Care Of A Child With Musculo Skelet Disorder Flashcards
(515 cards)
0
Q
In a neuro vascular check what do we look for
A
Pain Pallor Parasthesia Paralysis Bilateral pulse Polar Capillary refill
1
Q
What do we do to children prior to
MRI and ct scan to make compliance easier?
A
Sedate patient
2
Q
What is a contusion
A
Tearing of subcutaneous tissue
3
Q
Blood in the soft tissue
A
Hematoma
4
Q
What is a sprain
A
Torn ligaments
5
Q
What is a strain
A
Small tear in muscle or tendon
6
Q
Treatment for soft tissue injury
A
Rest (non weight bearing)
Ice
Compression
Elevation
7
Q
Two common fractures in children
A
Green stick and buckle fracture (wrist)
8
Q
What is Bryant’s traction
A
Skin traction used for children under 3 years old or 30 lbs
Used for dislocated hip or femur fracture
Buttocks is kept off bed
Risk for aspiration
Risk for volkmans ischemia
9
Q
What is Russell’s traction
A
Weight pulls in two directions
Vertical and horizontal
Body acts as counter weight
10
Q
Responsibility for traction
A
Applied and removed by MD Weights hang freely Pin care NV checks Observe for infection, compliance, and constipation
11
Q
What is osteomyelitis
A
Inflammation of the bone caused by staph
12
Q
What is Duchenne’s muscular dystrophy?
A
Progressive neuromuscular disease. Hereditary recessive, occurs in males. Fatty infiltration of muscle cells (breakdown)
13
Q
Signs and symptoms of DMD
A
Delayed walking Decrease muscle strength Clumsiness (no fine motor skills) Increase lordosis Gowers sign Over developed calve muscles
14
Q
What is Gowers sign
A
Difficulty getting up from sitting position. Holding calves to get up
15
Q
What is the prognosis with DMD and what care do we provide for patients with the disease?
A
Poor prognosis life expectancy is early 30s. Prevention of complications is main goal.
16
Q
When is DMD usually diagnosed
A
4-5 years of age
17
Q
What is another name for legg-calve-perthes disease
A
Coxaplana
18
Q
What is Coxaplana
A
Lack of circulation to the femoral head - slips out of acetabulum
19
Q
What is the cause of Coxaplana and how does it develop?
A
Unknown cause - results from trauma or synovitis prior
20
Q
What test is done to diagnose Coxaplana?
A
X-Ray
21
Q
How long is treatment for Coxaplana?
A
1-2 years
22
Q
What is the treatments for Coxaplana?
A
Bucks traction
Hip bracing to ABDUCT hips/legs
Maintain ROM
Limit activity during treatment
23
Q
What is the prognosis for Coxaplana?
A
Good however there’s a potential for hip degeneration in later years
24
Where do bone rumors usually develop?
In the long bones
25
What is Ewing's sarcoma?
Tumor growth in the marrow of long bones
26
What is the problem with Ewing's sarcoma?
It can metastasize to the lungs and other bones
27
S&S of Ewing's sarcoma
Pain
Possible mass at site
Possible fracture
28
What is osteosarcoma?
Primary malignant tumor of long bones. Also mets to lungs
29
Signs and symptoms of osteosarcoma
Pain, limited mobility, obvious tumor mass
30
What is the treatment for osteosarcoma
Amputation and chemo
31
What is given after amputation of affected limb in osteosarcoma for patient to return to a normal life
Possible prosthesis
32
What can cause juvenile rheumatoid arthritis?
Chronic strep infection
33
Systemic RA
Fever for 10 days, internal organs affected
34
Polyarticular
Arthritis in 5 or more joints
35
Pauciarticular
Arthritis in 4 or less joints
36
S&S of JRA
Swollen joints
Enlarged liver & spleen
Anemia, anorexia, rash
Pericarditis, myocarditis, uveitis (inflammation of anterior chamber in eye)
37
What test would be elevated in JRA?
