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NUR 440 Exam 2 > Musculoskeletal & Infectious Disesae > Flashcards

Musculoskeletal & Infectious Disesae Flashcards

1
Q

Child Bone Development

A 
Around 300 bones
Large Cartilage components
Bones are more flexible! 
Sense periosteum
Open epiphyseal plate
Spine C shaped
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2
Q

Adult Bone Development

A

206 Bones
Bones are ossified
Bones more dense and rigid
Spine S- shaped

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3
Q

Factors in Bone Development

A

Genetics, Gender (girls at 12, boys at 14), weight bearing exercise, nutrition, environment, sleep- microtears repair during sleep
Vit D, Calcium
Milk 3, 8oz glasses a day

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4
Q

Musculoskeletal System Assessment

A 
History
Size and symmetry
Joint ROM
Gait- Limping is NEVER NORMAL! Toe walking
Muscle strength and tone equal
Developmental milestones
Nutrition
Pain
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5
Q

Diagnostic and Lab Tests

A

Xray- great diagnostic tool, Bone scan - stress fractures , CT, MRI, ultrasound, Bone marrow biposy, muscle biposy, serum enzymes

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6
Q

Nursing Diagnnosis Muscuoloskeletal Conditons

A

Self care deficit
Skin breakdown
Altered mobility, comfort

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7
Q

Congenital Club Foot Etiology

A

Unknown cause, abnormal intrauterine positioning, family hx

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8
Q

Congenital Club Foot Treatment

A

Non-operative serial casting ASAP after birth
Casting ever 1 to 2 weeks
Surgery may be required, following long cast and bracing

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9
Q

Congenital Club Foot Nursing Care

A

Long range planning for casting and appointments
Promotion of normal developmental needs
Cast care
Monitoring neuromuscular function
5 P’s : Pallor, Pain, Pulses, Peristia (numbness), Paralysis

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10
Q

Developmental Dysplasia of the Hip Etiology

A 
Rotate legs out, feel a clicking, pops in and out of the socket
Maternal hormones
Intrauterine positioning
Delivery Methods
Postnatal positioning
Genetic Factors
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11
Q

Developmental Dysplasia of the Hip Treatment

A

Pavlik Harness- newborn to 6 months
Spica Cast- 6 to 18 months
Closed surgical reduction with casting

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12
Q

Developmental Dysplasia of the Hip Nursing Care

A

Monitor skin breakdown
Teaching for parents and caregivers
Promotion of normal developmental activities
Is the harness on correctly? How will the child get home?

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13
Q

Bow Leg

A

Knees out
2inches
Should grow out of it at age 3

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14
Q

Knock Knee

A

Knees in
3 inches between feet
Should grow out of it at age 3

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15
Q

Legg- Calve- Perthes Disease

A

Most common in boys 4-8 years
Interruption of blood supply- coag disorder
Genetic and family history
Mild trauma to site

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16
Q

Legg- Calve- Perthes Disease Progression

A 
Pre-necrosis- insult to blood supply
Necrosis/ asymptomatic- 3-6 months
Re-vasularization- 1-4 years
Bones Healing- re-ossification
Remodeling- improved joint function
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17
Q

Legg- Calve- Perthes Disease Treatment

A

Bracing or traction

Surgery to release muscles, treat acetabulum or femur and restore range of motion

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18
Q

Legg- Calve- Perthes Disease Complications

A 
If left untreated:
Osteoarthritis
Hip Dysfunction
Shortened Height
Leg length discrepancy
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19
Q

Slipped Capital Femoral Epiphysis

A 
Typically 11-12 yo
Limping, hip pain, femur slips out of joint
Obesity
Recent growth spurt
Hypothyroidism
Hypogonadism
Can be acute or gradual
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20
Q

Slipped Capital Femoral Epiphysis Manifestations

A

Pain in affected hip or referred to knee

Change in hip range of motion

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21
Q

Slipped Capital Femoral Epiphysis Treatment

A

Surgical fixation of hip and bone graft

Then Spica Cast or Russell traction

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22
Q

Slipped Capital Femoral Epiphysis Nursing Care

A 
Pain management
Monitor for complications of immobility
Traction of cast care
Body image
Weight control
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23
Q

