Week 3 Neuromuscular/Musculoskeletal Flashcards
What is cerebral palsy?
A nonprogressive motor disorder of the CNS resulting in an alteration in movement and posture
WHat causes cerebral palsy?
Trauma, Hemorrhage, anoxia, infection
What are the four types of CP?
- Spastic
- Athetoid
- Ataxic
- Mixed
What is a common sign of CP in infants?
Scissor legs
What are some complications of CP, depending on the type and location
- Altered speech
- Delayed development
- Seizures
- Difficulty swallowing, seeing, and/or hearing
- motor dysfunction
What are some nursing management for children with CP
- Support positive self-image
- Increase caloric intake
- Provide a safe environment
What is the “Goal” of CP?
Safe care
What are some medications used to treat the symptoms of CP?
- Diazepam
- Dantrolene
- Baclofen
- Botox
What is Muscular Dystrophy?
Progressive degeneration of skeletal muscle
MS has a genetic factor and ____ are more commonly affected
Males
Most patients with MS die before the age of
20
What is the most common cause of death in a patient with MS
respiratory failure
What is one “sign” that a child has MS?
Gowers sign
What is Gowers sign?
When a child gets up using mostly upper body strength
What are some assessments that point to MS?
- Missing milestones after 3 years
- Gowers sign
- INcreased weakness
- Muscle atrophy
- Scoliosis/Fractures
Most children with MS will be in a ___ by age 12
Wheel chair
What is spina bifida?
An umbrella term referring to neural tube defects
What is spina bifida occulta?
The nerves are not affected, but the spine is missing a column and there is a noticeable dimple in the back
What is Meningocele
When the is a malformed section of the spine and the meninges forms a pouch protruding out the back with no nerves present in the pouch
what is Myelomeningocele?
When the is a malformed section of the spine and the meninges forms a pouch protruding with spinal nerves present
what is encephalocele?
the pouch of meninges or meninges and nerves at the top of the head
What should the nurse do if a child is born with an unknown spina bifida?
cover it with saline soaked gauze
How much folic acid should women of child bearing age have each day?
0.4mg
How do fractures differ in children?
- The heal faster
- They have different patterns
- Young athletes are at risk for stress fractures
- Treated differently because the bones are still growing
What are the common childhood fractures?
- Greenstick
- Buckle
- Spiral
WHat is a greenstick fracture?
What the break isn’t complete. Like a green stick
How is fracture treatment different in children?
They may outgrow the casts so the child will need progressive casting
What are the 5 p’s of musculoskeletal injuries?
- Pain
- Pulselessness
- Pallor
- Paresthesis
- Paralysis
What are the 5 main assessments for childhood fractures?
- VS
- Lung sounds
- Bowel sounds
- Neuro checks
- Full Head to toe
What is teaching intervention for parents of children with a fracture or soft tissue injury?
RICE
- Rest
- Immobilize
- Cold
- Elevate
What is a spica cast?
A cast for the hips
What is club foot?
When the foot is twisted in a fix abnormal position
What are the treatments for club foot?
-Casting
-PROM
-Splints
-Surgery
Education
What is developmental dysplasia of the hip?
What the femoral head and acetabulum are not aligned
What are some signs of developmental hip dysplasia?
- Shortened limb
- Allis sign -skin folds uneven_
- Barlow sign hip clicking
- Delayed or altered walking
What are the treatments for Developmental hip dysplasia?
- Pavlik harness
- Spica cast
- Education
What is Osteogenesis imperfecta?
fragile bones
Pathologic fractures from connective tissue and bone defects. Low collagen production
What are some characteristics of Osteogenesis imperfecta
- multiple frequent fractures
- Limb/spinal deformities
- Blue sclera. thin soft skin, easily bruised, weak muscles, short stature and conductive hearing loss by adolescence
What are some nursing considerations when caring for a child with Osteogenesis imperfecta
- Safety and prevention of falls is key
- Don’t hold by ankles
- May need braces
- need lots of education and support
What are some meds for Osteogenesis imperfecta
Calcitonin, bisphosphonates, growth hormone
What is Legg-Clave-Perthes?
Aseptic Necrosis of the femoral head
What causes Legg-Clave-Perthes?
it is associated with an infection
When is Legg-Clave-Perthes most common?
2-12 years old
What is the main clue that the child may have What is Legg-Clave-Perthes
The child has a limp after an infection
What are the main interventions for Legg-Clave-Perthes
- Need to keep the femur head in contact with the acetabulum
- Address pain and inflammation
- Restore motion
What is Slipped Capital Femoral Epiphysis?
When the upper femoral epiphysis gradually slips from its functional position
When is Slipped Capital Femoral Epiphysis most common?
During adolescent growth spurts
What is the onset of Slipped Capital Femoral Epiphysis
It can be sudden or gradual
What are the interventions for Slipped Capital Femoral Epiphysis
- Bedrest
- Pain
- Surgery for fixation and/or stabilization
