Final Exam Flashcards

1
Q

Fluid-filled lesion greater than 1 cm in diameter

A

Bulla

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2
Q

Inflammation of skin and subcutaneous tissue

A

Cellulitis

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3
Q

Highly vascular, inner supportive layer of skin

A

Dermis

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4
Q

Also known as atopic dermatitis; chronic superficial inflammatory skin disorder characterized by dry scaly patches and pruritus

A

Eczema

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5
Q

Tough, outer layer of skin

A

Epidermis

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6
Q

Diffuse skin redness

A

Erythema

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7
Q

Highly ocntagious superficial skin infection caused by group A beta-hemolytic streptococcus or Staphylococcus aureus

A

Impetigo

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8
Q

Large, dry thinckeded lesions

A

Lichenification

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9
Q

Discolored spot on skin that is neigher raised nor depressed

A

Macule

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10
Q

Raised lesion

A

Papule

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11
Q

Head lice

A

Pediculosis capitis

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12
Q

Itchiness

A

Pruritus

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13
Q

Small, blisterlike elevation that contains pus

A

Pustule

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14
Q

Skin infestation caused by scabies mite

A

Scabies

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15
Q

Small, blisterlike elevation that contains serous fluid

A

Vesicle

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16
Q

Accessory structures of skin include

A

Hair, nails, Glands

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17
Q

Provide sebum into hair follicle

A

Sebaceous Gland

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18
Q

Provides thermoregulation through sweating

A

Sweat Gland

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19
Q

First line of defense against infectious organisms

A

Skin

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20
Q

Newborns are covered with this. Shed in first month of life

A

Lanugo

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21
Q

Newborns have thin ______ and little _______

A

skin, subcutaneous fat

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22
Q

Sweat glands are not fully developed until

A

Middle childhood

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23
Q

dark-colored areas may be present on sacrum or buttocks of Native American, Asian, African-American, or Latino infants

A

Mongolian spots (dermae melanocytosis)

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24
Q

Non-invasive procedure in which a skin sample is obtained with a sterile applicator; used to identify viral, bacterial, or fungal causes of skin lesions

A

Skin cultures

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25
Q

Non-invasive procedure in which epithelial cells are scraped off and examined microscopically to identify viral, bacterial, fungal, or parasitic causes of skin lesions

A

Skin scrapings

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26
Q

Invasive procedure in which a skin sample is removed for histological analysis

A

Skin biopsy

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27
Q

Requires informed consent.
May need to apply pressure to site until bleeding stops; sutures may be required.
Used to identify tumors or persistent dermatitis

A

Skin biopsy

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28
Q

Frequently related to food allergies when seen in infants

A

Eczema

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29
Q

Often related to allergies to dust mites when seen in older children

A

Eczema

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30
Q

Intensified by dry skin, detergents, constricting clothing, or perfumed soaps and lotions

A

Eczema

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31
Q

Red papules (raised lesions) usually appear first on cheeks and then spread to forehead, scalp, and down extensor surfaces of arms and legs

A

Eczema

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32
Q

Characterized in adolescents by lichenification on flexor folds, face, neck, back, upper arms, and dorsal aspects of hands, feet, fingers, and toes

A

Eczema

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33
Q

Teach to pat, not rub, skin dry after bathing when dealing with

A

Eczema

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34
Q

Used to control itching

A

Antihistamines

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35
Q

Topical steroids are applied to lesions to reduce inflammation during flare-ups of

A

Eczema

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36
Q

Begins with a single erythematous macule (nonraised discolored spot) 2 to 4 mm in diameter that rapidly progresses to a vesicle (small, blisterlike elevation that contains serous fluid) or pustule (small, blisterlike elevation that contains pus)

A

Nonbullous impetigo

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37
Q

Soak crusts of these bullae in warm water

A

Impetigo

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38
Q

Apply topical antibiotic ointment such as Neosporin, Polysporin, Bacitracin, or mupirocin (Bactroban) three or four times daily for five to seven days or as ordered for

A

Impetigo

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39
Q

Systemic antibiotic may be ordered, such as dicloxacillin (Dynapen), cephalexin (Keflex), cefaclor (Duricef), or erythromycin, if no response to topical antibiotics in 72 hours for

A

Impetigo

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40
Q

Infection is communicable for 48 hours after antibiotic treatment is begun with

A

Impetigo

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41
Q

Incubation period for nits (eggs) is 8 to 10 days for

A

Head lice (Pediculosis capitus)

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42
Q

Can survive up to 48 hours away from human host

A

Lice

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43
Q

Nits can survive for 8 to 10 days away from human host

A

Lice nits (eggs)

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44
Q

Apply about two ounces of pediculicidal agent onto wet hair and add additional water to make a lather, and allow lather to remain on hair for 10 minutes, then rinse hair thoroughly, for

A

Head lice

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45
Q

Wash clothing in hot water, and dry for at least 20 minutes for

A

Head lice

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46
Q

A second treatment may be needed 7 to 10 days after the first treatment for

A

Head lice

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47
Q

Itching begins about one month after infestation from

A

Scabies

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48
Q

Characterized by intense pruritus, especially at night and nap times.
Lesions appear as linear, grayish burrows 1 to 10 cm long ending in a pinpoint vesicle, papule, or nodule