ANA & the tests associated with Lupus
38
Treatment for JRA
NSAIDs, heat packs/hot showers
Good nutrition
Immunizations
Corticosteroids
39
What does uveitis lead to
Blindness
40
How can we do range of motion for a child with JRA
Play with child (catch, dance, etc)
41
Drug of choice for JRA
NSAIDS
42
What is the problem with NSAIDS
They are gastrotoxic therefore take with food/milk
43
What medication is acceptable to use in children with JRA that would otherwise not be acceptable
Aspirin
44
What is ankylosis and how is it prevented
Joint deformity and ROM will prevent it
45
What will affect immunizations in JRA
The steroid therapy the patient is on
46
What is wax & wane in JRA
On and off symptoms (exacerbations)
47
What is scoliosis
S like curvature of spine
48
What is functional scoliosis
Poor posture
49
What is structural scoliosis
Congenital
Neuromuscular
Idiopathic
50
How is scoliosis tested for
Patient bends over - dr feels spine
| X ray
51
What is treatment for curves under 20 degrees
Good posture
| backpack safety
52
Treatment for curves 20-40 degrees
Boston brace
Milwaukee brace
Daily exercise
53
Treatment for curves greater than 40 degrees
Harrington rods
| Spinal fusion
54
How long does patient wear back brace
23 hours a day for 2-3 years
55
How do we protect skin integrity when patient with scoliosis wears brace
Light tee shirt under brace
56
How long patient in hospital after surgery for scoliosis
48-72 hours
57
When does physical therapy start for back surgery in scoliosis
4-6 weeks after surgery
58
What do we do directly after sport injury
Ice 20 min on and off for first 24 hours
59
Inflammation of middle ear secondary to upper respiratory infection
Otitis media
60
Another name for otitis media
Ear infection
61
What can also cause an ear infection
Communicable disease complication
Haemophilus influenzae (flu)
Baby w/ bottle in bed
Second hand smoke
62
How does second hand smoke cause ear infection
Smoke damages cilia in ear
63
Signs and symptoms of OM (otitis media)
```
Pain in ear (pulling on ear)
Irritability
Diminished hearing
Fever
Headache
Vomiting & diarrhea
Potential for rupture of eardrum
```
64
Treatment for OM
Broad spectrum antibiotic if throat culture is positive
Analgesics
Ear drops
65
How do you administer ear drops in a child under 3 years old
Ear lobe down and back
66
How do you administer ear drops in a child over 3 years of age
Pinna up & back
67
Why do we not put cotton in the ear after administering ear drops in ear infections
The cotton will absorb all of the medication - ineffective treatment
68
Nursing care for ear infection
```
Meds as ordered - anti biotics and Tylenol
No cotton in ear
Place child on side if drum is ruptured
Cold compress for pain relief
Check temp
Avoid water in ears
```
69
If ear drum ruptured what do we do
Put patient on affected side to drain ear
70
How do you get swimmers ear
Going under water
71
How do we tell Difference between ear infection and swimmers ear
When you press on ear, pain with swimmers ear
72
What is a myringotomy
Procedure to drain fluid from straight eutstachian tube
73
What age is a myringotomy
Children under 5
74
How do the tubes come out after a myringotomy
They fall out on their own
75
What causes hearing impairment in newborns
Pre natal viral infection or German measles (rubella)
76
How do you get acquired deafness
Measles, mumps, meningitis, exposure to loud noise
Temporary due to wax build up
Chronic ear infections
Neurological deficit
77
What kind of delays can we expect to see in hearing impaired child
Speech, relationship and developmental delays
78
What kind of communication adaptation is available for the hearing impaired
ASL (American sign language)
79
Nursing interventions for hearing impairement
Safety concerns
Gain child attention before speaking
Face child at eye level
Proper care of hearing device
80
What is hyphema
Bleeding into the anterior chamber of the eye usually caused by blunt or penetrating trauma
82
A tearing of the subcutaneous tissue that results in hemorrhage, edema, or pain
Contusion
83
Blood in soft tissue
Hematoma
84
Torn ligament or ligaments stretched. Swelling pain and immobility occurs
Sprain
85
Small tear in muscle or tednon occuring overtime, pain and edema occur
Strain
86
Break in bone
Fracture
87
What type of fracture is Bone broken but not through skin
Simple
88
Fracture that is broken bone through skin, at great risk for infection
Compund
89
Fracture that is incomplete, one side is broken other side is bent
Greenstick
90
Fracture that is caused by forceful twisting motion
Spiral
91
With a spiral fracture what must we not rule out
child abuse
92
A non-displaced fracture is when
Bones are still in alignment
93
A displaced fracture is when
Bones have shifted and need to be re-aligned
94
No surgery, bones are gently put back into place and cast or traction is applied
Closed reduction
95
Surgical procedure usually requiring pins, rods, or other devices
Open reduction
96
Used when the immobilization required is more that what could be obtained by casting
Traction
97
What are the 4 purposes of traction
Ensure alignment, Secure corrected position, prevent or treat contracture deformities, and to relieve muscle spasm and back pain
98
How do we check pulses during nuerovascular assessment
Distal to injury or cast, if it is difficult use a doppler
99
If the child cannot feel touch on the extremety what can we expect it to be
compartment syndrome
100
What are the excersies called that are used to prevent muscle atrophy and to strenghten muscle
isometric excersices
101
Weights in traction care should
