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Child Health > Block #4 - Integumentary, Neurological, Musculoskeletal > Flashcards

Block #4 - Integumentary, Neurological, Musculoskeletal Flashcards

1
Q

Common Burn Causes for each age group

A

Toddler: hot water scalds
Older Children: flame-related burns
Child Abuse

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2
Q

3 Phases of Healing (and durations)

A
  • Inflammation (2-5 days): preps for repair
  • Proliferation (2-3 weeks): blood flow reestablished
  • Remodeling (3 weeks - 2 years): scar formation
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3
Q

Burn Care: 6 C’s

A

Clothing - remove
Cooling - cool burns immediately
Cleaning - wash with mild soap and rinse well
Chemoprophylaxis - topical ointment; tetanus booster
Covering - with sterile gauze
Comfort - give pain medications

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4
Q

Burn Therapeutic Management

A

First Priority: airway maintenance
Fluid replacement: critical 1st 24 hr
Nutrition: increased demand
Medication: abx, analgesics, anesthetics for procedure pain

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5
Q

Burn Complications

A
  • AIRWAY
  • Profound shock
  • Infection
  • Inhalation Injury
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6
Q

Frostbite: Cause

A

> 1 hr at lower than 32 degrees

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7
Q

Frostbite: S/S

A

Red, Blue, Waxy skin

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8
Q

Frostbite: Nursing Care

A
  • Place child in a warm area
  • Remove wet/cold clothing and replace with warm/dry
  • DO NOT MASSAGE area or apply dry heat
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9
Q

HPV

A

Causes warts (hands, feet, genital area)

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10
Q

HPV Risks

A

Increased cervical cancer risk

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11
Q

HPV: S/S

A
  • Rough, raised, and flesh-colored
  • Occur anywhere on the body
  • Usually no pain or itching
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12
Q

HPV: Nursing Care

A
  • Usually no intervention needed

- OTC or prescription meds

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13
Q

HPV Prevention

A

Vaccination: Gardasil after age 9

-makes some females very sick after administration

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14
Q

What is another name for Eczema?

A

Atopic Dermatitis

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15
Q

Eczema: S/S

A
  • Red, raised rash that is itchy (pruritic) and painful
  • Rash on infants: usually head, face, arms, and legs
  • Rash in older children: usually presents in the folds of the arms and legs
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16
Q

Eczema: Nursing Care

A
  • Prevent secondary infection
  • Provide good hygiene
  • Follow prescribed treatment protocols
  • Maintain skin hydration
  • Conduct frequent monitoring and rash assessment
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17
Q

Food Starting Order for Infants

A

Breastmilk/Formula
Rice cereal
Vegetables
Fruits

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18
Q

Lice

A

Infest the body, primarily where there is longer hair (nape of neck and behind ears)

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19
Q

Lice: Treatment

A
  • OTC shampoo
  • Mayo on scalp
  • Backwards combing
  • Whole family needs to be treated
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20
Q

Lupus

A

Butterfly rash
Treat with anti-malarials

  • Autoimmune condition
  • Systemic
  • COD is often kidney failure
  • Monitor BUN and creatinine
  • Immunosuppressants can increase risk of infection
  • Avoid sun and use sunscreen (rash cause)
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21
Q

Acne: Nursing Care

A

-Assess the acne
-Clean and moisturize with a water-soluble moisturizer
-Treat with benzoyl peroxide –> dries up
-Administer topic abx and then retinoids
Tetracycline: no one under 8 and no pregnant
Accutane (oral) –> toxic to fetus –> do a pregnancy test before admin

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22
Q

Accutane Risks

A

Can cause:

  • Depression
  • Birth Defects
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23
Q

S/S of ICP Change: Infants

A
  • Irritability; poor feeding
  • High pitch cry, difficulty to soothe
  • Fontanelles: tense and bulging
  • Cranial Suture Separation
  • “Sun setting” eyelid
  • Scalp veins distension
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24
Q

S/S of ICP Change: Children

A
  • Headache
  • Vomiting (w/o nausea)
  • Diplopia (double vision)
  • Seizure
  • Poor feeding
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25
Q

Levels of Consciousness

A 
Fully conscious
Confusion - impaired decision making
Disorientation - to time and place
Lethargy - sluggish speech
Obtundation - arouses with stimulation
Stupor - responds only to vigorous and repeated stimuli
Coma - no response to stimuli
Persistent Vegetative State - permanently lost function of the cerebral cortex
26
Q

Oculovestibular Test

A

Put ice water in the ear –> the eyes turn towards opposite ear if NOT brain dead

No movement = brain dead

27
Q

Cerebral Palsy

A

Most common permanent physical disability in childhood**

Etiology: prenatal encephalopathy

28
Q

Cerebral Palsy: Types

A

Spastic - tightened musculoskeletal system
Athetoid/Dyskinetic - random movements
Ataxic - Gait issue, rapid repetitive movements
Mixed/Dystonic

29
Q

Cerebral Palsy: Motor S/S

A
  • Poor head control after 3 months old
  • Stiff or rigid limbs
  • Arching back/pushing away
  • Floppy tone
  • Unable to sit without support at 8 months
  • Clenched fist after 3 months
30
Q

