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Fundamentals SEM2 > WEEL 8 PEDS > Flashcards

WEEL 8 PEDS Flashcards

ATI neuromuscular and musculoskeletal system

1
Q

what are the 5 injuries to know?

A

contusions
dislocations
sprains
strains
overuse

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2
Q

where could contusions occur that would be a potential sign of abuse?

A

the neck and cheek

children under 2 should not have frequent contusions unless they have a disorder

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3
Q

risk factors for contusions

A

decreased coordination (falls, bumping, etc)
blood disorder (anticoagulants)
collision
falls
jumping
participation in sports

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4
Q

clinical presentation of contusion

A

bluish or purplish color, or fade to greenish yellow

more severe manifestations: severe bone or soft tissue contusion include decreased movement, pain at the injury site, swelling, and ecchymosis

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5
Q

Why would a provider order lab work for a pediatric client who has several contusions?

A

to rule out blood disorders

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6
Q

what is a med that might be ordered for contusions?

A

ibuprofen

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7
Q

what could a painful bruise indicate?

A

injury to soft tissue or possibly the bone

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8
Q

how to ask younger ped patients to verbalize discomfort?

A

assist younger pediatric clients with verbalizing discomfort by giving them a doll to use to point to areas that hurt.

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9
Q

how long does it generally take for a bruise to heal

A

2 weeks

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10
Q

define dislocations

A

injury where two bones come apart at the joint, which may cause a tear in the ligament

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11
Q

what is the most common dislocated joint in peds?

A

shoulder joint

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12
Q

biggest risk factor for dislocations is

A

forceful movements

also:
intense activity
extreme sports
playing sports
Ehlers-Danlos syndrome

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13
Q

clinical presentation of peds patient with dislocation?

A

swelling and bruising around injury
pain
numbness
deformities
trouble moving joint
unaffected limb will be longer than dislocated limb

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14
Q

genetic condition that are high risk for dislocations

A

Ehlers-Danlos syndrome

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15
Q

treatments for dislocations

A

ice
immobilizing joint until provider sees it
splint/cast
maybe surgery

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16
Q

why is treatment time sensitive with dislocations?

A

healing will not begin until the bones are put back together

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17
Q

how will different age children communicate dislocations?

A

infants: cry
toddlers: point to area/hold affected joint
preschool: may be able to express but may need help
school-age: can even assits in finding out what they cause may be

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18
Q

what are some diagnostic tools for a dislocation?

A

X-ray or MRI

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19
Q

define sprains

A

damaging a ligament with excessive movements, such as stretching or twisting, resulting in injury

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20
Q

what are common locations for sprains in children

A

ankles and wrists

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21
Q

why are sprains NOT commonly seen in younger children?

A

their weaker growth plates

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22
Q

what ligaments are most commonly affected?

A

those of the ankle
posterior talofibular, anterior talofibular, and calcaneofibular ligaments.

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23
Q

risk factors for sprains

A

youth sports
lack of coordination
growth (plates are active)

most commonly in ankle with highly active kids

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24
Q

clinical presentation of sprains

A

discoloration/ecchymosis at site
decrease mobility in affected extremity
pain
swelling
holding limb or injured extremity

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25
Q

what age are sprains most commonly seen in

A

age 10-18

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26
Q

treatments and therapies for sprains

A

PRICE
ice application
mobilizing devices
elastic bandage
OTC analgesics

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27
Q

even though sprains are a minor injury, why are they taken seriously with peds patients?

A

the child is still growing

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28
Q

how to prevent sprains

A

good stretching!

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29
Q

define strain

A

injury to tendon or MUSCLE caused by stretching, leading to damage of the tissue and, at times, partial or complete tear to muscle

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30
Q

are strains commonly seen in younger children

A

no, due to weaker growth plates

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31
Q

risk factors for strains in peds

A

youth sports (football)
certain stages of growth
jumping sports

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32
Q

clinical presentation of strains

A

pain
redness
bruising
swelling
decreased movement in affected area
hold injury

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33
Q

how to prevent strains

A

have at least one rest day a week from activity
wearing protective gear
stretching before
warming up

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34
Q

when do overuse injuries occur

A

not resting in between a lot of physical activity

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35
Q

two types of overuse injuries

A

Sever’s disease
Osgood-Schlatter disease

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36
Q

Severe’s disease

A

when the pediatric client’s growth plate in the heel bone becomes inflamed

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37
Q

Osgood-Schlatter disease

A

the growth plate located at the top of the tibia (shin bone) becomes inflamed

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38
Q

risk factors for overuse injuries

A

poor body mechanics when training
excessive training
lack of rest
playing same sports over period of time, not taking a break in between seasons

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39
Q

clinical presentation of overuse injuries

A

discomfort
inflammation
also stress fracture/injured growth plate can indicate overuse

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40
Q

treatments for overuse

A

NSAIDs
heel pad for heal injury
crutches
rest
PT

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41
Q

when would certain mobilization tools be given?