A

Scabies

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49
Q

Apply lotion to cool, dry skin over entire body from chin down, and leave on for 8 to 12 hours before washing off. May apply to face of child older than 2 months if lesions are present, for ________

A

Scabies

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50
Q

All family members and close contacts (playmates and caregivers) should be treated, when dealing with

A

Scabies

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51
Q

Items that connot be washed should be sealed in plastic bags for four days before use, when dealing with

A

Scabies

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52
Q

Crotamiton (Eurax) and permethrin 5% cream (Elimite) are used for

A

Scabies

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53
Q

lindane (Kwell) should not be used on ______ or _______ because of risk of neurotoxicity and seizures

A

infants, young children

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54
Q

Most common site is legs, but any area can be affected

A

Cellulitis

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55
Q

History of trauma, impetigo, recent otitis media, or sinusitis may result in

A

Cellulitis

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56
Q

Usually results from a recent sinus infection

A

Periorbital Cellulitis

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57
Q

Facial cellulitis in young children usually results from recent episode of

A

Otitis media

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58
Q

Clients with this often appear ill and are often febrile

A

Cellulitis

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59
Q

Warmth and tenderness are present over affected site of

A

Cellulitis

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60
Q

Regional lymph nodes are often enlarged with

A

Cellulitis

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61
Q

White blood count will be elevated with

A

Cellulitis

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62
Q

Apply warm compress to affected area of

A

Cellulitis

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63
Q

Broad spectrum parenteral antibiotics are administered for this until infection subsides, then switch to oral; frequently prescribed antibiotics are nafcillin (Nafcil), dicloxacillin (Dynapen), or ceftriaxone (Rocephin)

A

Cellulitis

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64
Q

Oral antibiotics for this are usually prescribed for 10 days; frequently prescribed antibiotics are amoxicillin/clavulanate (Augmentin) or oxacillin (Bactocill)

A

Cellulitis

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65
Q

Marked improvement should be seen with treatment in 48 hours when dealing with

A

Cellulitis

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66
Q

Causes of burns

A

Thermal, chemical, electrical, or radioactive

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67
Q

Second-leading cause of injury or death in clients under age 14

A

Burns

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68
Q

Exposure of skin to flames, scalds, or contact with a hot object

A

Thermal burns

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69
Q

Exposure of skin or mucous membranes to chemical or caustic agents

A

Chemical burns

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70
Q

Exposure to electrical current in wires or appliances

A

Electrical burns

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71
Q

Exposure of skin to sunlight or radioactive substances

A

Radioactive burns

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72
Q

Substantial edema and capillary damage occur at site of injury in this type of burn

A

Partial-thickness (Second-degree) burns

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73
Q

A systemic response occurs of increased capillary permeability, which causes loss of fluid, electrolytes, and plasma proteins

A

Full-thickness (Third-degree) burns

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74
Q

This chart identifies extent of burn in a child

A

Lund and Browder

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75
Q

Partial- and full-thickness burns to less than 10% of total body surface area (TBSA) with no other significant injuries; client is more than 5 years old; and no burns on hands, feet, genitalia, face, nor any circumferential burns

A

Minor burns

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76
Q

Full-thickness burns of more than 10% of TBSA; burns of hands, feet, genitalia, face, or any circumferential burns; respiratory tract involvement; fractures or other soft tissue injuries; or deep chemical or electrical burns

A

Major burns

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77
Q

Damaged epithelium peels off in 5 to 10 days without scarring

A

Superficial burns (e.g., sunburn)

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78
Q

Crusts form in three to five days, and healing takes place from beneath.
May be grafted to speed healing if large area

A

Partial-thickness burns

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79
Q

Healing is slow with thin epithelial covering in about a month; scarring is usual.
Requires grafting unless very small injury

A

Full-thickness burns

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80
Q

Burns covering more than _______% TBSA usually require fluid replacement

A

10%

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81
Q

Assess renal function and urine output when dealing with

A

Burns

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82
Q

Morphine via IV route is usually prescribed for

A

Major burns

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83
Q

Administer analgesic about ____ minutes before wound care for ______

A

30, burns

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84
Q

Fluid of choice for burns

A

Lactated Ringers

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85
Q

Based on formula that considers body weight, body surface area, and maintenance needs

A

Fluid replacement for burns

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86
Q

Unless immunization status is known, administer tetanus toxoid for

A

Burns

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87
Q

Use mafenide (Sulfamylon), silver sulfadiazine (Silvadene), or bacitracin as topical antimicrobials for

A

Major burns

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88
Q

Infants and young children with ______ may need to be restrained

A

Burns

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89
Q

Give high-calorie, high-protein, high-carbohydrate diet to promote wound healing from

A

Burns

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90
Q

Debride wound every ___ to ____ hours as prescribed

A

8, 12

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91
Q

Must be washed off and reapplied every 8 to 12 hours

A

Sulfadiazine (Silvadene)