Scoliosis

A

Congenital, idiopathic, acquired
Truncal asymmetry, uneven shoulders, uneven hips, one sided rib hump, prominent scapula, hip and back pain, extreme fatigue, dyspnea with exertion

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24
Q

Scoliosis Treatment

A

Mild: 10-20 degree curve, physical therapy to improve posture and muscle strength and tone
Moderate: 20-40 degrees, Bracing to maintain current level of curve, does not reduce
Severe: >40 degrees, spinal fusion with segmental instrumentation

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25
Q

Muscular Dystrophy- Duchenne’s

A 
Genetic Autosomal recessive 
Lower extremities weakness
Gower Sign- Standing up abnornamlly
Toe- walking
Tripping, Limping
Enlarged calves 
Progress to complete immobility, respiratory difficulty and failure, cardiomyopthy, fractures and chronic disability
Eventually wheelchair ----- death
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26
Q

Muscular Dystrophy- Duchenne’s Treatment

A

Supportive and Palliative Care
Minimize family dysfunction
Maximize function and quality of life
Infection prevention, skin care, respiratory and nutritional support, PT and OT, parent support

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27
Q

Plastic Deformation Fracture

A

Bending of the bone

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28
Q

Buckel/ Torus Fracture

A

??

29
Q

Greenstick Fracture

A

Most common

Not all the way through

30
Q

Complete Fracture

A

Complete break

31
Q

Common Fracture Sites

A

Radius, Clavicle, Femur

32
Q

Fracture Nursing Care

A 
8 week recovery
5 P Check
Monitor for compartment syndrome
Pain management
Infection control and asepsis
Monitor neurovasular status 
Cast Care
Activity restriction
33
Q

Osteomyelitis

A

Infection of the bone
Long bone of lower extremity is most common
Can spread to soft tissue

34
Q

Osteomyelitis Manifestations

A

Pain, edema, decreased mobility, fever, redness surrounding affected area

35
Q

Osteomyelitis Treatment

A

IV antibiotics 3-6 weeks

PICC Line

36
Q

Nursing Role in Immunization

A 
Reduce transmission of infections
Educate parents
Screen for eligibility
Promote and provide immunizations
Reduce pain and anxiety with administration
Monitor for side effects
37
Q

Safe Administration of Immunizations

A 
22-25 g needle
5/8 in for newborns
1 in for 2-12 months
1 & 1/4 in Toddler
MAX 1cc
38
Q

Varicella Complications

A

Prevent with vaccine!

Complications: cellultis, pneumonia, sepsis, meningitis, reye’s syndrome, can be fatal!

39
Q

Varicella Vaccine

A

Subcut
Live virus 12-15 months AND 4-6 years
Do not give to immunosuppressed or allergic to neomycin or gelatin
Childbearing age girls avoid pregnancy for 3 months

40
Q

Diphtheria Infection

A

Bacterial
Cough, stidor, nosiey breathing, bluish white gry covering oropharynx, tonsils, soft, hard palate, severe sore throat, enlarged cervial lymph nodes

41
Q

Diphtheria Infection Complications

A

Endotoxins can cause myocarditis
Guillian Barre!
Severe Respiratory distress
Last seen in 2003

42
Q

Diphtheria Infection Vaccine

A

Inactivated

Given with DTAP, 5 doses

43
Q

Haemophilus Influenza Type B Infection

A

Bacterial
Manifestations specific for target site
Complications: meningitis, epiglottis, sinusitis, pneumonia, cellulitis and death in young infants
Vaccine: Inactivated, 4 doses

44
Q

Influenza A/B Viral Infection

A

Chills, cough, runny nose, sore throat, malasise, aches, HA, nausea, Anorexia, vomittingm diarrhea, abdominal pain, croup

45
Q

Influenza A/B Viral Infection Complications

A

Ear infection, exacerbation of lung disorders, pneumonia, myostitis, myocarditis, Guillian Barre

46
Q

Influenza A/B Viral Infection Vaccine

A 
Inactivated for all ages
Live for 2 and older
Yearly after 6 months
1st time <9 yo, 2 doses 4-6 weeks apart
80% effective
47
Q

Rubeola (Hard Measles)

