Exam

Question 1

4 functions of skin

Answer 1

Provide sensory input
Provide protection
Thermoregulation
Warning system for danger

Question 2

primary lesions

Answer 2

-skin changes produced by a causative factor
-Macules, papules, vesicles, patches, bullae, plaque, wheals, nodules, pustules, cysts

Question 3

secondary lesions

Answer 3

-Changes that result from alteration in the primary lesions, such as those caused by rubbing, scratching, medication, or involution and healing
-Crust, keloid, scar, fissure, excoriation, scale

Question 4

superficial burn

Answer 4

-Erythema, pain, heals 5-10 days, no scar
-Eg. sunburn

Question 5

partial thickness burn

Answer 5

-Epidermis and dermis
-Painful, moist, red, blister
-Heal in 14-21 days, scarring
-Wound is extremely sensitive

Question 6

full thickness burn

Answer 6

-Extend into subcutaneous tissue
-Nerve endings, sweat glands, hair follicles are destroyed
-Dry leathery appearance (deep red, white, black, brown)
-Loss of sensation (no pain)

Question 7

Full-thickness + underlying tissue burn

Answer 7

Muscle, fascia, bone, ligaments, tendons

Question 8

severity of burn injury

Answer 8

-Major burn injury: treat in specialized burn centre
-Moderate burn injury: treat in hospital with expertise in burn treatment
-Minor burn injury: treat in outpatient setting

Question 9

acute phase of burn

Answer 9

-First 24-48 hours
-Treatment of burn shock and management of pulmonary status
-Check peripheral pulses of burned extremity every hour

Question 10

management and rehab stage of burn

Answer 10

Completion of resuscitation through wound coverage
Preventing infection, closing the wound

Question 11

The major musculoskeletal consequences of immobilization

Answer 11

-Significant decrease in muscle size (atrophy), strength, and endurance
-Bone demineralization leading to osteoporosis → fractures
-Contractures and decreased joint mobility

Question 12

Psychological effects of immobility

Answer 12

-Diminished environmental stimuli
-Altered perception of self and environment
-Increased feelings of frustration and helplessness
-Depression, anger, protest, aggressive behaviour
-Developmental regression

Question 13

contusion

Answer 13

-Bruise
-Damage to soft tissue, subcutaneous structures, and muscle
-Escape of blood into tissues which causes ecchymosis
-Swelling, pain, disability
-Crush injuries (slam fingers in door, contact sports, etc)

Question 14

dislocations

Answer 14

-Occur when force of stress on ligament is sufficient to displace normal position of opposing bone ends or bone ends to socket
-Pain increases with active or passive movement of the affected extremity.
-May be an obvious deformity
-Subluxation or partial dislocation of radial head (pulled elbow) is common in kids under 5
-Should reset asap

Question 15

sprains

Answer 15

-Trauma to a joint from where the ligament is partially or completely torn or stretched by force
-May have associated damage to blood vessels, muscles, tendons, and nerves
-Grading (1, 2, 3)
-Rapid onset of swelling with disability, pain

Question 16

strain

Answer 16

-A microscopic tear to musculotendinous unit
-Similar to sprain
-Swollen, painful to touch
-Generally incurred over time

Question 17

types of fractures

Answer 17

-Complete: fracture fragments are separated
-Incomplete: fragments remain attached
-Simple or closed: no break in the skin
-Open or compound: Fractured bone protrudes through the skin
-Complicated: Bone fragments have damaged other organs or tissues
-Comminuted: Small fragments of bone are broken from fractured shaft and lie in surrounding tissue

Question 18

PRICE

Answer 18

P - Protection
R - Rest the injured part
I - Ice immediately (maximum 20 minutes at a time)
C - Compression with wet elastic bandage
E - Elevation of the extremity (several inches above the heart)

Immobilization and support (casts or splints as appropriate to injury)

Question 19

growth plate injuries

Answer 19

-The weakest point of long bones is the cartilage growth plate (epiphyseal plate).
-Frequent site of damage during trauma
-May affect future bone growth

Question 20

Bone healing and remodelling

Answer 20

-Bone healing and remodelling
-Newborn period: 2 to 3 weeks
-Early childhood: 4 weeks
-Later childhood: 6 to 8 weeks
-Adolescence: 8 to 12 weeks

Question 21

compartment syndrome - 6 Ps

Answer 21

-Pain: Severe pain that is not relieved by analgesics or elevation of the limb, movement that increases pain
-Pulselessness: Inability to palpate a pulse distal to the fracture or compartment
-Pallor: Pale appearing skin, poor perfusion, capillary refill greater than 3 seconds
-Paresthesia: Tingling or burning sensations
-Paralysis: Inability to move extremity or digits
-Pressure: Involved limb or digits may feel tense and warm; skin is tight, shiny; pressure within the compartment is elevated

Question 22

The main purposes of the traction

Answer 22

-Fatigue muscle to reduce spasm for realignment
-Align bone fragments
-Immobilize fracture until realignment is achieved
-To help prevent or improve contracture deformity
-To provide immobilization of specific areas of the body
-To reduce muscle spasms (rare in children)

Question 23

manual traction

Answer 23

Applied to the body part by the hands placed distal to the fracture site. Manual traction may be provided during application of a cast but more commonly when a closed reduction is performed.

Question 24

skin traction

Answer 24

Applied directly to the skin surface and indirectly to the skeletal structures. The pulling mechanism is attached to the skin with adhesive material or an elastic bandage. Both types are applied over soft, foam-backed traction straps to distribute the traction pull.

Question 25

skeletal traction

Answer 25

Applied directly to the skeletal structure by a pin, wire, or tongs inserted into or through the diameter of the bone distal to the fracture.

Question 26

distraction

Answer 26

-Process of separating opposing bone to encourage regeneration of new bone in created space
-Can be used when limbs are unequal in length and new bone is needed to elongate shorter limb
-External fixation device commonly used

Nursing care:
-Teach family: good hand hygiene, pin care, including observation for infection and loosening of the pins
-Use of crutches

Question 27

amputation - stump hygiene

Answer 27

soap-and-water washing every day and checking for skin irritation, breakdown, or infection

Question 28

When is the optimum time for the child to be fitted with a prosthetic device?

Answer 28

When the infant begins sitting up and can maintain balance

Question 29

Signs of hyperglycemia

Answer 29

Lethargic, confusion, thirst, weakness, N/V, abdo pain, flushed, signs of dehydration, kussmaul’s respirations, fruity breath, diminished reflexes, polyuria, blurred vision

Question 30

Signs of hypoglycemia

Answer 30

Labile, irritable, nervous, difficulty concentrating, speaking, focusing, shaky feeling, headache, dizziness, pallor, sweating, tachycardia, palpitations, tremors, dilated pupils, diplopia