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92
Q

H2-receptor antagonists such as ranitidine (Zantac) or famotidine (Pepcid) are given to prevent stress ulcers in

A

Major burns

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93
Q

Connective tissue that composes most of skeleton of an embryo and changes to bone through process of ossification

A

Cartilage

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94
Q

Congenital malposition of foot involving bone and soft tissue

A

Clubfoot

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95
Q

Congenital condition leading to improper formation and function of hip socket

A

Developmental dysplasia of the hip (DDH)

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96
Q

Long central shaft in long bones that constitutes major portion of bone

A

Diaphysis

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97
Q

Rounded end portion of long bones that consist of layers of cartilage, subcondral bone, and spongelike cancellous bone

A

Epiphysis

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98
Q

Situated between diaphysis and epiphysis and plays major role in longitudinal growth in children

A

Epiphyseal plate

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99
Q

discontinuity in bone caused by force to the bone

A

Fracture

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100
Q

Condition in which there is avascular necrosis of femoral epephysis in school-age children

A

Legg-Calve-Perthes disease

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101
Q

Columns of spongy tissue that unite diaphysis with epiphyseal plate

A

Metaphysis

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102
Q

Inherited condition where there is progressive weakness and wasting of symmetrical groups of skeletal muscle, with increasing disability and deformity

A

Muscular Dystrophy

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103
Q

Process of gradual conversion of cartilage to bony structures, which begins in embryo and continues until 18 to 21 years of age

A

Ossification

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104
Q

Immature bone cells that replace cartilage cells as bones grow

A

Osteoblasts

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105
Q

Inherited disorder characterized by connective tissue and bone defects leading to bones that are fractured by the slightest trauma

A

Osteogenesis imperfecta (OI)

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106
Q

Infection of bone that may be caused by any microorganism, but usually caused by bacteria

A

Osteomyelitis

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107
Q

Thin, tough membrane covering central shafts of all bones, containing blood vessels that nourish the bone

A

Periosteum

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108
Q

Enlargement of muscles as a result of infiltration by fatty tissue that occurs in Duchenne’s muscular dystrophy

A

Pseudohypertrophy

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109
Q

Lateral curvature of spine, which may be idiopathic or caused by neuromuscular disease

A

Scoliosis

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110
Q

A condition where proximal femoral head displaces posteriorly and inferiorly in relation to neck of hte femur during rapid adolescent growth spurt

A

Slipped Capitol Femoral Epiphysis

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111
Q

Involves pulling on a body part in one direction against a counter-pull exerted in opposite direction; used to reduce dislocations and immobilize fractures

A

Traction

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112
Q

Stronger than bone until puberty; as a child grows, muscles increase in length and circumference

A

Tendons and ligaments

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113
Q

During childhood and adolescence it is essential to provide sufficient _______ to promote adequate bone density and prevent osteoporosis later in life

A

Calcium intake

114
Q

Foot is twisted and fixed in an abnormal position; may be one or a combination of four deformities

A

Clubfoot

115
Q

Foot is lower than heel

A

Plantar flexion

116
Q

Heel is lower than foot

A

Dorsiflexion

117
Q

Foot turns in

A

Varus Deviation

118
Q

Foot turns out

A

Valgus deviation

119
Q

Nursing care for client after casting and after surgical repair of clubfoot

A
  1. Neurovascular checks, at least every 2 hours.
  2. Observe for any swelling around cast edges.
  3. Elevate ankle and foot on pillows.
  4. Monitor drainage on cast.
  5. Pain management.
  6. Appropriate distraction
120
Q

Assessment findings for ________ include affected leg shorter than the other, telescoping or piston mobility of affected leg, hx of delay in walking, limp and toe walking, trendelenburg sign, waddling gait with bilateral dislocation, lordosis with bilateral dislocation

A

Developmental dysplasia of hip (DDH)

121
Q

when child bears weight on affected side, pelvis tilts downward on normal side instead of upward as it would with normal stability

A

Trendelenburg Sign

122
Q

For infants less than 3 months, the most common treatment of this process is a Pavlik harness, usually worn for three to six months

A

Developmental dysplasia of hip (DDH)

123
Q

an adjustable chest halter that abducts legs; soft plastic stirrups hold hips flexed, abducted and externally rotated; may or may not be removed for bathing

A

Pavlik harness

124
Q

For infants older than 3 months of age, skin traction followed by spica cast application may be required to treat

A

Developmental dysplasia of hip (DDH)

125
Q

Characteriazed by occurrence of pathologic fractures resulting from connective tissue and bone defects

A

Osteogenesis Imperfecta (OI)

126
Q

Results from a biochemical defect in collagen production

A

Osteogenesis Imperfecta (OI)

127
Q

Major clinical manifestations of this disease include multiple and frequent fractures, some of which may be present at birth

A

Osteogenesis Imperfecta (OI)

128
Q

Calcitonin, which aids bone healing, may be used for

A

Osteogenesis Imperfecta (OI)

