Skeletal Disorders

Question 1

List normal findings in an neurovascular assessment.

Answer 1

Warm extremity, brisk capillary refill, free movement, normal sensation of the affected extremity, and equal pulses

Question 2

What is compartment syndrome?

Answer 2

Damage to nerves and vasculature of an extremity due to compression

Question 3

What are the signs and symptoms of compartment syndrome?

Answer 3

Abnormal neurovascular assessment: cold extremity, severe pain, inability to move the extremity, and poor capillary refill

Question 4

Why are fractures of the epiphyseal plate (a hyaline cartilage plate in the metaphysis at each end of a long bone) a special concern?

Answer 4

Fractures of the epiphyseal plate (growth plate) may affect the growth of the limb.

Question 5

How is skeletal traction applied?

Answer 5

Skeletal traction is maintained by pins or wires applied to the distal fragment of the fracture

Question 6

What discharge instructions should be included concerning a child with a spica cast? (a sort of orthopedic cast used to immobilize the hip or thigh. It is used to facilitate healing of injured hip joints or of fractured femurs)

Answer 6

Check child’s circulation. Keep cast dry. Do not place anything under cast. Prevent cast soilage during toileting or diapering. Do not turn child using an abductor bar.

Question 7

What are the signs and symptoms of congenital dislocated hip in infants?

Answer 7

Unequal skin folds of the buttocks, Ortolani sign, limited abduction of the affected hip, and unequal leg lengths

Question 8

How would the nurse conduct a scoliosis screening?

Answer 8

Ask the child to bend forward from the hips, with arms hanging free. Examine the child for a curve in the spine, a rib hump, and hip asymmetry.

Question 9

What instructions should a child with scoliosis receive about a skeletal brace?

Answer 9

The child should be instructed to wear the brace 23 hours per day; wear a T-shirt under brace; check skin for irritation; perform back and abdominal exercises; and modify clothing. The child should be encouraged to maintain normal activities as able.

Question 10

What care is indicated for a child with juvenile rheumatoid arthritis?

Answer 10

Prescribed exercise to maintain mobility; splinting of affected joints; and teaching about medication management and side effects of drugs.