hang freely and not touch the floor
102
Ropes in pulley for traction care should
Move freely, and not be obstructed
103
What is the last thing that child will develop, and when should it advance
Fine motor coordination, before 7 yo
104
By 18 months the child should be able to
Walk steady
105
By 6 years of age the child should be able to in reference to gait
walk like an adult
106
Muscle tone is developed
Cephalocaudal
107
What is psuedoparalysis
When child is afraid to move extremity because it is going to hurt
108
What are the 5 P's in Neurovasuclar Assessment
Pain, Pallor, Parasthesia, Paralysis, Pulse
109
Tearing of subcutaneous tissue
Contusion
110
Blood in the soft tissue
Hematoma
111
What does RICE stand for and what is it used for
Rest, Ice, Compression, Elevation. Soft tissue injuires
112
When elevating for a soft tissue injury what must we elevate it by
Above level of heart
113
How do we wrap an Ace bandage
Wrap distal to proximal
114
A buckle fracture is also known as a
Greenstick fracture
115
If growth plate is involved what can happen
Permanent deformitiy
116
What are the two things we need to look for, in plaster cast - post op
Can dry unevenly, can cause pressure
117
Why is fiberglass preferred over Plaster (3)
Drys quicker, lighter, easier to remove
118
Spica body casts are from the
nipple line to ankles
119
Why is buttocks kept of bed
So no compression on sciatic nerve
120
What is Volkman's ischemia
lack of blood flow
121
Skin traction is used for children (age,weight)
under 3 years old or under 30lbs
122
Describe Russels traction
Weight pulls in two direction, body acts ad counterweight
123
Skeletal fraction is
2 weights hanging from bed frame
124
What is patient at risk for in skeletal tracrtion
risk for infection and immobility
125
In skeletal traction, what bone does it go through
Femur
126
Halo traction is used for the
Neck
127
In Bryants traction what does the patient have a risk for
Volkman's ischemia
128
Inflammation of the bone, staph aureus, and a blood borne infection is
Osteomyelitis
129
What are the 3 S&S of Osteomyelitis
Fever, Pain, Psuedoparalysis
130
With an elevated ESR, and Luekocytosis what can we expect
Osteomyelitis
131
For Osteomyeltiss it is important the the limb affected remains
immobile
132
Breakdown, deferioration of muscles, more common in males
Duchenne's Muscular Dystrophy
133
Fatty infilration of muscle cells with tissue breakdown happens in
Duchenne's Muscular Dystrophy
134
What are 4 S&S of Duchenne Muscular Dystropy
Delayed Walking, decreased muscle strength, Lordosis, Clumsiness
135
What is the name of the sign and what is it in Duchenne Muscular Dystrophy
Kids cant lift themselves off the floor, grabbing when lifting GOWERS SIGN
136
What is the life extpectancy for Duchenne Muscular Dystrophy
early 30s
137
Also known as Coxaploma, it is a Degenerative Hip disease
Legg-Calve-Perthes Disease
138
Lack of circulation to femoral head
Legg-Calve-Perthes Disease
139
Can have 4-8 years with limp, cause is unknown,
Legg-Calve-Perthes Disease
140
What usually comec before a diagnosis of Legg-Calve-Perthes Disease
Trauma or Synovitis
141
Bucks traction is mainly done to
Abduct legs
142
What are 3 tx. For Legg-Calve-Perthes Disease
Bucks traction, Hip bracing, Maintaining ROM but limiting activity
143
What is prognosis for Legg-Calve-Perthes Disease
Good-w/ potential for hip degeneration in later years
144
tumor that causes deformity and pain
Benign
145
tumor that had development of abnormal cells
Malignant
146
Growth in marrow of long bones. Mets to lungs and other bones, usually occurs after a fracture
Ewings Sarcoma
147
Primary malignant tumor of long bones
Osteosarcoma
148
What is one thing patient does not want to hear that has Osteosarcoma
Success stories
149
What are 3 things we can do for patient post op Osteosarcoma surgery
Teach about phantom limb pain, PT to prothesis, emotional support
150
Arthirits children get that usually follows a strep infection
Juvenile Rheumathoid Arthritis
151
Fever that is x10 days, affects internal organs
Systemic Fever
152
Arthritis in 5 or more joints is called
Polyarticular
153
Arthriits in 4 or less joints is called
Pauciarticular
154
Inflammation of the eyes is called
Uveitis
155
What is the child at risk for who is taking NSAIDS
ulcers and gastric bleeding
156
For kids with juvenile rheumathoid arthritis, we want to prevent Ankylosis which is a
Joint deformity
157
What will excarbate symptoms in Juvenile Rhuemathoid Arthritis
Poor nutrition
158
What can we have child do for Juvenile Rheumathooid Arthritis that might help
Do alphabet with hands and feet
159
When do we usually screen for Scoliosis and how do we confirm
Between 9-13 confirmed with X-ray
160
What is maxiumum weight for a child to carry that has scoliosis
5 lbs
161
What is the tx for Curves under 20 degrees
Good posture, backpack safety
162
What is the tx. For 20-40 degrees (3)
Bostom Brace, Milwaukee Brace, Daily exercise
163
What are 2 tx. For Curves greater than 40 degrees
Harrington Rods, Spinal Fusion
164
How long should patient have brace on
23 hours a day
165
What can patient experience post op surgery for scoliosis
Constipation
166
When can we start p.t. for Scoliosis after surgery
Minimal pt after 3 days, Intense after 6 weeks
167
What do we do post op surgery scoliosis
Log roll
168
To help skin integrity what can we tell patient to do that has a brace
Tee shirt underneath brace
169
For sports injuries how long should we apply ice at a time
20 minutes on/off
170
Brusing in the peri-area is usually a sign of
Abuse
171
Otitis media simply is a
Ear infection
172