129
Q

Medications that increase bone mass

A

Biphosphonates

130
Q

A self-limiting disorder in which there is aseptic necrosis of femoral head

A

Legg-Calve-Perthes disease

131
Q

Affects clients between ages of 2 and 12 years, but is most comon in those 5 to 7 years of age

A

Legg-Calve-Perthes disease

132
Q

Aseptic necrosis of femoral capitol epiphysis with degenerative changes producing flattening of femoral head

A

Stage I: avascular stage of Legg-Calve-Perthes disease

133
Q

old bone absorption and revascularization occurs during this time

A

Stage II: Fragmentation or revascularization stage of Legg-Calve-Perthes disease

134
Q

New bone formation occurs during this time

A

Stage III: reparative stage of Legg-Calve-Perthes disease

135
Q

Gradual reformation of femoral head occurs during this time

A

Stage IV: regeneration stage of Legg-Calve-Perthes disease

136
Q

Undiagnosed or late-diagnoses of this disease can lead to osteoarthritis and hip dysfunction in later life

A

Legg-Calve-Perthes disease

137
Q

Initial treatment of this disease includes rest to reduce inflammation and restore motion

A

Legg-Calve-Perthes disease

138
Q

Postoperative care following surgical treatment for Legg-Calve-Perthes disease includes

A
  1. Frequent neurovascular checks
  2. Pain management
  3. Activity based on surgeon’s orders
139
Q

A condition in which upper femoral epiphysis gradually slips from its functional position

A

Slipped capitol femoral epiphysis

140
Q

Onset of symptoms may be gradual, with persistent hip pain that is aching or mild, and can be referred to thigh and/or knee, along with limp and decreased ROM and internal rotationof hip; client may hold leg in an externally rotated position to relieve stress and pain in hip joint. An acute slip presents with sudden, severe pain and cannot bear weight

A

Slipped capitol femoral epiphysis

141
Q

Client should be placed on strict bedrest until surgery; adolescent may use crutches, as long as affected leg is non-weight bearing, but should not sit in a wheelchair, as this may increase the slippage when treating

A

Slipped capitol femoral epiphysis

142
Q

Lateral curvature of the spine; may be functional, which occurs as a compensatory mechanism in clients who have unequal leg lengths or poor posture

A

Scoliosis

143
Q

A permanent curvature of spine accompanied by damage to vertebrae

A

Structural scoliosis

144
Q

Occurs most often during rapid growth spurt in adolescence, 11 to 14 years for females, 13 to 16 years for males

A

Structural scoliosis

145
Q

A parent that notices a skirt hangs unevenly, or that a bra is adjusted unevenly from one side to the other, may lead to a finding of

A

Structural scoliosis

146
Q

Exam for this process reveals unequal shoulder heights, waist angles, scapula prominences, rib prominences, and chest asymmetry

A

Scoliosis

147
Q

Screening for this by school nurse begins in fifth grade as mandated by law in many states

A

Scoliosis

148
Q

Postoperative care for ________ includes ROM excersies, log rolling every two hours, encouraging coughing, deep breathing, and use of incentive spirometry, NPO, nasogastric tube, strict intake and output, frequent VS and neurological checks, monitoring hematocrit, blood transfusions, pain management, antibiotic administration, antiembolism stockings or sequential compression boots, and gradual resumption of activity as ordered

A

Scoliosis

149
Q

Teaching for Milwaukee or other brace when used for scoliosis:

A
  1. Brace worn for 23 hours a day
  2. Brace off to shower, bathe, or swim
  3. T-shirt should be worn under brace next to skin for protection
  4. Pelvic tilt and lateral strenghening exercises are done several times a day while in brace to correct thoracic lordosis
  5. Consistent use of brace will provide maximum benefit
  6. Slight muscle aches may be noticed when first wearing brace
  7. Encourage adolescent to be as active as possible while in brace
150
Q

Group of disorders characterized by progressive degeneration of skeletal muscles (muscles that are under voluntary control)

A

Muscular Dystrophy

151
Q

All muscular dystrophies are ________disorders

A

Inherited

152
Q

The most common type of musclular dystrophy is _______, and is a sex-linked recessive trait, therefore only occurs in males

A

Duchenne’s (pseudohypertrophic muscular dystrophy

153
Q

Symptoms of this generally become obvious and acute at 3 years of age

A

Muscular dystrophy

154
Q

Symptoms of this usually begin with waddling gait, lordosis, difficulty climbing stairs, running or pedaling a bike

A

Muscular dystrophy

155
Q

Clients have difficulty walking on an even surface and rise from floor only by rolling onto their stomachs, then pushing themselves to their knees, and walk their hands up their legs to stand. This is known as

A

Gower’s sign

156
Q

Muscles feel unusually woody on palpation and look enlarged

A

Pseudohypertrophy

157
Q

A diet low in calories and high in protein, as well as a high fiber, and high fluid diet is encouraged with

A

Muscular Dystrophy

158
Q

An infection of bone

A

Osteomyelitis

159
Q

Can occur at any age, but is most common between 1 and 12 years

A

Osteomyelitis

160
Q

This process usually begins with acute symptoms, systemic malaise, fever, irritability, rapid pulse, and possibly dehydration

