LASTQUIZ Flashcards
1
Q
A tearing of the subcutaneous tissue that results in hemorrhage, edema, or pain
A
Contusion
2
Q
Blood in soft tissue
A
Hematoma
3
Q
Torn ligament or ligaments stretched. Swelling pain and immobility occurs
A
Sprain
4
Q
Small tear in muscle or tednon occuring overtime, pain and edema occur
A
Strain
5
Q
Break in bone
A
Fracture
6
Q
What type of fracture is Bone broken but not through skin
A
Simple
7
Q
Fracture that is broken bone through skin, at great risk for infection
A
Compund
8
Q
Fracture that is incomplete, one side is broken other side is bent
A
Greenstick
9
Q
Fracture that is caused by forceful twisting motion
A
Spiral
10
Q
With a spiral fracture what must we not rule out
A
child abuse
11
Q
A non-displaced fracture is when
A
Bones are still in alignment
12
Q
A displaced fracture is when
A
Bones have shifted and need to be re-aligned
13
Q
No surgery, bones are gently put back into place and cast or traction is applied
A
Closed reduction
14
Q
Surgical procedure usually requiring pins, rods, or other devices
A
Open reduction
15
Q
Used when the immobilization required is more that what could be obtained by casting
A
Traction
16
Q
What are the 4 purposes of traction
A
Ensure alignment, Secure corrected position, prevent or treat contracture deformities, and to relieve muscle spasm and back pain
17
Q
How do we check pulses during nuerovascular assessment
A
Distal to injury or cast, if it is difficult use a doppler
18
Q
If the child cannot feel touch on the extremety what can we expect it to be
A
compartment syndrome
19
Q
What are the excersies called that are used to prevent muscle atrophy and to strenghten muscle
A
isometric excersices
20
Q
Weights in traction care should
A
hang freely and not touch the floor
21
Q
Ropes in pulley for traction care should
A
Move freely, and not be obstructed
22
Q
What is the last thing that child will develop, and when should it advance
A
Fine motor coordination, before 7 yo
23
Q
By 18 months the child should be able to
A
Walk steady
24
Q
By 6 years of age the child should be able to in reference to gait
A
walk like an adult
25
Muscle tone is developed
Cephalocaudal
26
What is psuedoparalysis
When child is afraid to move extremity because it is going to hurt
27
What are the 5 P's in Neurovasuclar Assessment
Pain, Pallor, Parasthesia, Paralysis, Pulse
28
Tearing of subcutaneous tissue
Contusion
29
Blood in the soft tissue
Hematoma
30
What does RICE stand for and what is it used for
Rest, Ice, Compression, Elevation. Soft tissue injuires
31
When elevating for a soft tissue injury what must we elevate it by
Above level of heart
32
How do we wrap an Ace bandage
Wrap distal to proximal
33
A buckle fracture is also known as a
Greenstick fracture
34
If growth plate is involved what can happen
Permanent deformitiy
35
What are the two things we need to look for, in plaster cast - post op
Can dry unevenly, can cause pressure
36
Why is fiberglass preferred over Plaster (3)
Drys quicker, lighter, easier to remove
37
Spica body casts are from the
nipple line to ankles
38
Why is buttocks kept of bed
So no compression on sciatic nerve
39
What is Volkman's ischemia
lack of blood flow
40
Skin traction is used for children (age,weight)
under 3 years old or under 30lbs
41
Describe Russels traction
Weight pulls in two direction, body acts ad counterweight
42
Skeletal fraction is
2 weights hanging from bed frame
43
What is patient at risk for in skeletal tracrtion
risk for infection and immobility
44
In skeletal traction, what bone does it go through
Femur
45
Halo traction is used for the
Neck
46
In Bryants traction what does the patient have a risk for
Volkman's ischemia
47
Inflammation of the bone, staph aureus, and a blood borne infection is
Osteomyelitis
48
What are the 3 S&S of Osteomyelitis
Fever, Pain, Psuedoparalysis
49
With an elevated ESR, and Luekocytosis what can we expect
Osteomyelitis
50
For Osteomyeltiss it is important the the limb affected remains
immobile
51
Breakdown, deferioration of muscles, more common in males
Duchenne's Muscular Dystrophy
