wound

37
Q

hematogenous osteomyelitis

A

preexisting infection spreads to bone

38
Q

Juvenile idiopathic arthritis

A

chronic childhood arthritis, inflammation in surrounding tissues of joints

39
Q

Manifestations of JIA

A

stiffness of joints in morning
swelling
loss of mobility
warm to touch
tender to touch
soft tissue contractions

40
Q

Systemic Lupus Erythematosus

A

chronic autoimmune disease of connective tissues and blood vessels

41
Q

Manifestations of SLE

A

abdominal pain
arthralgia
glomerulonephritis

42
Q

Hallmark signs of SLE

A

butterfly rash
photosensitivity
oral ulcers

43
Q

Clubfoot

A

deformity of the ankle and foot

44
Q

talipes varus

A

inversion (foot bending inward)

45
Q

talipes valgus

A

eversion (foot bending outward)

46
Q

talipes equinus

A

“horse foot” plantar flexion where toes are lower than heels

47
Q

talipes equinovarus

A

toes are facing inward and lower than heel

48
Q

patient education and nursing care for child with clubfoot

A

encouraging holding and cuddling
meet developmental needs
perform neurovascular and skin integrity checks

49
Q

what are two effects of casting?

A

skin breakdown
neurovascular alterations

50
Q

s/s of Legg-Calve Perthes disease

A

hip stiffness
limited ROM
intermittent painless limp
shortening of the affected leg

51
Q

complications of legg-calve perthes

A

joint degeneration
permanent disability

52
Q

Types of Developmental dysplasia of the hip

A

Acetabular, subluxation, and dislocation

53
Q

Acetabular dysplasia

A

delay in acetabular development

54
Q

Subluxation

A

incomplete dislocation of the hip

55
Q

dislocation

A

femoral head does not have contact with acetabulum

56
Q

risk factors for DDH

A

birth order
family hx
breech
LGA

57
Q

expected findings for DDH

A

asymmetry
shortening of the femur
widened perineum
one leg shorter than the other

58
Q

Osteogenesis imperfecta

A

inherited connective tissue condition that results in bone fractures, deformity and restricted growth

59
Q

expected findings for osteogenesis imperfecta

A

multiple bone fractures
blue sclera
hearing loss
small, discolored teeth

60
Q

patient education for OI

A

caution with live vaccines
low impact exercises
consult with PT

61
Q

complications of OI

A

disuse osteoporosis
hearing loss
permanent deformities

62
Q

Cerebral palsy

A

nonprogressive impairment of motor function

63
Q

s/s of CP

A

failure to meet milestones
choking w/ feeding
tongue thrust
poor head control
rigid posture
seizures

64
Q

Spastic CP

A

muscle tightness or spasticity
can present in a extremities
gait can appear crouched

65
Q

Dyskinetic CP

A

non-spastic
involuntary jerking movements

66
Q

Ataxic CP

A

lack of coordination, can’t reach an object

67
Q

Medications for Cerebral palsy

A

baclofen and diazepam

68
Q

Baclofen and what are the nursing actions?

A

skeletal muscle relaxant
monitor for increased fatigue, nausea, or hepatoxicity

69
Q

two complications of cerebral palsy

A

aspiration and injury

70
Q

Spina bifida

A

neural tube defect present at birth; failure of the osseous spine to close

71
Q

Spina bifida cystica

A

protrusion of sac is visible

72
Q

Meningocele

A

sac contains spinal fluid and meninges
risk of infection if ruptures

73
Q

Myelomeningocele

A

common
sac contains spinal fluid, meninges, and nerves

74
Q

risk factors for spina bifida

A

medications or drugs during pregnancy
maternal malnutrition
lack of folic acid

75
Q

assessment findings for spina bifida occult

A

dimpling in lumbosacral area
hair tuft

76
Q

assessment findings for spina bifida cystica

A

flaccid muscles
lack of bowel control
prolapse of rectum
protruding sac

77
Q

nursing care for spina bifida

A

assess sac
assess LOC
infection precaution

78
Q

nursing preoperative actions for spina bifida

A

protect sac
apply sterile dressing moist with 0.9% NS
place infant in incubator without clothes
avoid rectal temps or cuddling
don’t remove dressing if dry, add more saline

79
Q

complications of spina bifida

A

increased intracranial pressure, skin ulceration, latex allergy, bladder and/or bowl issues, orthopedic issues

80
Q

Muscular dystrophy

A

progressive degeneration of skeletal muscle groups

81
Q

expected findings for muscular dystrophy

A

fatigue
unsteady gait
muscle weakness
delayed motor skill

Pediatrics (17 decks)

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