A

Osteomyelitis

161
Q

Symptoms of this process include pain, tenderness, swelling, and redness in area of infection; there is also decreased mobility of affected extremity

A

Osteomyelitis

162
Q

Blood studies for this process reveal an increased white blood cell count, C-reactive protein, and erythrocyte sedimentation rate (ESR); blood cultures will be positive

A

Osteomyelitis

163
Q

Surgery may be needed for this for incision and drainage; if surgical drainage is carried out, polyethylene tubes are placed in wound- one tuve instills antibiotic solution directly into wound, while other provides drainage

A

Osteomyelitis

164
Q

IV antibiotics for three to six weeks, initiated in hospital, and then continued at home; length of IV therapy is determined by duration of symptoms, initial response to treatment, and sensitivity of organism; oral antibiotics for two weeks following IV antibiotics; both used for __________

A

Osteomyelitis

165
Q

Providing good food sources of calcium and protein for bone healing is important for

A

Osteomyelitis

166
Q

Growth plate or epiphyseal plate is a common place of this injury, and can lead to improper growth if not treated correctly

A

Fractures

167
Q

Used to describe fractures of growth plate and is based on angle of fracture in relation to epiphysis

A

Salter-Harris classification system

168
Q

___________ of a child’s bone is thicker and stronger and aids in rapid healing

A

Periosteum

169
Q

Adolescents who limit their intake of calories and calcium and who are involved in sports such as distance running or gymnastics are at risk for __________

A

Stress fractures

170
Q

May present with chronic pain that changes in intensity

A

Stress fracture

171
Q

Growth plate undisturbed, growth disturbances rare, common fracture

A

Type 1 fracture

172
Q

Growth disturbances rare, most comon fracture

A

Type II fracture

173
Q

Serious threat to growth and joint, less common fracture

A

Type III fracture

174
Q

Serious threat to growth (fracture)

A

Type IV fracture

175
Q

Rare fracture, crush injury causes cell death in growth plate, resulting in arrested growth and limited bone length. If bone plate is partially destroyed, angular deformities may result

A

Type V fracture

176
Q

Break across entire section of a bone at a right angle to the bone shaft resulting in two or more fragments

A

Complete (transverse) fracture

177
Q

Associated with high impact forces; bone breaks into three or more segments

A

Comminuted fracture

178
Q

Broken bone does not protrude through the skin

A

Closed fracture

179
Q

Associated with twisting force; fracture coils around the bone

A

Spiral fracture

180
Q

Broken bone protrudes through the skin leaving a path to the fracture site; high risk of infection exists

A

Open fracture

181
Q

Caused by compression force; often seen in young children

A

Greenstick fracture

182
Q

The five “Ps” in affected extremity

A
  1. Pain and joint tenderness
  2. Pulselessness distal to fracture site
  3. Pallor
  4. Paresthesia distal to fracture site
  5. Paralysis or movement distal to fracture site
183
Q

Things to assess for when in a cast

A

Neuro status of involved extremity and compare with unaffected side; assess temp, pallor, pain, tingling sensation, edema, pulse, and cap refill every 15 minutes for the first hour, then hourly for 24 hours, then every 2 to 4 hours

184
Q

Used for clients under 3 years of age and weighing less than 35 pounds, who have a fractured femur or congenital hip dysplasia; both legs are placed in skin traction, hips are flexed at a 90 degree angle, with knees extended, and both buttocks are slightly elevated above mattress

A

Bryant’s traction

185
Q

Used for knee immobilization or for short-term immobilization of a fracture; this running skin traction keeps legs in extended position without hip flexion

A

Buck’s traction

186
Q

Used for fractures of femur and lower leg; skin traction is placed on lower leg while knee is suspended in a padded sling; hips and knees are slightly flexed; skin care and monitoring of skin resting in the sling is indicated

A

Russell’s traction

187
Q

Inspect pin insertion sites at least every _____ hours for redness, swelling, irritation, or drainage

A

Eight

188
Q

Used for fractures of humerus; flexed arm is suspended horizontally; this may be applied as skin or skeletal traction

A

Dunlop’s traction

189
Q

Used when minimal traction is needed; traction is applied to skin with adhesive ematerials or straps; foam boots and skin serve as the counter-pull

A

Skin traction

190
Q

Used when a greater strength of traction or a longer period of traction is needed; pull is directly applied to bone by pins or wires surgically placed through distal end of bone

A

Skeletal traction

191
Q

Skeletal traction used for fractures of femur or tibia; hip and knee are positioned at 90 degree angles, and lower part of extremity is put into a sling or boot cast; ensure skin care to area in boot cast or sling

A

90-90 traction

192
Q

Attached to extremity by percutaneous transfixing of pins or wires to bone; these can be used for simple fractures or for complicated fractures or deformities

A

External fixators

193
Q

claim more lives during adolescence than all other causes of death combined

A

Injuries

194
Q

is considered part of normal growth and development for the adolescent

A

Risk-taking behavior

195
Q

This stage of development is generally a period of wellness

A

Adolescence

196
Q
Establishment of autonomy (Erikson)
Sexual identity
A vocational/educational identity
Identity and self-perception
Early and middle adolescents are egocentric.
A

Developmental tasks of the adolescent

197
Q

characterizes the last stage of cognitive development. (Piaget)

A

Formal operations, or abstract thinking

198
Q

Cognitive thinking during adolescence moves from concrete to

A

abstract reasoning

199
Q

predict stages of sexual maturation

A

Sexual maturity ratings (SMRs; Tanner stages)

200
Q

Girls achieve reproductive maturity ____ years after menarche.