52
Fatty infilration of muscle cells with tissue breakdown happens in
Duchenne's Muscular Dystrophy
53
What are 4 S&S of Duchenne Muscular Dystropy
Delayed Walking, decreased muscle strength, Lordosis, Clumsiness
54
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
55
What is the life extpectancy for Duchenne Muscular Dystrophy
early 30s
56
Also known as Coxaploma, it is a Degenerative Hip disease
Legg-Calve-Perthes Disease
57
Lack of circulation to femoral head
Legg-Calve-Perthes Disease
58
Can have 4-8 years with limp, cause is unknown,
Legg-Calve-Perthes Disease
59
What usually comec before a diagnosis of Legg-Calve-Perthes Disease
Trauma or Synovitis
60
Bucks traction is mainly done to
Abduct legs
61
What are 3 tx. For Legg-Calve-Perthes Disease
Bucks traction, Hip bracing, Maintaining ROM but limiting activity
62
What is prognosis for Legg-Calve-Perthes Disease
Good-w/ potential for hip degeneration in later years
63
tumor that causes deformity and pain
Benign
64
tumor that had development of abnormal cells
Malignant
65
Growth in marrow of long bones. Mets to lungs and other bones, usually occurs after a fracture
Ewings Sarcoma
66
Primary malignant tumor of long bones
Osteosarcoma
67
What is one thing patient does not want to hear that has Osteosarcoma
Success stories
68
What are 3 things we can do for patient post op Osteosarcoma surgery
Teach about phantom limb pain, PT to prothesis, emotional support
69
Arthirits children get that usually follows a strep infection
Juvenile Rheumathoid Arthritis
70
Fever that is x10 days, affects internal organs
Systemic Fever
71
Arthritis in 5 or more joints is called
Polyarticular
72
Arthriits in 4 or less joints is called
Pauciarticular
73
Inflammation of the eyes is called
Uveitis
74
What is the child at risk for who is taking NSAIDS
ulcers and gastric bleeding
75
For kids with juvenile rheumathoid arthritis, we want to prevent Ankylosis which is a
Joint deformity
76
What will excarbate symptoms in Juvenile Rhuemathoid Arthritis
Poor nutrition
77
What can we have child do for Juvenile Rheumathooid Arthritis that might help
Do alphabet with hands and feet
78
When do we usually screen for Scoliosis and how do we confirm
Between 9-13 confirmed with X-ray
79
What is maxiumum weight for a child to carry that has scoliosis
5 lbs
80
What is the tx for Curves under 20 degrees
Good posture, backpack safety
81
What is the tx. For 20-40 degrees (3)
Bostom Brace, Milwaukee Brace, Daily exercise
82
What are 2 tx. For Curves greater than 40 degrees
Harrington Rods, Spinal Fusion
83
How long should patient have brace on
23 hours a day
84
What can patient experience post op surgery for scoliosis
Constipation
85
When can we start p.t. for Scoliosis after surgery
Minimal pt after 3 days, Intense after 6 weeks
86
What do we do post op surgery scoliosis
Log roll
87
To help skin integrity what can we tell patient to do that has a brace
Tee shirt underneath brace
88
For sports injuries how long should we apply ice at a time
20 minutes on/off
89
Brusing in the peri-area is usually a sign of
Abuse
90
Otitis media simply is a
Ear infection
91
Second hand smoke can sometimes damage the ulna resulting in a
Otitis media
92
What are 3 ways to get Otitis media
Haemophilus Influenzae, Baby w/ bottle in bed, Second hand smoke
93
What are 4 things we see for children who develop Otitis media
Pulling on ear, Irritability, Fever, Vomiting/Diarhhea
94
After ear drops what must we have child do
Lay still for 5 min
95
What do we use in the ear for tx. Of Otitis Media
Broad Spectrum Antibiotic
96
How do we place eyedrops for children under 3 years
ear lobe down and back
97
How do we place eyedrops for children over 3 years
Pinna up and back
98
It is important that we do not place what in childs ear
cotton
99
Common procedure that we do to drain fluid from straight eustacian tube
Myringotomy
100
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
101
Hearing impairment prenataly usually comes from what two things
Viral infection, garman measles
102
Acquired deafness usally comes from what 4 things
