Pediatric Assessment and Intervention Flashcards
bradydysrhythmia
abnormally slow heart rate (
tachydysrhythmia
abnormally fast heart rate (>200-300 beats/min)
can lead to CHF
sickle cell anemia
decreased energy for daily tasks
pain and require intervention for pain management
Osteogenesis imperfecta
brittle bones
marfans syndrome
excessive growth at the epiphyseal plates
long slender fingers, skull symmetries, tall stature.
hypermobile joints and poorly developed striated muscles
achondroplasia
stunting of epiphyseal plate growth and cartilage formation.
usually grow 4 feet or less in height
limbs have typical width but shorter in length
arthrogryposis multiplex congenital
incomplete contracture of many joints.
stiff spindly extremities and the appearance of thickened knee and elbow joints. their muscles may be underdeveloped and may experience paralysis.
club hand
partial or full absence of the radius and bowing of the ulnar shaft
polydactyly
a person has excess fingers or toes
syndactyly
webbing occurs between the fingers or toes
bradydactyly
overly large digits
microdactyly
overaly small digits
amelia
absence of a limb or distal segments of a limb
pauciarticular JRA
less than 5 joints involved
polyarticular JRA
more than 5 joints involved
systemic JRA
polyarticular and organ involvement is present. hight fever, rash, anorexia, elevated white blood count .
complete fracture
the bone is broken into many splintered pieces
comminuted fracture
the broken bone leads to an external wound at the site of the fracture and bone often protrudes through the skin
epiphyseal fracture
the break occurs between the shaft of the bone and the epiphysis. this only occurs in peds clients
greenstick fracture
the bone is partially broken and partially bent. only occurs in children
lordosis
anteroposterior curvature directed posteriorly. lumbar region
secondary to anterior pelvic tilt
tx: stretching tight hip flexors, strengthening abs, postural training, back bracing
kyphosis
upper back
tx: postural training, strengthening, milwaukee brace, anterior spinal release and posterior spinal fusion.
scoliosis curves
mild
scoliosis curves >40 degrees
result in permanent deformity
curves of 65-80 degrees
result in reduced camrdiopulm. function
tx: boston brace
thoracolumbosacral orthotic
hemiplegia
affects UE and LE on one side of the body.
quadriplegia
also tetraplegia. affect UE and LE on BOTH sides of the body
diplegia
quadriplegia with mild UE involvement and significant involvement of the LE
spasticity
increased flexor or extensor tone
athetosis
punctuation of tone from low to normal with little spasticity
choreoathetosis
constant fluctuations from low to high tone without contractions typically appears as jerky movements
flaccidity
marked low tone (usually progress to spasticity)
ataxia
tone usually within the normal range but involving lower-extremity flexion patterns
stabismus
eye alignment deviation
nystagmus
reflexive back-and forth mvmt of the eyes when the head moves
dysarthria
difficulty pronouncing or articulating words
tonic clonic seizure
most frequent type; the person experiences a sensation that the seizure is about to begin. usually follow by a loss of consciousness and rhythmic clonic contractions. the seizure may last as long as 5 min.
absence seizures
a brief lapse or loss of awareness along with the absence of motor activity. lasts 30 sec. or longer may be mistaken for daydreaming
cyclonic seizures
contractions of single muscles or muscle groups
akinetic seizures
loss of muscle tone for more than 30 min
status epilectus
extended seizures prompt medical intervention needed to maintain body functions and hydration
complex partial seizures
originiate in the temporal lobe and appear as lip smacking, chewing, or buttoning and unbuttoning clothing. similar to absence seizures
simple partial seizures
originate in the motor cortez and results in clonic activity of the face or extremities. may experience visual or auditory hallucinations or olfactory sensations .
facioscapulohumeral muscular dystrophy (MD)
affects face, upper arms, scap region. sloped shoulders and limited ability to raise arms above head. manlike appearance in face
duchennes MD
most common form. affecting only boys
enlarged muscles and a positive GOWER’s sign
have difficulty going up and down the stairs and getting up from a lying down position. progress quickly and wheelchair by age 9. die near their 20s as a result of respiratory problems or cardiovascular complications.
congenital MD aka (CMD)
onset in utero or during the 1st year of life. brain involvement is apparent along with neuromuscular functioning. It is characterized by hypotonia, generalized weakness, and contractures.