A

2-5

201
Q

Type of inheritance when one parent has an illness, and the other parent does not. 50% chance of child having the disease.

A

Autosomal Dominant Inheritance (Ex. Neurofibromytosis, and some blood groups)

202
Q

Type of inheritance when both parents are carriers of a disease. Child will have 25% chance of having the disease, 50% chance of being a carrier, and 25% chance of being normal

A

Autosomal Recessive Inheritance (Ex. Sickle Cell, cystic fibrosis)

203
Q

Type of inheritance when mother is a carrier and father does not have the disease. Female child has 50% chance of being a carrier, and 50% chance of being normal. Male child has 50% chance of having the disease, and 50% chance of being normal.

A

X-Linked Recessive Inheritance (Ex. Hemophilia)

204
Q

At what age a child is functioning

A

Mental Age

205
Q

Nursing responsibilities for a child with a developmental disability

A

Facilitating initial grief, assistance with coping, identifying resources to meet lifelong needs.

206
Q

A legal term that encompasses both intellectual disability and disability that occurs as a result of a developmental disorder

A

Developmental Disability

207
Q

Disorder of intellectual impairment

A

Down Syndrome

208
Q

Disorders of known genetic cause

A

Fragile X and Rett Syndrome

209
Q

Behavioral Characteristics of ____________
› Disruptive behaviors, such as temper tantrums
› Self-injurious behaviors
› Extreme agitation
› Autistic-like behaviors (e.g., gaze avoidance, hand flapping,
echolalia, abnormal speech patterns)
› Hyperkinetic behaviors, including restlessness, agitation, and
attention deficits
› Hand biting
› Sensory motor integration deficits (i.e., poor coordination,
tactile defensiveness)

A

Fragile X Syndrome

210
Q

almost exclusively linked to female gender.
characterized by an initial period of normal development, with symptoms emerging between the ages of 6 and 18 months.
Social and intellectual development stops, and seizures and physical disabilities emerge.

A

Rett Syndrome

211
Q

Disorders related to environmental alterations

A

Fetal Alcohol Syndrome (FAS), Nonorganic failure to thrive

212
Q

Disorders with little understood genetic influence

A

Autism Spectrum Disorders

213
Q

Trisomy 21-
3 chromosomes on DNA strand 21.
Occurs in 1.7 of 1000 live births with life expectancy of 55

A

Down Syndrome

214
Q

Family hx, maternal age >35 (25% of children born with Down Syndrome), paternal age >55, are all risk factors for a child to have

A

Down Syndrome

215
Q

Congenital heart defects (VSD most common), thyroid dysfunction, leukemia, imperforate anus, Hirschsprung’s disease, infertility, are all co-morbidities of

A

Down Syndrome

216
Q

The presence of more than one type of cell in a person, usually described as a percentage. Same features and health problems as a baby with trisomy 21. May have fewer characteristics, but will vary greatly. Percentages are not accurate predictor of outcome.

A

Mosaic Down Syndrome

217
Q

Clinical presentation/characteristics of this include, flat facial profile, short neck, abnormally shaped ears, depressed nasal bridge, protruding tongue, Simian crease-single deep transverse crease on the palm, Almond shaped eyes (upward slant), white spots on the iris of the eye (Brushfield Spots), protruding abdomen, stubby fingers, mental retardation, muscular low tone (hypotonia)

A

Down Syndrome

218
Q

A malformation of the upper part of the spine located under the base of the skull in some individuals- may cause spinal cord compression. May require surgical stabilization.

IMPORTANT BECAUSE IT CAN AFFECT OVERALL FUNCTIONING OF CHILD

A

Atlantoaxial Instability

219
Q

Care of child with this disease includes correction of heart defect, feeding issues, ancillary support services (PT, OT, speech), promote parental attachment/bonding, promote independence, genetic counseling for parents

A

Down Syndrome

220
Q

It is important to maintain a routine for a child with _________

A

Autism

221
Q
Characteristics of this syndrome include:
› Three facial abnormalities
› Smooth philtrum (lip)
› Thin vermillion border
› Small palpebral fissures
› Growth deficit
› Less than or equal to 10th percentile for height, weight, or both
› Central nervous system abnormalities
› Head circumference less than or equal to 10th percentile
› Brain abnormalities
› Motor deficits or seizures
› Intellectual/functional deficits
A

Fetal Alcohol Syndrome (FAS)