Second hand smoke can sometimes damage the ulna resulting in a
Otitis media
173
What are 3 ways to get Otitis media
Haemophilus Influenzae, Baby w/ bottle in bed, Second hand smoke
174
What are 4 things we see for children who develop Otitis media
Pulling on ear, Irritability, Fever, Vomiting/Diarhhea
175
After ear drops what must we have child do
Lay still for 5 min
176
What do we use in the ear for tx. Of Otitis Media
Broad Spectrum Antibiotic
177
How do we place eyedrops for children under 3 years
ear lobe down and back
178
How do we place eyedrops for children over 3 years
Pinna up and back
179
It is important that we do not place what in childs ear
cotton
180
Common procedure that we do to drain fluid from straight eustacian tube
Myringotomy
181
What are 4 things we must do/ look out for post Myringectomy
keep ears dry, ear plugs, no submerging head under water, monitor for tube falling out
182
A tearing of the subcutaneous tissue that results in hemorrhage, edema, or pain
Contusion
183
Blood in soft tissue
Hematoma
184
Torn ligament or ligaments stretched. Swelling pain and immobility occurs
Sprain
185
Small tear in muscle or tednon occuring overtime, pain and edema occur
Strain
186
Break in bone
Fracture
187
What type of fracture is Bone broken but not through skin
Simple
188
Fracture that is broken bone through skin, at great risk for infection
Compund
189
Fracture that is incomplete, one side is broken other side is bent
Greenstick
190
Fracture that is caused by forceful twisting motion
Spiral
191
With a spiral fracture what must we not rule out
child abuse
192
A non-displaced fracture is when
Bones are still in alignment
193
A displaced fracture is when
Bones have shifted and need to be re-aligned
194
No surgery, bones are gently put back into place and cast or traction is applied
Closed reduction
195
Surgical procedure usually requiring pins, rods, or other devices
Open reduction
196
Used when the immobilization required is more that what could be obtained by casting
Traction
197
What are the 4 purposes of traction
Ensure alignment, Secure corrected position, prevent or treat contracture deformities, and to relieve muscle spasm and back pain
198
How do we check pulses during nuerovascular assessment
Distal to injury or cast, if it is difficult use a doppler
199
If the child cannot feel touch on the extremety what can we expect it to be
compartment syndrome
200
What are the excersies called that are used to prevent muscle atrophy and to strenghten muscle
isometric excersices
201
Weights in traction care should
hang freely and not touch the floor
202
Ropes in pulley for traction care should
Move freely, and not be obstructed
203
What is the last thing that child will develop, and when should it advance
Fine motor coordination, before 7 yo
204
By 18 months the child should be able to
Walk steady
205
By 6 years of age the child should be able to in reference to gait
walk like an adult
206
Muscle tone is developed
Cephalocaudal
207
What is psuedoparalysis
When child is afraid to move extremity because it is going to hurt
208
What are the 5 P's in Neurovasuclar Assessment
Pain, Pallor, Parasthesia, Paralysis, Pulse
209
Tearing of subcutaneous tissue
Contusion
210
Blood in the soft tissue
Hematoma
211
What does RICE stand for and what is it used for
Rest, Ice, Compression, Elevation. Soft tissue injuires
212
When elevating for a soft tissue injury what must we elevate it by
Above level of heart
213
How do we wrap an Ace bandage
Wrap distal to proximal
214
A buckle fracture is also known as a
Greenstick fracture
215
If growth plate is involved what can happen
Permanent deformitiy
216
What are the two things we need to look for, in plaster cast - post op
Can dry unevenly, can cause pressure
217
Why is fiberglass preferred over Plaster (3)
Drys quicker, lighter, easier to remove
218
Spica body casts are from the
nipple line to ankles
219
Why is buttocks kept of bed
So no compression on sciatic nerve
220
What is Volkman's ischemia
lack of blood flow
221
Skin traction is used for children (age,weight)
under 3 years old or under 30lbs
222
Describe Russels traction
Weight pulls in two direction, body acts ad counterweight
223
Skeletal fraction is
2 weights hanging from bed frame
224
What is patient at risk for in skeletal tracrtion
risk for infection and immobility
225
In skeletal traction, what bone does it go through
Femur
226
Halo traction is used for the
Neck
227
In Bryants traction what does the patient have a risk for
Volkman's ischemia
228
Inflammation of the bone, staph aureus, and a blood borne infection is
Osteomyelitis
229
What are the 3 S&S of Osteomyelitis
Fever, Pain, Psuedoparalysis
230
With an elevated ESR, and Luekocytosis what can we expect
Osteomyelitis
231
For Osteomyeltiss it is important the the limb affected remains
immobile
232
Breakdown, deferioration of muscles, more common in males
Duchenne's Muscular Dystrophy
233
Fatty infilration of muscle cells with tissue breakdown happens in
Duchenne's Muscular Dystrophy
234
What are 4 S&S of Duchenne Muscular Dystropy
Delayed Walking, decreased muscle strength, Lordosis, Clumsiness
235
What is the name of the sign and what is it in Duchenne Muscular Dystrophy
Kids cant lift themselves off the floor, grabbing when lifting GOWERS SIGN
236
What is the life extpectancy for Duchenne Muscular Dystrophy
early 30s
237
Also known as Coxaploma, it is a Degenerative Hip disease
Legg-Calve-Perthes Disease
238
Lack of circulation to femoral head
Legg-Calve-Perthes Disease
239
Can have 4-8 years with limp, cause is unknown,
Legg-Calve-Perthes Disease
240