Measles, Mumps, Meningitis, and exposure to loud noise
103
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
104
What is the eye chart called
Snelly chart
105
Increased oxygen can usually lead to
Eye problems, Retinopathy or Nueropathy
106
Irregular shaped cornea or lens, that causes blurry vision is called
Astigmitism
107
Astigmitism is usally tx. With
Corrective lenses
108
Wandering, lazy eye, due to decreased muscle is called
Amblyopia
109
What does child do frequently that has Amblyopia
Cover bad eye when trying to focus
110
What is the tx. For Amblyopia
Patch good eye 22 out of 24 hrs a day
111
Ambylopia can occur up to how many years old
nine
112
Unable to focus eyes at sametime also called cross eyed
Strabismus
113
What are two tx for Strabismus
Alternating patches in unaffected eye, training excercis (Vision therapy)
114
Children with Conjuctivitis usually wake up with very dry eyes, what can we do
Warm compress to ears, wipe from inner to outer
115
Bleeding into the anterior chamber of the eye
Hyphema
116
How does Hyphemas usually happen
Blunt trauma or penetration
117
Children with Hyphemas should be on strict bed rest for how long
7-10 days
118
How do we tx. Hyphemas (3)
Strict bed rest, Both eyes patched, CBR to prevent increase of IOP
119
Retinoblastomas usually develops when
in utero
120
What is one way we can pre-diagnose Retinoblastoma
Light does not refrect properly (pictures)
121
Malignant tumor Chromosone 13 defieceny
Retinoblastoma
122
Cats eye is associated with
Retinoblastoma
123
Cryosurgery is used for what and why
Retinoblastoma, best and least invasive
124
Freezing by lazer used for Retinoblastoma
Cryosurgery
125
Enucleation is the
Removal of eye
126
Tx. That destorys blood vessels by laser used for Retinoblastoma
Photocoagulation
127
What are 3 nursing responsicbilties for Retinoblastoma
Elbow restraints, protect pressure dressing, eye prothess
128
Commuted fractures are usually what related
Sport
129
For kids in bryants traction we should always observe for
risk of aspiration
130
Osteomyeltitis usually happens in kids who (2)
Don̥t wear shoes, step on a pebble
131
Elevated Serum levels can usually mean
Duchenne's Muscular Dystrophy
132
Kids with Duchenne Muscular Dystrophy tend to have a overgrown
Calf muscle
133
Anemia usually occurs due to
Ewings Sarcoma
134
Meningitis can usually lead to
Deafness
135
What do we do to children prior toMRI and ct scan to make compliance easier?
Sedate patient
136
In a neuro vascular check what do we look for
PainPallorParasthesiaParalysisBilateral pulsePolarCapillary refill
137
What is a contusion
Tearing of subcutaneous tissue
138
Blood in the soft tissue
Hematoma
139
What is a sprain
Torn ligaments
140
What is a strain
Small tear in muscle or tendon
141
Treatment for soft tissue injury
Rest (non weight bearing)IceCompressionElevation
142
Two common fractures in children
Green stick and buckle fracture (wrist)
143
What is Bryant's traction
Skin traction used for children under 3 years old or 30 lbsUsed for dislocated hip or femur fractureButtocks is kept off bedRisk for aspirationRisk for volkmans ischemia
144
What is Russell's traction
Weight pulls in two directionsVertical and horizontalBody acts as counter weight
145
Responsibility for traction
Applied and removed by MDWeights hang freely Pin careNV checksObserve for infection, compliance, and constipation
146
What is osteomyelitis
Inflammation of the bone caused by staph
147
What is Duchenne's muscular dystrophy?
Progressive neuromuscular disease. Hereditary recessive, occurs in males. Fatty infiltration of muscle cells (breakdown)
148
Signs and symptoms of DMD
Delayed walkingDecrease muscle strengthClumsiness (no fine motor skills)Increase lordosisGowers signOver developed calve muscles
149
What is Gowers sign
Difficulty getting up from sitting position. Holding calves to get up
150
What is the prognosis with DMD and what care do we provide for patients with the disease?
Poor prognosis life expectancy is early 30s. Prevention of complications is main goal.