222
Q

Bacterial infection of the bone

A

Osteomyelitis

223
Q

Nursing care for osteomyelitis

A

› Assessment and documentation of the child’s status
› Pain management
› Administration of antibiotics without iatrogenic injury

224
Q

Symptoms of this include bone pain, edema, joint pain, and fever

A

Osteomyelitis

225
Q

May be idiopathic or nosocomial

Due to trauma or pins

A

Osteomyelitis

226
Q

› Most common spinal deformity

› Most common in preadolescent growth spurt & usually idiopathic

A

Scoliosis

227
Q

› Treatment for this disease includes:

› 40: spinal fusion with rod placement

A

Scoliosis

228
Q

Clinical manifestations of this disease include:
› Visible curve of spine
› Rib hump when child is bending forward
› Asymmetric rib cage
› Uneven shoulder or pelvic heights
› Prominence of the scapula or hip
› Difference in space between arms and trunk when child is
standing
› Apparent leg-length discrepancy

A

Scoliosis

229
Q

Types of Muscular Dystrophy

A

› Duchenne- most common, onset 1-4 yr, rapid progression, X
–linked recessive
› Myotonic-onset in severe neonatal form, autosomal dominant
› Becker-onset-5-10 yrs, slow progressive, x-linked recessive,
mobile to late teens
› Congenital-onset birth, slow but variable, autosomal
recessive
› Fascioscapulohumeral-onset first decade, may span many
decades, autosomal dominant or recessive
› Emeray-Dreifus-scapuloperoneal or scapulohumeral- onset
middle childhood to early teens slow progress-x-linked
recessive

230
Q

› Younger than 16 years
› Joint swelling in at least one joint for at least 6 weeks that is
not the result of trauma, infection, or malignancy (Dannecker
& Quartier 2009)

A

Juvenile Idiopathic Arthritis

231
Q

› Etiology is unknown, multifactorial, genetic predisposition,
immune response with environmental triggers ( infections or
trauma)
› Joints may be stiff , swollen, warn to the touch and
erythematous with limited range of motion. Stiffness is worse
in the morning or after prolonged rest periods

A

Juvenile Idiopathic Arthritis

232
Q

Treatment for Juvenile Idiopathic Arthritis

A
› Medication
› Physical therapy
› Occupational therapy
› Family education
› Home care
› Activity should be encouraged as tolerated
233
Q

Nursing outcomes for ›juvenile idiopathic arthritis

A

› Keeping the child free from injury
› Controlling pain
› Enhancing physical mobility
› Promoting age-appropriate developmental behaviors

234
Q

› Brittle-Bone Disease, Collagen Defect
› Thin Soft Skin, Increased Flexibility, Short Stature, Weak
Muscles, Hearing Loss
› Parents may be blamed for the child’s injuries until the
diagnosis is established

A

Osteogenesis Imperfecta

235
Q

› Autosomal dominant or recessive inherited disorder with
fragility of connective tissues resulting in bone defects
› Symptoms: sclera normal or blue, teeth brittle or normal, poor
growth, short stature, frequent fractures, thin skin,
hyperextensibility of ligaments, easy bruising, Conductive
hearing loss by age 20 to 30 years
› Diagnosis: hx, PE, xrays

A

Osteogenesis Imperfecta

236
Q

Treatment for osteogenesis imperfecta

A

supportive, lightweight braces/splints, PT, surgical

rods if indicated

237
Q

Nursing considerations for osteogenesis imperfecta

A

› Prevention of fractures
› Identification of mobility issues that affect the child’s
functioning
› Gentle turning, passive range of motion exercises
› Daily skin care
› Proper nutrition to support growth and development, with
emphasis on foods high in calcium
› Family education- Teach parents safe/gentle handling, injury
prevention
› IO Foundation

238
Q

Girls experience budding of the breasts followed by

A

the appearance of pubic hair

239
Q

Approximately 1 year after breast development

A

height increases rapidly until it reaches its peak

240
Q

Growth in height in girls typically ceases

A

2 to 2½ years after menarche

241
Q

Boys first experience testicular enlargement, followed in approximately 1 year by

A

penile enlargement

242
Q

Pubic hair usually ________ the growth of the penis

A

precedes

243
Q

The growth spurt in boys occurs later than it does in girls, beginning between ages ______ and ____ years and ending between ___ and ___ years

A

10½, 16, 13½, 17½

244
Q

. Growth continues at a much slower pace for several years after the spurt but usually ceases between

A

18 and 20 years of age

245
Q

Menarche usually occurs between ages

A

9 and 15

246
Q

Most young women achieve reproductive maturity ___to ___ years after the start of menstruation

A

2 to 5

247
Q

a biologic process that brings about PHV, or the “growth spurt,” the changes in body composition, and the development of primary and secondary sexual characteristics in both sexes

A

Puberty

248
Q

The beginning Tanner stages frequently occur in the _______ child

A

school-age

249
Q

Tanner stages 3 to 5 occur in

A

Adolescence

250
Q

In boys, puberty is considered delayed if testicular enlargement or pubic hair development has not occurred by age

A

14

251
Q

Absence of breast budding or pubic hair development in girls by _____ years is reason for referral

A

13

252
Q

Sexual maturation in girls begins with the appearance of

A

breast buds (thelarche)

253
Q

Thelarche occurs at approximately age ___ to ___ and is followed by __________

A

8 to 11

The growth of pubic hair

254
Q

The first sign of pubertal changes in boys is

A

testicular enlargement in response to testosterone secretion

255
Q

The skin has five major functions:

A

(1) to protect the deeper tissues from injury, drying, and invasion by foreign matter; (2) to regulate temperature; (3) to aid in excretion of water; (4) to aid in production of vitamin D; and (5) to initiate the sensations of touch, pain, heat, and cold.