What usually comec before a diagnosis of Legg-Calve-Perthes Disease
Trauma or Synovitis
241
Bucks traction is mainly done to
Abduct legs
242
What are 3 tx. For Legg-Calve-Perthes Disease
Bucks traction, Hip bracing, Maintaining ROM but limiting activity
243
What is prognosis for Legg-Calve-Perthes Disease
Good-w/ potential for hip degeneration in later years
244
tumor that causes deformity and pain
Benign
245
tumor that had development of abnormal cells
Malignant
246
Growth in marrow of long bones. Mets to lungs and other bones, usually occurs after a fracture
Ewings Sarcoma
247
Primary malignant tumor of long bones
Osteosarcoma
248
What is one thing patient does not want to hear that has Osteosarcoma
Success stories
249
What are 3 things we can do for patient post op Osteosarcoma surgery
Teach about phantom limb pain, PT to prothesis, emotional support
250
Arthirits children get that usually follows a strep infection
Juvenile Rheumathoid Arthritis
251
Fever that is x10 days, affects internal organs
Systemic Fever
252
Arthritis in 5 or more joints is called
Polyarticular
253
Arthriits in 4 or less joints is called
Pauciarticular
254
Inflammation of the eyes is called
Uveitis
255
What is the child at risk for who is taking NSAIDS
ulcers and gastric bleeding
256
For kids with juvenile rheumathoid arthritis, we want to prevent Ankylosis which is a
Joint deformity
257
What will excarbate symptoms in Juvenile Rhuemathoid Arthritis
Poor nutrition
258
What can we have child do for Juvenile Rheumathooid Arthritis that might help
Do alphabet with hands and feet
259
When do we usually screen for Scoliosis and how do we confirm
Between 9-13 confirmed with X-ray
260
What is maxiumum weight for a child to carry that has scoliosis
5 lbs
261
What is the tx for Curves under 20 degrees
Good posture, backpack safety
262
What is the tx. For 20-40 degrees (3)
Bostom Brace, Milwaukee Brace, Daily exercise
263
What are 2 tx. For Curves greater than 40 degrees
Harrington Rods, Spinal Fusion
264
How long should patient have brace on
23 hours a day
265
What can patient experience post op surgery for scoliosis
Constipation
266
When can we start p.t. for Scoliosis after surgery
Minimal pt after 3 days, Intense after 6 weeks
267
What do we do post op surgery scoliosis
Log roll
268
To help skin integrity what can we tell patient to do that has a brace
Tee shirt underneath brace
269
For sports injuries how long should we apply ice at a time
20 minutes on/off
270
Brusing in the peri-area is usually a sign of
Abuse
271
Otitis media simply is a
Ear infection
272
Second hand smoke can sometimes damage the ulna resulting in a
Otitis media
273
What are 3 ways to get Otitis media
Haemophilus Influenzae, Baby w/ bottle in bed, Second hand smoke
274
What are 4 things we see for children who develop Otitis media
Pulling on ear, Irritability, Fever, Vomiting/Diarhhea
275
After ear drops what must we have child do
Lay still for 5 min
276
What do we use in the ear for tx. Of Otitis Media
Broad Spectrum Antibiotic
277
How do we place eyedrops for children under 3 years
ear lobe down and back
278
How do we place eyedrops for children over 3 years
Pinna up and back
279
It is important that we do not place what in childs ear
cotton
280
Common procedure that we do to drain fluid from straight eustacian tube
Myringotomy
281
What are 4 things we must do/ look out for post Myringectomy
keep ears dry, ear plugs, no submerging head under water, monitor for tube falling out
282
A tearing of the subcutaneous tissue that results in hemorrhage, edema, or pain
Contusion
283
Blood in soft tissue
Hematoma
284
Torn ligament or ligaments stretched. Swelling pain and immobility occurs
Sprain
285
Small tear in muscle or tednon occuring overtime, pain and edema occur
Strain
286
Break in bone
Fracture
287
What type of fracture is Bone broken but not through skin
Simple
288
Fracture that is broken bone through skin, at great risk for infection
Compund
289
Fracture that is incomplete, one side is broken other side is bent
Greenstick
290
Fracture that is caused by forceful twisting motion
Spiral
291
With a spiral fracture what must we not rule out
child abuse
292
A non-displaced fracture is when
Bones are still in alignment
293
A displaced fracture is when
Bones have shifted and need to be re-aligned
294
No surgery, bones are gently put back into place and cast or traction is applied
Closed reduction
295
Surgical procedure usually requiring pins, rods, or other devices
Open reduction
296
Used when the immobilization required is more that what could be obtained by casting
Traction
297
What are the 4 purposes of traction
Ensure alignment, Secure corrected position, prevent or treat contracture deformities, and to relieve muscle spasm and back pain
298
How do we check pulses during nuerovascular assessment
Distal to injury or cast, if it is difficult use a doppler
299
If the child cannot feel touch on the extremety what can we expect it to be
compartment syndrome
300
What are the excersies called that are used to prevent muscle atrophy and to strenghten muscle
isometric excersices
301
Weights in traction care should
hang freely and not touch the floor
302
Ropes in pulley for traction care should
Move freely, and not be obstructed
303
What is the last thing that child will develop, and when should it advance
Fine motor coordination, before 7 yo
304
By 18 months the child should be able to
Walk steady
305
By 6 years of age the child should be able to in reference to gait
walk like an adult
306
Muscle tone is developed
Cephalocaudal
307
What is psuedoparalysis
When child is afraid to move extremity because it is going to hurt