A

cane: problem with balance

crutches: cannot bear weight on one extremity

walker: difficulty bearing weight on the other both legs

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42
Q

plastic deformation

A

bent bone, not fracture

children because of their bones

requires surgery

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43
Q

two fractures in children

A

torus: buckle (catch yourself from a fall)

greenstick: not fully broken bone (splintering of the bone)

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44
Q

complicated/complex fracture (comminuted)

A

bone shatters into pieces and damages surrounding tissues or blood vessels

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45
Q

how to confirm fracture

A

X-ray
MRI
CT scan

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46
Q

what is a disease that would increase risk for child to get fractures

A

juvenile osteoporosis

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47
Q

risk factors for fractures include

A

weaker bones
decrease calcium/vitamin D
obesity
sports

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48
Q

clinical presentation of fractures

A

pain
swelling
discoloration
ecchymosis (bruising)
limbing
limited use of extremity
deformity to the extremity

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49
Q

Buckle fractures are typically sustained when a child

A

runs
falls
or put hands out to catch themselves

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50
Q

labs and Dx for fractures

A

X-ray, MRI
CBC to rule out bone infection
vit D/calcium/phosphorus levels checked

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51
Q

comps of fractures: compartment syndrome

A

increase fascia leads to decrease perfusion to injury site

manifestations:
pain that continues to worsen, an inability to move the affected body part, and a tingling sensation

immediate surg intervention!

52
Q

comps of fractures: physeal involvement

A

damage to growth plates (injuries to physis)

53
Q

comps of fractures: nonunion and malunion

A

nonunion: bone doesn’t heal due to LACK of circulation

malunion: bone doesn’t heal and leads bone to be shorter or shaped weird

54
Q

comps of fractures: infection

A

open fractures can lead to infections (treat with antibiotics)

55
Q

comps of fractures: pulmonary emboli

A

FAT embolus going into lungs!!

fracture=fat bone marrow into blood stream and go into lungs

respiratory depression and needs immediate treatment

56
Q

infection section: what infection does it cover?

A

osteomyelitis

57
Q

define osteomyelitis

A

bone infection that can occur when bacteria or fungi attack any bone in the body.

58
Q

patho of osteomyelitis: what is the most common bacteria that causes it?

A

Staphylococcus aureus

59
Q

screening for osteomyelitis

A

no screening, if a client is exhibiting manifestations then you can do a BIOPSY to diagnose condition

60
Q

patho of osteomyelitis

A
  1. has to be damaged or have an area exposed to foreign antibodies
  2. bacteria and microbes settle in the metaphysis of the bone
  3. can cause necrosis if blood supply stops or slows down
61
Q

what is osteomyelitis caused by

A

an infection in the blood
fractures (open)
inadequate circulation to extremities
surgery can create an exposure to foreign bodies

62
Q

what are risk factors for osteomyelitis (two main ones; plus a few extra causes)

A

compromised immune system and sickle cell disease

infections
break to the bone
skin trauma

63
Q

clinical presentation of osteomyelitis

A

similar to cold or the flu

fever
lethargy
nausea
limping of affected extremity
discomfort
redness on the skin
swelling above the site of infection

64
Q

labs for osteomyelitis

A

CBC (WBC count: high indicates an infection)
X-ray
bone scan
biopsy
MRI

65
Q

procedure of a bone scan

A

help determine reason for bone pain

injecting radioactive tracers and use a camera to scan the bones to create an image

66
Q

treatment for osteomyelitis

A

IV antibiotics

67
Q

what is the choice antibiotic for osteomyelitis

A

vancomycin

68
Q

why would osteomyelitis result in amputation

A

if it causes extensive damage to the bone and surrounding tissue

69
Q

when does osteomyelitis usually occur in infants?

A

premature infants because they do not have a very strong immune system

increase risk for infection

70
Q

education to prevent skin infections for parents and ped clients

A

hand washing
any opening of skin should be washed with soap and water
wounds should be covered with clean gauze
contact PCP if wound takes longer than 1 week to heal

71
Q

why to educate parents about with play for peds patients with osteomyelitis?

A

give child NSAIDs because they can lower pain and they are play and socialize

72
Q

how to help prevent osteomyelitis

A

good bone health:

movement and physical activity to help strengthen bones

educate patients to do PT after treatment

hand hygiene
stay up to date on vaccines

73
Q

define torticollis

A

condition that causes the neck to be in an unexpected position or to look “twisted”

74
Q

what causes torticollis

A

shortened sternocleidomastoid

A large pair of muscles in the neck.