256
Q

a chronic inflammatory skin condition seen frequently in infants. It is referred to as “cradle cap” when located on the scalp. It often begins in the first 2 to 3 weeks of life and usually disappears by age 12 months

A

Seborrheic dermatitis

257
Q

a skin inflammation that results from direct skin-to-irritant contact

A

Contact dermatitis

258
Q

Herpes labialis, commonly referred to as a “fever blister,” is one of the most common manifestations of

A

HSV 1

259
Q

Chronic, inflammatory rash caused by rapid proliferation of keratinocytes. Hereditary predisposition; onset in first 2 decades of life.

A

Psoriasis

260
Q

develops from release into the blood of products found in normal muscle; the release can be occasioned by electrical injury

A

Myoglobinuria

261
Q

follows electrical injury because of the associated cellular destruction and hypovolemic shock. Ringer’s lactate solution, the fluid used for fluid resuscitation, contains sufficient bicarbonate to manage the acidosis that accompanies burn shock but not enough to correct that associated with shock after electrical injury (i.e., pathophysiologic hypovolemic shock, not a “shock” from the electrical current).

A

Metabolic acidosis

262
Q

Nursing care of the adolescent with acne includes

A

teaching about regular, gentle cleansing of the skin, applying topical medications, and encouraging a healthy lifestyle with adequate rest, exercise, and a balanced diet.

263
Q

In comparison with adults, children who sustain burn injuries are at increased risk for

A

fluid and heat loss, hypertrophic scarring, cardiovascular problems, infection, and protein and calorie deficiency.

264
Q

A minor burn wound should be

A

cleaned with mild soap and water, débrided of loose debris and tissue, and covered with an antimicrobial ointment and a sterile dressing.

265
Q

occur as a result of trauma to a joint in which ligaments are stretched or are partially or completely torn

A

Sprains

266
Q

also known as pulls, tears, or ruptures, result from an excessive stretch of muscle

A

Strains

267
Q

pain, swelling, localized tenderness, limited range of motion, poor weight bearing, and a pop or snapping sound (sprain)

A

Manifestations of soft tissue injuries

268
Q

The primary goal in managing a soft tissue injury is to

A

control swelling and prevent further injury.

269
Q

the natural curvature of the thoracic spine in the sagittal plane

A

Kyphosis

270
Q

the most common cause of hyperkyphosis in adolescents

A

Scheuermann’s disease

271
Q

Bilateral knee pain that occurs with running, jumping, or climbing stairs; associated with growth and more common in boys; pain and swelling at the tibial tubercle from inflammation at the tendon insertion site

A

Osgood-Schlatter Disease

272
Q

Softened, loose, or separated cartilage and bone along the femoral articular surface; knee pain, parapatellar ache that worsens with sports or vigorous activity

A

Osteochondritis Dessecans of the Knee

273
Q

Tall, lanky, abnormally long arms with reduced extension of the elbows

A

Marfan

274
Q

Age-normal skills across all domains

A

Normal Intelligence (IQ 85 to 115)

275
Q

Early milestones achieved, including language and social skills

Likely to be noticed when school performance is monitored

Vocational skills adequate for competitive employment, can live independently as adults

A

Borderline Intellectual Disability (IQ 71 to 84)

276
Q

Slight delay in achieving developmental milestones but can communicate well and demonstrate some social skills

May require special education services with an emphasis on vocational and self-maintenance skills

Able to form and maintain adult relationships and can care for themselves

A

Mild Intellectual Disability (IQ 50-55 to ~70)

277
Q

Noticeable delay in motor and speech development by preschool age

Can communicate, although have less than adequate social skills

Usually can achieve cognitively at an elementary school level

Can live best as an adult in a supportive and supervised setting, such as a group home

Can perform unskilled work in a supervised setting, such as a sheltered workshop

A

Moderate Intellectual Disability (IQ 35-40 to 50-55)

278
Q

Early and marked delay in all motor skills

Limited expressive speech and self-help skills

Constant supervision required, with group home living possible as an adult

A

Severe Intellectual Disability (IQ 20-25 to 35-40)

279
Q

May be able to walk

May have primitive speech

Usually requires complete provision of activities of daily living

A

Profound Intellectual Disability (IQ <20 to 25)

280
Q

Spans ages 11 to 21 years

A

Adolescence

281
Q

Tissue that joins fx bone ends or repairs damaged bone; begins as cartilaginous tissue and becomes hardened through osteoblastic activity

A

Callus