308
What are the 5 P's in Neurovasuclar Assessment
Pain, Pallor, Parasthesia, Paralysis, Pulse
309
Tearing of subcutaneous tissue
Contusion
310
Blood in the soft tissue
Hematoma
311
What does RICE stand for and what is it used for
Rest, Ice, Compression, Elevation. Soft tissue injuires
312
When elevating for a soft tissue injury what must we elevate it by
Above level of heart
313
How do we wrap an Ace bandage
Wrap distal to proximal
314
A buckle fracture is also known as a
Greenstick fracture
315
If growth plate is involved what can happen
Permanent deformitiy
316
What are the two things we need to look for, in plaster cast - post op
Can dry unevenly, can cause pressure
317
Why is fiberglass preferred over Plaster (3)
Drys quicker, lighter, easier to remove
318
Spica body casts are from the
nipple line to ankles
319
Why is buttocks kept of bed
So no compression on sciatic nerve
320
What is Volkman's ischemia
lack of blood flow
321
Skin traction is used for children (age,weight)
under 3 years old or under 30lbs
322
Describe Russels traction
Weight pulls in two direction, body acts ad counterweight
323
Skeletal fraction is
2 weights hanging from bed frame
324
What is patient at risk for in skeletal tracrtion
risk for infection and immobility
325
In skeletal traction, what bone does it go through
Femur
326
Halo traction is used for the
Neck
327
In Bryants traction what does the patient have a risk for
Volkman's ischemia
328
Inflammation of the bone, staph aureus, and a blood borne infection is
Osteomyelitis
329
What are the 3 S&S of Osteomyelitis
Fever, Pain, Psuedoparalysis
330
With an elevated ESR, and Luekocytosis what can we expect
Osteomyelitis
331
For Osteomyeltiss it is important the the limb affected remains
immobile
332
Breakdown, deferioration of muscles, more common in males
Duchenne's Muscular Dystrophy
333
Fatty infilration of muscle cells with tissue breakdown happens in
Duchenne's Muscular Dystrophy
334
What are 4 S&S of Duchenne Muscular Dystropy
Delayed Walking, decreased muscle strength, Lordosis, Clumsiness
335
What is the name of the sign and what is it in Duchenne Muscular Dystrophy
Kids cant lift themselves off the floor, grabbing when lifting GOWERS SIGN
336
What is the life extpectancy for Duchenne Muscular Dystrophy
early 30s
337
Also known as Coxaploma, it is a Degenerative Hip disease
Legg-Calve-Perthes Disease
338
Lack of circulation to femoral head
Legg-Calve-Perthes Disease
339
Can have 4-8 years with limp, cause is unknown,
Legg-Calve-Perthes Disease
340
What usually comec before a diagnosis of Legg-Calve-Perthes Disease
Trauma or Synovitis
341
Bucks traction is mainly done to
Abduct legs
342
What are 3 tx. For Legg-Calve-Perthes Disease
Bucks traction, Hip bracing, Maintaining ROM but limiting activity
343
What is prognosis for Legg-Calve-Perthes Disease
Good-w/ potential for hip degeneration in later years
344
tumor that causes deformity and pain
Benign
345
tumor that had development of abnormal cells
Malignant
346
Growth in marrow of long bones. Mets to lungs and other bones, usually occurs after a fracture
Ewings Sarcoma
347
Primary malignant tumor of long bones
Osteosarcoma
348
What is one thing patient does not want to hear that has Osteosarcoma
Success stories
349
What are 3 things we can do for patient post op Osteosarcoma surgery
Teach about phantom limb pain, PT to prothesis, emotional support
350
Arthirits children get that usually follows a strep infection
Juvenile Rheumathoid Arthritis
351
Fever that is x10 days, affects internal organs
Systemic Fever
352
Arthritis in 5 or more joints is called
Polyarticular
353
Arthriits in 4 or less joints is called
Pauciarticular
354
Inflammation of the eyes is called
Uveitis
355
What is the child at risk for who is taking NSAIDS
ulcers and gastric bleeding
356
For kids with juvenile rheumathoid arthritis, we want to prevent Ankylosis which is a
Joint deformity
357
What will excarbate symptoms in Juvenile Rhuemathoid Arthritis
Poor nutrition
358
What can we have child do for Juvenile Rheumathooid Arthritis that might help
Do alphabet with hands and feet
359
When do we usually screen for Scoliosis and how do we confirm
Between 9-13 confirmed with X-ray
360
What is maxiumum weight for a child to carry that has scoliosis
5 lbs
361
What is the tx for Curves under 20 degrees
Good posture, backpack safety
362
What is the tx. For 20-40 degrees (3)
Bostom Brace, Milwaukee Brace, Daily exercise
363
What are 2 tx. For Curves greater than 40 degrees
Harrington Rods, Spinal Fusion
364
How long should patient have brace on
23 hours a day
365
What can patient experience post op surgery for scoliosis
Constipation
366
When can we start p.t. for Scoliosis after surgery
Minimal pt after 3 days, Intense after 6 weeks
367
What do we do post op surgery scoliosis
Log roll
368
To help skin integrity what can we tell patient to do that has a brace
Tee shirt underneath brace
369
For sports injuries how long should we apply ice at a time
20 minutes on/off
370
Brusing in the peri-area is usually a sign of
Abuse
371
Otitis media simply is a
Ear infection
372
Second hand smoke can sometimes damage the ulna resulting in a
Otitis media
373
What are 3 ways to get Otitis media
Haemophilus Influenzae, Baby w/ bottle in bed, Second hand smoke
374
What are 4 things we see for children who develop Otitis media
Pulling on ear, Irritability, Fever, Vomiting/Diarhhea
375
After ear drops what must we have child do
Lay still for 5 min
376
What do we use in the ear for tx. Of Otitis Media
Broad Spectrum Antibiotic
377
How do we place eyedrops for children under 3 years