Cerebral Palsy: Behavioral S/S

A
  • Excessive irritability
  • No smiling by 3 months
  • Feeding Difficulties (hold jaw when feeding)
  • Persistent tongue thrusting
  • Frequent gagging or choking while feeding
  • Impaired socialization
31
Q

Meningitis: Worst Kind

A

Meningococcal

32
Q

Meningitis: prevention

A

Hib Vaccine

33
Q

Meningitis: Order of Care

A
  • Private Room
  • Isolation precautions (droplet)
  • Sign on door
  • Blood Cultures
  • IV start (fluids)
  • Admin broad abx
  • Wait for culture results –> focused abx tx
34
Q

Seizure: Priorities

A

Safety is #1

35
Q

Seizure: Cause

A

Malfunction of brain’s electrical system
Determined by site of origin

Most common neurologic dysfunction in kids

36
Q

Epilepsy

A

2+ unprovoked seizures

37
Q

Seizure: Major Causes in Children

A
  • Birth injuries (anoxia) or congenital CNS defects
  • Acute infections in late infancy and early childhood
  • Usually idiopathic if >3 yr
38
Q

Absence Seizures: Motor Signs

A 
Lip-smacking
Twitching of eyes
Face
Slight hand movement
May drop held object
Children rarely fall
No incontinence
39
Q

Atonic Seizures

A

Sudden momentary loss of muscle tone
Sudden fall to the ground, often onto their face
Less severe seizure - head droops forward several times

40
Q

Myoclonic Seizures: S/S

A
  • May be single or repetitive
  • No loss of consciousness
  • Often occur when falling asleep
  • May be a nonspecific symptom in many CNS disorders
  • May be mistaken as exaggerated startle reflex
41
Q

Infantile Spasms

A

WORST OUTCOMES

  • Onset: 6 to 8 months
  • Usually associated with mental retardation
  • Specific spike seen on EEG

2x more common in males

42
Q

Common Seizure/Spasm Triggers in Pediatrics

A
  • Changes in light-dark patterns (camera flashes, headlights, rotating fan blades, reflections off snow/water)
  • Sudden loud noises
  • Extreme temperature changes
  • Dehydration
  • Fatigue
43
Q

Muscular Dystrophy: definition

A

symmetrical wasting of skeletal muscle groups

44
Q

Duchenne Muscular Dystrophy (DMD)

A

Most common and most severe

45
Q

DMD: Characteristics

A
  • Onset b/w 3-5 years
  • Progressive muscle weakness, wasting, and contractures
  • Calf muscle hypertrophy in most patients*
  • Progressive generalized weakness
  • Death from respiratory failure or cardiac failure
46
Q

DMD: Clinical Manifestations

A
  • Waddling gait, frequent falls, Gower Sign (must use all 4 extremities to get up)
  • Lordosis (inward curve of spine)
  • Enlarged muscles, especially thighs and upper arms
  • Profound muscle atrophy in late stages
  • Mental deficiency
47
Q

Club Foot: S/S

A
  • Plantar flexion
  • Inverted heel
  • Abducted forefoot
48
Q

Club Foot: Nursing Care

A

-Serial casting or baby shoe
Start immediately after diagnosis
-Manage pain
-Educate family

49
Q

Myelomeningocele: Prevention

A

Results from Spina Bifida - prevent with Folic Acid

50
Q

Myelomeningocele: Nursing Care

A

Place newborn prone (protect sack)
Keep sack moist, clean, and sterile (covered)
Provide post-op care for laminectomy & closure of defect

NO RECTAL TEMP

51
Q

Scoliosis Treatment

A
  • Assess body image and maintain orthotic brace compliance (TLSO brace)
  • Surgery for rod placement if severe of when pulmonary function becomes compromised
52
Q

Scoliosis: TLSO Brace

A
  • Wear until skeletal system has fully matured

- Wear 23 hours a day

53
Q

Legg-Calve-Perthes

A

Aseptic Necrosis of the Femoral Head

  • Wasting
  • Flattening
  • Takes 12 months for revasculating
  • New bone development in 1-2 years
54
Q

Legg-Calve-Perthes: S/S

A
  • Hip or knee soreness or stiffness

- Painful limp, quadriceps atrophy

55
Q

Legg-Calve-Perthes: Nursing Care

A
  • Monitor non-weight-bearing
  • Assess ROM, pain, and neuro status
  • Educate the family
  • Serial casting 1-3 years of age, will be able to return to normal
56
Q

Osteogenesis Imperfecta

A

Brittle Bone Disease
Most common genetic bone disorder

Type-2 = incompatible with life (LETHAL)
Type 1,3,4 = can be managed
even changing a diaper may cause fracture

57
Q

Osteogenesis Imperfecta: S/S

A
  • Lax joints
  • Small and weak muscles
  • Numerous fractures
  • Bone deformities (bowing)
58
Q

Compartment Syndrome: Classic Sign

A

Unrelenting Pain, not relieved by narcotics

59
Q

Compartment Syndrome

A

Possible complication of fracture
Priority is prevention
Elevate extremity to prevent swelling
Frequent neurovascular checks

Notify HCP immediately if suspected*

60
Q

Shaken Baby Syndrome

A

Warning Sign: story doesn’t match up
S/S:
-unconscious
-retinal bleed

Child Health (9 decks)

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