75
Q

an indication of torticollis

A

ped client is consistently turning head to one side

76
Q

congenital muscular torticollis

A

infants

damage to muscles when born

77
Q

risk factors for torticollis

A

trauma during pregnancy and birth
rheumatoid disorder
stroke
stress to muscles

78
Q

common manifestation of torticollis

A

twisting of the neck

other:
fever
problems with balance
vision
headaches
vomiting

79
Q

treatment for torticollis

A

PT and neck brace kind of thing (tubular orthosis)

with consistent Tx, it can be resolved in 6 months

80
Q

how to treat infant who has torticollis

A

tummy time: encourage baby to turn head away from affected side

81
Q

spinal curvature: 3 main things

A

Scoliosis: spine has an S shape

Lordosis: spine tups back and back is swayed

Kyphosis: spine tips forward (hunchback)

82
Q

screening for scoliosis

A

Adam’s test

83
Q

risk factors for spinal curvature

A

anomalies in the vertebrae
trauma to the spine
degenerative disc disease
severe slouching
compensation in the spine

84
Q

Development Dysplasia of the Hip (DDH)

A

anomaly in the acetabulum

85
Q

risk factors for DDH

A

female
infant born breeched
restricted from swaddling or restricted movement in womb
family Hx of bone disorders (osteoarthritis)

86
Q

clinical presentation of DDH

A

infant with limited ROM in the hip (differing lengths of legs as well)

87
Q

treatment for DDH

A

orthotic device (Pavlik harness) worn all day

surgical treatment (if hip becomes dislocated

88
Q

Legg-Calve-Perthes Disease

A

occurs when the head of the femur (thigh bone) begins to die because of decreased blood flow

89
Q

what can cause Legg-Calve-Perthes disease

A

blood clots or blood vessel damage/blockage

90
Q

clinical presentation of Legg-Calve-Perthes disease

A

decrease ROM in hip
painful rotation of the thigh
differing leg lengths
pain when walking
atrophy of the thigh

91
Q

Congenital Talipes Equinovarus (Clubfoot)

A

present from birth

infants foot is twisted to the side due to SHORTENED tendons

92
Q

risk factors for clubfoot

A

being male
family Hx
cerberal palsy
birth defects
smoking during preg
born breeched

93
Q

clinical presentation of clubfoot

A

foot turned (inward)

94
Q

treatment for clubfoot

A

series of casts

95
Q

what are three skeletal alterations to know for peds?

A

osteogenesis imperfecta

juvenile idiopathic arthritis

systematic lupus erythematosus

96
Q

define osteogenesis imperfecta

A

a condition present at birth and is also called brittle bone disease. Pediatric clients with this disease will have very fragile bones that may have an unexpected shape and can easily fracture

97
Q

what is the ONLY risk factors for osteogenesis imperfecta?

A

family history carrying the gene (that causes collagen production is distrupted)

98
Q

what medication to give for osteogenesis?

A

Ibandronate (bisphosphonates)

99
Q

what is osteogenesis imperfecta increase risk for

A

fractures because of weak bones

100
Q

Juvenile Idiopathic Arthritis

A

autoimmune disorder during childhood which the BODY attacks the synovial fluid (inflammation)

101
Q

clinical presentation of JIA

A

fever
eye discomfort
inflammation
rash
difficulty ambulating
joint stiffness

102
Q

medications prescribed for JIA

A

corticosteroids and DMARDs

103
Q

two meds to know for JIA

A

prednisone
methotrexate

104
Q

Systemic Lupus Erythematous

A

SLE (aka lupus) autoimmune disease that attacks healthy tissue and organs

leads to inflammation and compromises the integrity of the body tissues anywhere in the body

105
Q

what can trigger SLE

A

increase in hormones (most commonly seen in adolescent females)

106
Q

risk factors for SLE

A

cigarette smoke
low vitamin D
stress

107
Q

clinical presentation of lupus

A

BUTTERFLY RASH on face
pain in joints
fever
hair loss
weight loss
mouth sores
swelling of the hands or feet

108
Q

goal of treatment for SLE

A

prevent organs from being attacked and decrease the severity of flareups

109
Q

medications for SLE

A

hydroxychloroquine

110
Q

define cerebral palsy

A

non-progressive motor dysfunction (brain damage)

111
Q

risk factors for CP

A

premature
LBW
prenatal deprivation of oxygen!!!! (brain damage)
intrauterine infection
birth tramua
genetic

112
Q

clinical presentation of CP (important)

A

unexpected muscle tone

muscle spasticity
hyperreflexia
clonus
dyskinesia
ataxia
hypo/hyper tonia

113
Q

management for CP

A

improve ADLs and functional task, strength, conditioning

114
Q

meds to help with seizures for CP

A

Diazepam

115
Q

define hypotonia

A

condition of poor muscle ton

116
Q

risk factors for developing hypotonia include

A

inherited
prenatal hypoxia
Down syndrome
Prader Willi syndrome

117
Q

clinical presentation of hypotonia

A

low Apgar score (0-1) in activity category

flaccid limbs

118
Q

tx for hypotonia

A

occupational, speech, and physical therapy may be beneficial to reduce the risk of additional deformities, maximize muscle function, and promote mobility.

119
Q

define spinal muscular atrophy

A

recessive genetic disease, causes WEAK muscles

120
Q

risk factors for SMA

A

only way is if BOTH parents are carriers

121
Q

tx for SMA

A

Gi doctor
pulmonologist
dietitian
PT
neurologist

122
Q

define muscular dystrophy

A

group of generalized progression of muscle weakness and degeneration

123
Q

risk factor for muscle dystrophy

A

mom is carrier

124
Q

clinical presentation of muscle dystrophy

A

development delays
appears clumsy
weak
falls

125
Q

med for MD

A

Delandistrogene moxeparvovec

Fundamentals SEM2 (7 decks)

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