ear lobe down and back
378
How do we place eyedrops for children over 3 years
Pinna up and back
379
It is important that we do not place what in childs ear
cotton
380
Common procedure that we do to drain fluid from straight eustacian tube
Myringotomy
381
What are 4 things we must do/ look out for post Myringectomy
keep ears dry, ear plugs, no submerging head under water, monitor for tube falling out
382
A tearing of the subcutaneous tissue that results in hemorrhage, edema, or pain
Contusion
383
Blood in soft tissue
Hematoma
384
Torn ligament or ligaments stretched. Swelling pain and immobility occurs
Sprain
385
Small tear in muscle or tednon occuring overtime, pain and edema occur
Strain
386
Break in bone
Fracture
387
What type of fracture is Bone broken but not through skin
Simple
388
Fracture that is broken bone through skin, at great risk for infection
Compund
389
Fracture that is incomplete, one side is broken other side is bent
Greenstick
390
Fracture that is caused by forceful twisting motion
Spiral
391
With a spiral fracture what must we not rule out
child abuse
392
A non-displaced fracture is when
Bones are still in alignment
393
A displaced fracture is when
Bones have shifted and need to be re-aligned
394
No surgery, bones are gently put back into place and cast or traction is applied
Closed reduction
395
Surgical procedure usually requiring pins, rods, or other devices
Open reduction
396
Used when the immobilization required is more that what could be obtained by casting
Traction
397
What are the 4 purposes of traction
Ensure alignment, Secure corrected position, prevent or treat contracture deformities, and to relieve muscle spasm and back pain
398
How do we check pulses during nuerovascular assessment
Distal to injury or cast, if it is difficult use a doppler
399
If the child cannot feel touch on the extremety what can we expect it to be
compartment syndrome
400
What are the excersies called that are used to prevent muscle atrophy and to strenghten muscle
isometric excersices
401
Weights in traction care should
hang freely and not touch the floor
402
Ropes in pulley for traction care should
Move freely, and not be obstructed
403
What is the last thing that child will develop, and when should it advance
Fine motor coordination, before 7 yo
404
By 18 months the child should be able to
Walk steady
405
By 6 years of age the child should be able to in reference to gait
walk like an adult
406
Muscle tone is developed
Cephalocaudal
407
What is psuedoparalysis
When child is afraid to move extremity because it is going to hurt
408
What are the 5 P's in Neurovasuclar Assessment
Pain, Pallor, Parasthesia, Paralysis, Pulse
409
Tearing of subcutaneous tissue
Contusion
410
Blood in the soft tissue
Hematoma
411
What does RICE stand for and what is it used for
Rest, Ice, Compression, Elevation. Soft tissue injuires
412
When elevating for a soft tissue injury what must we elevate it by
Above level of heart
413
How do we wrap an Ace bandage
Wrap distal to proximal
414
A buckle fracture is also known as a
Greenstick fracture
415
If growth plate is involved what can happen
Permanent deformitiy
416
What are the two things we need to look for, in plaster cast - post op
Can dry unevenly, can cause pressure
417
Why is fiberglass preferred over Plaster (3)
Drys quicker, lighter, easier to remove
418
Spica body casts are from the
nipple line to ankles
419
Why is buttocks kept of bed
So no compression on sciatic nerve
420
What is Volkman's ischemia
lack of blood flow
421
Skin traction is used for children (age,weight)
under 3 years old or under 30lbs
422
Describe Russels traction
Weight pulls in two direction, body acts ad counterweight
423
Skeletal fraction is
2 weights hanging from bed frame
424
What is patient at risk for in skeletal tracrtion
risk for infection and immobility
425
In skeletal traction, what bone does it go through
Femur
426
Halo traction is used for the
Neck
427
In Bryants traction what does the patient have a risk for
Volkman's ischemia
428
Inflammation of the bone, staph aureus, and a blood borne infection is
Osteomyelitis
429
What are the 3 S&S of Osteomyelitis
Fever, Pain, Psuedoparalysis
430
With an elevated ESR, and Luekocytosis what can we expect
Osteomyelitis
431
For Osteomyeltiss it is important the the limb affected remains
immobile
432
Breakdown, deferioration of muscles, more common in males
Duchenne's Muscular Dystrophy
433
Fatty infilration of muscle cells with tissue breakdown happens in
Duchenne's Muscular Dystrophy
434
What are 4 S&S of Duchenne Muscular Dystropy
Delayed Walking, decreased muscle strength, Lordosis, Clumsiness
435
What is the name of the sign and what is it in Duchenne Muscular Dystrophy
Kids cant lift themselves off the floor, grabbing when lifting GOWERS SIGN
436
What is the life extpectancy for Duchenne Muscular Dystrophy
early 30s
437
Also known as Coxaploma, it is a Degenerative Hip disease
Legg-Calve-Perthes Disease
438
Lack of circulation to femoral head
Legg-Calve-Perthes Disease
439
Can have 4-8 years with limp, cause is unknown,
Legg-Calve-Perthes Disease
440
What usually comec before a diagnosis of Legg-Calve-Perthes Disease
Trauma or Synovitis
441
Bucks traction is mainly done to
Abduct legs
442
What are 3 tx. For Legg-Calve-Perthes Disease
Bucks traction, Hip bracing, Maintaining ROM but limiting activity
443
What is prognosis for Legg-Calve-Perthes Disease
Good-w/ potential for hip degeneration in later years
444
tumor that causes deformity and pain
Benign
445
tumor that had development of abnormal cells
Malignant
446