CMD 1
does no involve severe intellectual functioning
CMD 2
involves muscle and brain abnormalities
CMD 3
involves muscle, brain, and eye abnormalities
CMD 4
involves muscle, brain, and eye abnormalities.
encephalocele
a protrusion in the occipital region of the brain. typically associated with severe deficits such as cognitive impairments, hydrocephalus, motor impairments and seizures.
anecephaly
neural development above the level of the brain stem is lacking. do not survive infancy.
spina bifida
the most common type of neural tube defect. mild form is spina bidifa occult and no symptoms may be present.
myclomeningocele
most severe form of spina bifida. children usually display sensorimotor problems at or below the level of lesion. LE paralysis and loss of sensation is common. complications include hydrocephalus and arnold-chiari syndrome
erb-duchenne palsy
caused by an injury to the upper brachial plexus (the C5 and C6 nerve fibers, such as extreme sh. flexion (with arm overhead).
weakness or wasting of the small muscles of the hands and sensory discrimination in the hand and arm. typically unilateral
looks like waiters tip position
Klumpke’s palsy
compression or traction of the lower brachial plexus. (c8 and T1).
paralysis of the hand and wrist muscles (aka claw hand deformity)
fabrication of a sling that fits proximally around the humerus to ensure proper alignment and prevent subluxation due to gravity. PROM and AROM exercises, tactile stem, engagement in activities that are bilateral in nature to increase body scheme,
TBI acute care intervention
sensory stim, ROM, positioning, splinting
TBI rehab intervention
assessments, regaining function with ADLS, regaining function with IADLs, regaining executive functioning, training on AD for school.
TBI community reentry intervention
home and community visits to assess activity demands and to problem solve strategies, home or school modifications and introducing to AD, collaborating with school personnel, family and rehab team.
Mild ID (intellectual disability) IQ:
between 55-70 ability to learn academic skills at the 3rd-7th grade leave. able to work with minimal support
Moderate ID (intellectual disability) IQ:
between 40-55. able to learn academic skills at least the 2nd grade level and able to perform unskilled as well as some skilled work tasks
severe ID (intellectual disability) IQ:
25-40. able to communicate and perform some basic ADLs and health habits. often requires support to complete routines
profound ID (intellectual disability) IQ:
below 25. requires caregiver assistance for basic tasks also generally has neuromuscular, orthopedic or behavioral deficits
Rett syndrome
found only in girls. development appears normal for the first 6 mo. of age. the childs head growth beings to slow and she loses hand skills and demonstrates poorly coordinated trunk and gait coordination. initially a loss of social skills occurs but social skills reemerge later. common behavior is handwringing and other repetitive behaviors. usually non ambulatory and nonverbal by late childhood.
Trisomy 13 or Patau’s syndrome
have multiple anomalies affecting their eyes, ears, nose, lip, palate, and digits only 20% of children survive.
Turner’s syndrome
present with webbing of the neck, congenital edema of the extremities and cardiac problems. may be short may develop obesity. may have difficulty with visual perception.
Klinefelter’s syndrome
learning disabilities and emotional/behavioral problems. they are tall, slim, and have small genitalia and unable to father children.
neurofibromatosis
multiple tumors. have mild ID or learning disabilities, speech disorders, short stature, and skeletal anomalies.
William’s syndrome
present with cerebral and cardiovascular abnormalities. have an ID, but characteristic affinity for music, social skills, and writing. difficulty with visual, spatial and motor skills.
Phenylketonuria (PKU)
error in processing amino acid in proteins. The GUTHRIE test can be done at birth to diagnose. diet is the primary means to treat PKU. may resolve around age 10.
Galactosemia
the inability to convert milk sugar to glucose which could result in spleen and liver dysfunction. avoid milk products and breast milk.
neurodelopmental approach (handwriting)
activities that modulate muscle tone
activities that promise proximal joint stability
activities that improve hand function
acquisition approach (handwriting)
handwriting should be taught directly
should be implanted in brief daily lessons
should be individualized to the child
should be overland and used in a functional way.
biomechanics approach
sitting posture, paper position, pencil grip and adjustment, paper modifications.
Ayres sensory integration
proximal senses are emphasized in a childs early life.
a. vestibular
b. tactile
c. proprioceptive
distal senses are not through to have a large impact until later in childhood.
a. vision
b. hearing
facilitation
observing the child and improving the childs environmental supports
monitoring
observing the child and letting the child know the OT is present. encouraging the child, using guiding questions to prompt the child to problem solve
gentle correction
characterized by altering the environment, reminding the child of the expectations, modeling the appropriate behavior, and redirecting the child to another location or activity.
moderate correction
giving the child a break by redirecting the child
strong correction
a time out, that is tie away from the activity until the child is calm.
