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RN Nursing Care of Children > Pedi Musculoskeletal Disorders > Flashcards

Pedi Musculoskeletal Disorders Flashcards

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1
Q

Fractures

Healing

A

Bone healing and remodeling is faster in children than adults due to thicker periosteum and good blood supply

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2
Q

Fractures

Risk Factors

A

Obesity
poor nutrition
developmental characteristics

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3
Q

Fractures

Evidence

A

radiographic evidence of previous fractures in various stages of healing or in infants may = physical abuse or osteogenesis imperfecta

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4
Q

Fractures

Stress

A

tiny cracks in bone

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5
Q

Fractures

Spiral

A

break spirals around bone

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6
Q

Fractures

Greenstick

A

incomplete fracture of bone

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7
Q

Fractures

Plastic deformation (bend)

A

bone is bent no more than 45 degrees

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8
Q

Fractures

Buckle (torus)

A

compression of bone = bulge or raised area at fracture site

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9
Q

Fractures

Transverse

A

break is straight across bone

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10
Q

Fractures

Oblique

A

break is diagonal across bone

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11
Q

Fractures

Growth Plate

A

injury to end of long bone on growth plate

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12
Q

Fractures

Complete

A

Bone fragments are separated

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13
Q

Fractures

Incomplete

A

Bone fragments are still attached

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14
Q

Fractures

Closed or simple

A

fracture occurs without a break in the skin

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15
Q

Fractures

Open of compound

A

fracture occurs with an open wound and bone protruding

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16
Q

Fractures

Complicated fracture

A

fracture results in injury to other organs and tissues

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17
Q

Fractures

Manifestations

A 
Pain
Crepitus
deformity
edema
ecchymosis
warmth or redness
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18
Q

Fractures

Diagnostics

A

X-ray

MRI

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19
Q

Fractures

Nursing Care

A

ABCs
VS, pain, neurological status
Neurovascular status of injured extremity
supine position
stabilize injured area, elevate and apply ice
keep client warm

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20
Q

Pain Scales

A

toddler - FLACC Scale
pre-school - Faces
5 years and older - Numeric pain scale

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21
Q

Fractures

Plaster of Paris

A

heavy, not water resistant, 10-72 hrs to dry

22
Q

Fractures

Synthetic fiberglass

A

light, water resistant, 5-20 min to dry

23
Q

Fractures

Prior to casting

A

observe skin for integrity
clean and dry
pad to bony prominences
show procedure on doll/toy

24
Q

Fractures

Casting

Nursing care

A

assess and monitor neurovascular status
elevate above heart for first 24-48 hr to prevent swelling
ice for first 24 hr
turn and position q2h
support/elevate when sitting
assess for increased warmth or hot spots could indicate infection
monitor for drainage: outline area with a marker and date and time the area
use moleskin over any rough areas that might rub against skin
assist with proper crutch fitting and reinforce proper use

25
Q

Fractures

Casting

Family Education

A

When cast is applied it will feel warm but won’t burn
if pain is sever and not alleviated within 1 hr of pain med admin call MD
teach neurovascular checks and when to call MD
explain cast removal and cast cutter

26
Q

Traction

A

selection of traction determined by type of fracture, age of client, associated injuries

27
Q

Traction

Skin traction

A

uses pulling force that is applied by weights
Buck, Russell, Bryant
Russell - assess child’s position, hip flexion must be maintained
do not remove boots
weights hang freely

28
Q

Traction

Skeletal traction

A

continuous pulling force applied to specific bone
pin or rod inserted through bone
force applied through use of weights attached by rope
allows child to change position without interfering with pull of traction (90/90 traction- femur/tibia)
assess pin sites for infection and provide care per facility protocol

29
Q

Traction

Halo

A

cervical traction
halo bar encircles head
screws inserted into outer table of skull
attached to either bed traction or rods secured to a vest
assure that wrench is available to release rods attached to vest to do CPR

30
Q

Compartment syndrome

A

compression of nerves, blood vessels, muscle inside confined space

31
Q

Compartment syndrome

Manifestations

A

increased pain unrelieved with elevation or analgesics
intense pain when passively moved
paresthesia or numbness
pulselessness distal to fracture
inability to move digits
warm digits with skin that is tight and shiny
pallor

32
Q

Compartment syndrome

Prevention

A

loosen constrictive dressing or cut bandage or tape
elevate extremity apply ice
prepare for fasciotomy

33
Q

Clubfoot

A

deformity of ankle or foot
can affect one or both feet
isolated defect or in association with other disorders such as cerebral palsy and spinal bifida

34
Q

Talipes varus

A

inversion - bending inward

35
Q

Talipes valgus

A

eversion - bending outward

36
Q

Talipes calcaneous

A

dorsiflexion - toes are higher than heels

37
Q

Talipes equinus

A

plantar flexion - toes are lower than heels

38
Q

Talipes equinovarus

A

toes are facing inward and lower than heel

39
Q

Talipes equinus

Sign of

A

sign of

40
Q

Clubfoot

Diagnostic

A

Prenatal ultrasound

41
Q

Clubfoot

Nursing Care

A

hold and cuddle
developmental needs
neurovascular and skin integrity
perform and teach cast care

42
Q

Clubfoot

Therapeutic procedures

A

Castings

Series of casting starting shortly after birth and continuing until maximum correction

43
Q

Clubfoot

Surgical interventions

A

osteotomy - removing part of bone
fusion - fusing two or more bones together
tendon lengthening or shortening

44
Q

Developmental Dysplasia of the Hip DDH

Manifestations

A

Infant: asymmetry of gluteal and thigh folds; limited hip abduction; shortening of femur; positive Ortolani test - reduced by abduction; positive Barlow test - dislocated by adduction

Child: one leg shorter; positive Trendelenburg sign - bear weight affected side pelvis tilts down toward unaffected sign; walking on toes on one foot; walk with limp

45
Q

DDH

Treatment

Newborn - 6 mos

A

Pavlik harness for 12 weeks - check straps every 1-2 weeks; shirt worn under harness
Bryant traction - skin traction; for adduction contracture; hips flexed 90degrees with buttock raised
Hip spica cast - needs to be changed to accommodate growth; cast on pillows

46
Q

DDH

Treatment

6 mos - 2 years

A

surgical closed reduction with placement of hip spica cast

47
Q

DDH

Complications

A

post-op complications - atelectasis, ileus, infection
effects of immobilization - decreased muscle strength, bone demineralization, altered bowel motility
effects of casting - skin breakdown, neurovascular alterations

48
Q

Osteogenesis Imperfecta (OI)

A

disorder of bones resulting in fractures and deformity

49
Q

Osteogenesis Imperfecta (OI)

Manifestations

A 
multiple bone fractures
blue sclera
early hearing loss
bowed legs and arms
kyphosis
scoliosis
50
Q

Osteogenesis Imperfecta (OI)

Medication

A

pamidronate - increase bone density
IV
adverse effects: hypokalemia, hypomagnesemia, hypocalcemia, hypophosphatemia, general malaise

51
Q

Scoliosis

A

deformity of spine and affects ribs
curve greater than 10 degrees
child bend over observe for asymmetry of ribs and flank

52
Q

Scoliosis

Treatments

A

Bracing
Surgical interventions (greater than 45 degrees curvature) - spinal fusion with rods; autologous (self-donated) blood donations
post-op: monitor pain, admin analgesia using PCA pump
frequent turning to prevent damage to the spinal fusion

RN Nursing Care of Children (10 decks)

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