A

Rash starts 2-4 days after prodromal period
Begins on face and spreads to trunk and extremities
Symptoms lasts 4-7 days
Generalized Malaise, fatigue, lymphadenopathy, anorexia, cough
Lesions can erupt on mucus membranes in mouth

48
Q

Rubeola (Hard Measles) Complications

A

Ear infection, pneumonia, encephalitis, bronchitis, death

The younger the more at risk

49
Q

Rubeola (Hard Measles) Vaccine

A

Subcut
Live, given with MMR
2 doses
Egg allergy= observe 90 minutes after injection
Avoid pregnancy for 4 weeks post immunization

50
Q

Parotitis (Mumps)

A

Bilateral or unilateral parotid gland swelling, peaking by the third day
Meningeal irritation: stiff neck, HA and photophobia
Can be confused with cellulitis

51
Q

Parotitis (Mumps) Complications

A

Orchitis, inflammation of the epididymis, scrotal swelling, pancreatitis, glomerulonephritis, myocarditis, hearing impairment, cerebellar, ataxia

52
Q

Parotitis (Mumps) Vaccine

A

Subcut
Live
Given with Measles and MMR
2 doses

53
Q

Pertussis

A

Bacterial infection
Prodomal Stage 1- nasal congestion, runny nose, low grade fever, mild non-productive cough for 2 weeks
Paroxymal Stage 2- severe cough at night, thick mucus plugs, whooping sound after breathing, periods of hypoxai and apnea- 6 weeks
Convalescent Stage 3- Paroxysms gradually subsitde

54
Q

Pertussis Vaccine

A

DTAP and TDAP with Diptheria and tetanus
5 doses
Encouraged to get TDAP when tetanus booster

55
Q

Poliomyelitis

A

Viral Infection
Prodromal: Fever, HA, back ache, vomitting and sore throat
Manifestations: Affects CNS, vomitting, sore throat, stiff neck, progressive weakness, meningeal irritation, respiratory tract muscle weakness, paralysis

56
Q

Poliomyelitis Complications

A

Permanent motor paralysis, respiratory arrest, myocardial failure, aseptic meningitis, post polio syndrome

57
Q

Poliomyelitis Vaccine

A

Subcut or IM
4 doses
Contraindicated in pregnancy, children with hypersensitivity to neomycin, streptomycin or polymyxin B

58
Q

Rotavirus

A

Viral Infection
Watery diarrhea 1-2 days, following fever and vomiting
10-20 stools a day, symptoms can last 3-8 days
Complications: dehydration, electrolyte imbalance, death in some cases
Vaccine: Oral, Live, 3 doses

59
Q

Rubella

A

Viral Infection
Prodomal: 1-5 days before rash, low grade fever, HA, malaise, sore throat, anorexia, pinpoint lesions on soft palate, generalized lympthadenopathy, 7 days before rash appears

60
Q

Rubella Clinical Manifestations

A

Pink, non-confluent, maculopapular rash on the face

Rash progresses to neck, trunk and legs

61
Q

Rubella Complications

A

Dangerous to pregnant women

62
Q

Rubella Vaccine

A

Subcut
Live
2 doses

63
Q

Tetanus

A 
Bacterial Infection
Stiffness of the neck and jaw
Painful facial spasms, HA, difficulty chewing and swallowing
Prolonged and painful muscle spasms
Suffocation from respiratory spasms 
Increased oral secretions
64
Q

Tetanus Complications

A

Laryngospam, respiratory distress, death

65
Q

Tetanus Vaccine

A

5 doses

Booster every 10 years

66
Q

Erythema Infectiosum 5th Disease

A 
Viral Infection
Fiery-red rash on cheeks
Later a lacy, erythmatous maculopapualr rash on trunk and limbs
Circumoral pallor
Rash lasting up to 3 weeks
No vaccine
67
Q

Lyme Disease

A

Bacterial Infection

Prodromal: malaise, fatigue, HA, stiff neck, milk fever, and muscle and joint aches

68
Q

Lyme Disease Manifestations

A

1-4 months later, multiple erythema migran, cranial nerve palsy, HA, meningitis, fatigue
Arthritis months later

69
Q

Lyme Disease Complications

A

Neuro deficits- Bell’s palsy, encephalopathy, optic neuropathy, peripheral nerve disorders

NUR 440 Exam 2 (4 decks)

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