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NURS 373 > MSK and Articular Dysfunction > Flashcards

MSK and Articular Dysfunction Flashcards

(78 cards)

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1
Q

One of the most difficult aspects of illness for a child

A

immobility

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2
Q

Muscular effects of immobilization

A

decreased muscle strength & endurance

atrophy & loss of joint mobility

can happen very quickly

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3
Q

What nurse can do to promote muscle strengths and mobility

A

passive ROM exercises if child is unable to do this themselves

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4
Q

Skeletal effects of immobilization

A

bone demineralization

negative calcium balance

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5
Q

What does bone demineralization increase the risk of?

A

fractures

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6
Q

Metabolism effects of immobilization

A

decreased metabolic rate; hypercalcemia

decreased production of stress hormones

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7
Q

Cardiovascular effects of immobilization

A

altered distribution of blood volume; venous stasis

dependent edema; diminished vasopressor mechanism

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8
Q

What are adolescents at an increased risk of related to cardiovascular?

A

DVT

especially if on birth control

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9
Q

Respiratory effects of immobilization

A

atelectassis* use incentive spirometry

decreased need for oxygen; diminished vital capacity

poor abdominal tone & distention

loss of respiratory muscle strength

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10
Q

GI effects of immobilization

A

constipation and anorexia*

distention

caused by poor abdominal tone

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11
Q

Integumentary effects of immobilization

A

decreased circulation and pressure leading to decreased healing capacity

skin breakdown - not as bad as adults

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12
Q

Urinary system effects of immobilization

A

alteration of gravitational force

difficulty voiding in supine position

urinary retention

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13
Q

Psychological effects of immobilization (many)

A

diminished environmental stimuli

altered perception of self and environment

increased feelings of frustration, helplessness, anxiety

depression, anger, aggressive behavior

developmental regression

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14
Q

What to tell parents related to psychological effects

A

developmentally normal responses

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15
Q

Effects of immobilization on family

A

logistics

family support, home care

coping skills

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16
Q

What are most traumatic soft-tissue injuries caused by in children?

A

sports and play!

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17
Q

strain

A

tendon

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18
Q

sprain

A

ligament

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19
Q

dislocation

A

at a joint

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20
Q

contusion

A

muscle and soft tissue

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21
Q

separation

A

at the epiphysis

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22
Q

What to do for sprains and strains

A

RICE

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23
Q

RICE acronym

A

rest

ice

compression

elevation

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24
Q

Consideration when using ice

A

30 mins max at a time

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25
Skippy joint injury
slipped capital femoral epiphysis hip joint gets loose and slips out very painful
26
T or F: Children break bones easier than adults
TRUE but they health faster
27
T or F: Fractures are rare in infants
TRUE MVA, birth injury
28
Epiphyseal injuries
cartilage growth plate weakest point of long bones frequent site of damage during trauma may affect future bone growth
29
Treatment for epiphyseal injuries
ORIF
30
Post-ORIF complications
vascular necrosis infection
31
Main types of fractures (4)
1) simple or closed 2) compound or open 3) complicated 4) comminuted
32
simple or closed fracture
does not produce a break in the skin most can be casted
33
compound or open fracture
fractured bone protrudes through the skin
34
complicated fracture
bone fragments have damaged other organs or tissues
35
comminuted
small fragments of bone are broken from fractured shaft and lie in surrounding tissue
36
Type of fracture that can be indicative of non-accidental injury
spiral involves twisting of the bone
37
Tests that are done when non-accidental injury suspected (2)
1) skeletal survey 2) blood work - look for something that could predispose child to injury
38
CSM acronym
colour sensation movement
39
5 P's of fracture assessment
Pain Pallor Paresthesia Pulselessness Paralysis
40
6th P that the physician would assess for
pressure
41
What are we assessing for with the 5 Ps?
compartment syndrome
42
Treatment for compartment syndrome
remove cast
43
Cast care consideration
don't stick anything in the cast don't get wet (unless fibreglass) look for signs of compartment syndrome e.g. swollen fingers bath and lotion after cast removed prepare kids for cast removal --> scary
44
Osteosarcoma
most common type of primary malignant bone tumour in children
45
Symptoms of osteosarcoma
localized pain limping palpable mass
46
Most common location of osteosarcoma
femur
47
Treatment of osteosarcoma
chemo rotationplasty
48
Traction
moving away from this using ropes, pulleys, and weights, gently pulls on a fractured or dislocated body part to realign bones and reduce pain
49
Developmental Dysplasia of the Hip (DDH)
hip abnormalities -shallow acetabulum -subluxation (incomplete dislocation) -dislocations
50
When to assess for developmental dysplasia of the hip
after birth
51
Clinical manifestation of DDH
shortened limb on AFFECTED side restricted abduction of hip on affected side unequal gluteal folds when infant prone
52
Tests that physicians do for DDH (2)
1) Ortolani 2) Barlow
53
Ortolani test
hip started off dislocated abducting will hear "clunk" as dislocated femur enters the acetabulum
54
Barlow test
hip started off reduced adducting positive if hips pops out
55
Treatment for DDH when child UNDER 6 months
Pavlik Harness stays on for 4 to 8 weeks hip in constant flexion and abduction
56
Treatment for DDH when child 6 to 8 months
Spica cast
57
Petaling of cast meaning
putting tape around sharp edges
58
Osteogenesis Imperfecta (OI)
aka brittle bone disorder connective tissue disorder defective periosteal bone formation and reduced cortical thickness of bones hyperextensibility of ligaments
59
Treatment and management for Osteogenesis Imperfecta
primarily supportive drugs are not that great handle with care education for parents, daycare, school diet rich in calcium physio, swimming surgery - rods
60
What to NEVER do with children with Osteogenesis Imperfecta
lift under the armpits pulls arms or legs
61
Scoliosis
complex spinal deformity
62
3 planes that scoliosis occurs on
1) lateral curvature 2) spinal rotation causing rib asymmetry 3) thoracic hypokyphosis
63
Signs/symptoms of scoliosis
pain ill-fitting clothes visible deformities
64
Diagnosis of scoliosis
x-ray!
65
Treatment for scoliosis when grade of curve is < 50%
brace
66
Treatment for scoliosis when grade of curve is > 50%
surgery
67
Osteomyelitis
inflammation and infection of bony tissue exogenous or hematogenous sources
68
Most common cause of osteomyelitis
S. aureus
69
Types of osteomyelitis (4)
1) acute hematogenous 2) exogenous 3) subacute 4) chronic
70
Signs and symptoms of osteomyelitis
begin ABRUPTLY resemble symptoms of arthritis and leukemia marked leukocytosis 
71
Diagnosis of osteomyelitis
MRI* bone cultures obtained from biopsy or aspirate early x-rays may appear normal
72
Treatment of osteomyelitis
prompt, vigorous IV antibiotics 3 to 4 weeks or up to several months monitor hematologic, renal, hepatic responses to treatment prevent complications like fractures
73
BIG nursing consideration for osteomyelitis
complete bed red and immobility DON'T move the patient
74
Other considerations for osteomyelitis
pain management PICC line calories and protein long-term hospitalization psychosocial
75
Juvenile Idiopathic Arthritis (JIA) symptoms (many)
stiffness swelling loss of mobility warmth (without redness) tender sometimes symptoms increase with stressors growth retardation
76
Is children, which joints are typically affected with arthritis?
LARGE joints
77
Diagnosis of JIA
blood work -WBC -ESR, CRP genetic test
78
Management of JIA
no specific cure meds: steroids, NSAIDs methotrexate - in more severe cases, cytotoxic pain management physical activity nutrition

NURS 373 (12 decks)

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