151
When is DMD usually diagnosed
4-5 years of age
152
What is another name for legg-calve-perthes disease
Coxaplana
153
What is Coxaplana
Lack of circulation to the femoral head - slips out of acetabulum
154
What is the cause of Coxaplana and how does it develop?
Unknown cause - results from trauma or synovitis prior
155
What test is done to diagnose Coxaplana?
X-Ray
156
How long is treatment for Coxaplana?
1-2 years
157
What is the treatments for Coxaplana?
Bucks tractionHip bracing to ABDUCT hips/legsMaintain ROMLimit activity during treatment
158
What is the prognosis for Coxaplana?
Good however there's a potential for hip degeneration in later years
159
Where do bone rumors usually develop?
In the long bones
160
What is Ewing's sarcoma?
Tumor growth in the marrow of long bones
161
What is the problem with Ewing's sarcoma?
It can metastasize to the lungs and other bones
162
S&S of Ewing's sarcoma
PainPossible mass at sitePossible fracture
163
What is osteosarcoma?
Primary malignant tumor of long bones. Also mets to lungs
164
Signs and symptoms of osteosarcoma
Pain, limited mobility, obvious tumor mass
165
What is the treatment for osteosarcoma
Amputation and chemo
166
What is given after amputation of affected limb in osteosarcoma for patient to return to a normal life
Possible prosthesis
167
What can cause juvenile rheumatoid arthritis?
Chronic strep infection
168
Systemic RA
Fever for 10 days, internal organs affected
169
Polyarticular
Arthritis in 5 or more joints
170
Pauciarticular
Arthritis in 4 or less joints
171
S&S of JRA
Swollen jointsEnlarged liver & spleenAnemia, anorexia, rashPericarditis, myocarditis, uveitis (inflammation of anterior chamber in eye)
172
What test would be elevated in JRA?
ANA & the tests associated with Lupus
173
Treatment for JRA
NSAIDs, heat packs/hot showersGood nutritionImmunizationsCorticosteroids
174
What does uveitis lead to
Blindness
175
How can we do range of motion for a child with JRA
Play with child (catch, dance, etc)
176
Drug of choice for JRA
NSAIDS
177
What is the problem with NSAIDS
They are gastrotoxic therefore take with food/milk
178
What medication is acceptable to use in children with JRA that would otherwise not be acceptable
Aspirin
179
What is ankylosis and how is it prevented
Joint deformity and ROM will prevent it
180
What will affect immunizations in JRA
The steroid therapy the patient is on
181
What is wax & wane in JRA
On and off symptoms (exacerbations)
182
What is scoliosis
S like curvature of spine
183
What is functional scoliosis
Poor posture
184
What is structural scoliosis
CongenitalNeuromuscular Idiopathic
185
How is scoliosis tested for
Patient bends over - dr feels spineX ray
186
What is treatment for curves under 20 degrees
Good posturebackpack safety
187
Treatment for curves 20-40 degrees
Boston braceMilwaukee braceDaily exercise
188
Treatment for curves greater than 40 degrees
Harrington rodsSpinal fusion
189
How long does patient wear back brace
23 hours a day for 2-3 years
190
How do we protect skin integrity when patient with scoliosis wears brace
Light tee shirt under brace
191
How long patient in hospital after surgery for scoliosis
48-72 hours
192
When does physical therapy start for back surgery in scoliosis
4-6 weeks after surgery
193
What do we do directly after sport injury
Ice 20 min on and off for first 24 hours
194
A disorder in which the blood supply to the epiphyses of the bone is disrupted
Legg-Calve-Perthes Disease
195
Bucks extension is also called a
Skin traction
196
A yellow bruise lasts approximately
7-10 days
197
One of the most common causes of death in a child with muscular dystrophy is
Cardiac Failure
198
What type of traction would the nurse expect to be used for a 20-month old who has a fractured femur
Bryants
199
Fracture involving the epiphyseal plate can result in
impaired bone growth
200
X-linked disorder
Duchennes muscular dystrophy
201
Most common tx. for Legg-Calve-Perthes Disease is
Ambulation-abduction casts or braces
202
What finding in any traction should be reported ASAP
Tingling in toes, hands
203
Uveitis is found in
Juvenile Rheumatoid Arthritis
204
Describe how we would find childs legs in Bryants traction
Legs at right angles to the body
