Orthopedic Conditions Flashcards
Clubfoot
Which parent education would the nure provide about the frequency of cast changes needed for an infant with talipes equinovarus (clubfoot)?
Each week
Casts are changed weekly to accomodate the rapid growth of early frequency
DDH
Six weeks after birth an infant is found to have developmental dysplasia of the hip. The nurse explains to the parents the benefits of early treatment.. Which is the rationale for the immediate institution of corrective measures?
Infants’ cartilaginous hip joints promote molding of the acetabulum
The cartilaginous hip joints are the basis for the use of abduction devices (e.g., Pavlik harness) and spice casts when the infant is very young
Factures
What type of fracture is common in preschool children?
Greenstick
Ossification of the long bones is incomplete in childhood; children’s bones can flex to about a 45-degree angle before breaking. When the bone is angulated beyond 45 degrees, the compressed side bends and the torsion side breaks (greenstick fracture).
DDH
Which clinical finding would the nurse expect during the physical assessment of an infant with developmental dysplasia of the hip (DDH)?
Limited abduction of the affected hip
In DDH, the head of the femur slips out the acetabulum and restricts abduction of the hip.
DDH
Which assessment finding would the nurse recognize as the Ortolani sign?
Audible click on hip manipulation
With specific manipulation, an audible click may be heard as the femoral head slips into the acetabulum; this is known as the Ortolani sign.
Scoliosis
What should the nurse tell the parent concerning an exercise program for her child diagnosed with idiopathic scoliosis who has a mild structural curve?
Exercise is used in conjuction with a brace
An exercise program and a brace are the treatments of choice for a mild structural scoliosis.
DDH
Which treatment would the nurse expect for a newborn with developmental dysplasia of the hip?
A fitted Pavlik harness
The Pavlik harness promotes hip abduction and flexion.
DDH
The home care nurse for a 3-month-old infant with developmental dysplasia of the hip sees the infant sleeping without the Pavlik harness. Which education would the nurse provide the parents?
Explain to the parent the importance of wearing the harness continuously
For optimal outcome, the harness should be worn continuously; some practitioners permit its removal for bathing.
DDH
Which procedure would the nurse use to elevate the head of an infant in a spica cast?
Raising the enite mattress at the head of the crib
When elevation of the head is desired, the entire mattress or crib should be raised at the head of the crib.
DDH
Which parent teaching would the nurse provide for a 4-month-old infant with a spica cast?
Obtain a specially designed car seat
Standard seat belts and car seats are not easily adapted for use by children in spica casts; specifically designed devices are available to meet safety requirements.
DDH
Which intervention would be included in the plan of care for a child immediately after the application of a spica cast?
Performing a neurovascular assessment of the legs
After cast application swelling may continue, which can cause presure that interferes with circulation. Assessment of capillary refill, sensation, movement, skin temperature, and skin color provides information about neurovascular integrity.
DDH
A mother asks the nurse how to keep her child’s spica cast clean. How would the nurse respond?
“Place plastic wrap or duct tape around the perineal edges of the cast.”
Suggesting the use of a protective nonabsorbent material is supportive, constructive, practical, and factural.
Muscular Dystrophy
Which intervention is appropriate for the nurse to teach the parent of a child with Duchenne muscular dystrophy?
Perform range-of-motion exercises.
Range-of-motion exercises are essential to help acieve the primary objectives of maintaining optimal muscle function for as long as possible and preventing the development of contractures.
Fractures
A toddler has just had a cast applied for a fractured wrist. The wrist and elbow are immobilized. Which information would the nurse include in the home care instructions before discharge? Select all that apply
SATA
Report swelling of fingers
Elevate casted arm when the child is standing
When swelling of the fingers occurs, the cast may become too tight, resulting in neurovascular damage; permanent damage can occur in 6 to 8 hours. The casted arm should be in a sling when the child is upright to promote venous return.