Growth in marrow of long bones. Mets to lungs and other bones, usually occurs after a fracture
Ewings Sarcoma
447
Primary malignant tumor of long bones
Osteosarcoma
448
What is one thing patient does not want to hear that has Osteosarcoma
Success stories
449
What are 3 things we can do for patient post op Osteosarcoma surgery
Teach about phantom limb pain, PT to prothesis, emotional support
450
Arthirits children get that usually follows a strep infection
Juvenile Rheumathoid Arthritis
451
Fever that is x10 days, affects internal organs
Systemic Fever
452
Arthritis in 5 or more joints is called
Polyarticular
453
Arthriits in 4 or less joints is called
Pauciarticular
454
Inflammation of the eyes is called
Uveitis
455
What is the child at risk for who is taking NSAIDS
ulcers and gastric bleeding
456
For kids with juvenile rheumathoid arthritis, we want to prevent Ankylosis which is a
Joint deformity
457
What will excarbate symptoms in Juvenile Rhuemathoid Arthritis
Poor nutrition
458
What can we have child do for Juvenile Rheumathooid Arthritis that might help
Do alphabet with hands and feet
459
When do we usually screen for Scoliosis and how do we confirm
Between 9-13 confirmed with X-ray
460
What is maxiumum weight for a child to carry that has scoliosis
5 lbs
461
What is the tx for Curves under 20 degrees
Good posture, backpack safety
462
What is the tx. For 20-40 degrees (3)
Bostom Brace, Milwaukee Brace, Daily exercise
463
What are 2 tx. For Curves greater than 40 degrees
Harrington Rods, Spinal Fusion
464
How long should patient have brace on
23 hours a day
465
What can patient experience post op surgery for scoliosis
Constipation
466
When can we start p.t. for Scoliosis after surgery
Minimal pt after 3 days, Intense after 6 weeks
467
What do we do post op surgery scoliosis
Log roll
468
To help skin integrity what can we tell patient to do that has a brace
Tee shirt underneath brace
469
For sports injuries how long should we apply ice at a time
20 minutes on/off
470
Brusing in the peri-area is usually a sign of
Abuse
471
Otitis media simply is a
Ear infection
472
Second hand smoke can sometimes damage the ulna resulting in a
Otitis media
473
What are 3 ways to get Otitis media
Haemophilus Influenzae, Baby w/ bottle in bed, Second hand smoke
474
What are 4 things we see for children who develop Otitis media
Pulling on ear, Irritability, Fever, Vomiting/Diarhhea
475
After ear drops what must we have child do
Lay still for 5 min
476
What do we use in the ear for tx. Of Otitis Media
Broad Spectrum Antibiotic
477
How do we place eyedrops for children under 3 years
ear lobe down and back
478
How do we place eyedrops for children over 3 years
Pinna up and back
479
It is important that we do not place what in childs ear
cotton
480
Common procedure that we do to drain fluid from straight eustacian tube
Myringotomy
481
What are 4 things we must do/ look out for post Myringectomy
keep ears dry, ear plugs, no submerging head under water, monitor for tube falling out
482
Hearing impairment prenataly usually comes from what two things
Viral infection, garman measles
483
Acquired deafness usally comes from what 4 things
Measles, Mumps, Meningitis, and exposure to loud noise
484
What are 3 things we can do to better communication in imparied hearing
Gain child attention before speaking, face at eye level, proper care of hearing devices
485
What is the eye chart called
Snelly chart
486
Increased oxygen can usually lead to
Eye problems, Retinopathy or Nueropathy
487
Irregular shaped cornea or lens, that causes blurry vision is called
Astigmitism
488
Astigmitism is usally tx. With
Corrective lenses
489
Wandering, lazy eye, due to decreased muscle is called
Amblyopia
490
What does child do frequently that has Amblyopia
Cover bad eye when trying to focus
491
What is the tx. For Amblyopia
Patch good eye 22 out of 24 hrs a day
492
Ambylopia can occur up to how many years old
nine
493
Unable to focus eyes at sametime also called cross eyed
Strabismus
494
What are two tx for Strabismus
Alternating patches in unaffected eye, training excercis (Vision therapy)
495
Children with Conjuctivitis usually wake up with very dry eyes, what can we do
Warm compress to ears, wipe from inner to outer
496
Bleeding into the anterior chamber of the eye
Hyphema
497
How does Hyphemas usually happen
Blunt trauma or penetration
498
Children with Hyphemas should be on strict bed rest for how long
7-10 days
499
How do we tx. Hyphemas (3)
Strict bed rest, Both eyes patched, CBR to prevent increase of IOP
500
Retinoblastomas usually develops when
in utero
501
What is one way we can pre-diagnose Retinoblastoma
Light does not refrect properly (pictures)
502
Malignant tumor Chromosone 13 defieceny
Retinoblastoma
503
Cats eye is associated with
Retinoblastoma
504
Cryosurgery is used for what and why
Retinoblastoma, best and least invasive
505
Freezing by lazer used for Retinoblastoma
Cryosurgery
506
Enucleation is the
Removal of eye
507
Tx. That destorys blood vessels by laser used for Retinoblastoma
Photocoagulation
508
What are 3 nursing responsicbilties for Retinoblastoma
Elbow restraints, protect pressure dressing, eye prothess
509
Commuted fractures are usually what related
Sport
510
For kids in bryants traction we should always observe for
risk of aspiration
511
Osteomyeltitis usually happens in kids who (2)
DonÕt wear shoes, step on a pebble
512
Elevated Serum levels can usually mean
Duchenne's Muscular Dystrophy
513
Kids with Duchenne Muscular Dystrophy tend to have a overgrown
Calf muscle
514
Anemia usually occurs due to
Ewings Sarcoma
515
Meningitis can usually lead to
Deafness
