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Neuromusculoskeletal Issues Flashcards

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1
Q

[Blank] are the leading cause of death in children 1-19 years.

A

Unintentional injuries

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2
Q

Causes of immobilization

A

congenital defects
prolonged ventilation and sedation
surgical or traction

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3
Q

muscular effects of immobilization

A

loss of joint mobility
atrophy
decreased muscle strength

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4
Q

skeletal effects of immobilization

A

bone demineralization
unbalanced calcium

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5
Q

cardio effects of immobilization

A

orthostatic intolerance
increased workload of heart
clots

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6
Q

Respiratory effects of immobilization

A

decreased respiratory effort
reduction in movement of secretions

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7
Q

G.I. effects of immobilization

A

decreased mobility of the bowel
risk for aspiration

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8
Q

Renal effects of immobilization

A

hypercalcemia because renal is designed to function in an upright position
urinary retention
impaired ureteral peristalsis
difficulty voiding

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9
Q

Metabolism effects of immobilization

A

decreased metabolic rate
decreased production of stress hormones

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10
Q

Integumentary effects of immobilization

A

decreased circulation and pressure
risk for ischemia and damage

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11
Q

Neurosensory effects of immobilization

A

loss of innervation
range of motion
effects of improper positions
nerve tissue damage

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12
Q

Nursing care management for immobilization

A

physical assessment
wheelchairs, canes
ROM

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13
Q

one thing you have to do for a single spica cast?

A

note diaper to maintain dryness

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14
Q

Nursing care for amputation

A

assessment
positioning
pain management
elastic bandaging

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15
Q

what is the most frequently broken bone in children?

A

clavicle

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16
Q

comminuted fracture

A

small fragments of bone are broken and lie in surrounding tissues

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17
Q

greenstick fracture

A

compressed side of bone bends but tension side of bone breaks

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18
Q

Manifestations of fracture

A

generalized swelling
pain and tenderness
diminished functional use

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19
Q

Five Ps of fracture assessment

A

Pain and point of tenderness
Pulselessness
Pallor
Paresthesia (sensation distal to the fracture)
Paralysis (movement distal to fracture site)

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20
Q

Nursing management for fractures

A

alleviate pressure on nerves
pain management
palpate of cast for hot spots
pulses, skin color, temperature

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21
Q

Fracture complications

A

circulatory impairment
nerve compression syndromes
compartment syndrome
physeal damage

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22
Q

what is compartment syndrome?

A

when pressure within close space compromises circulation to muscle and nerves due to tight casts

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23
Q

Osteomyelitis

A

infection of the bone secondary to blood stream infection

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24
Q

Ankle-foot orthosis usage

A

used to prevent foot drop due to bedrest, trauma, or paralysis

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25
Knee-ankle-foot orthosis usage
prevent buckling of the knee and to support extremity when there is paralysis
26
Hip-knee-ankle-foot usage
to provide various types of control for the knee and ankle joints
27
Stages of bone healing
1.) hematoma formation 2.) cellular proliferation 3.) callus formation 4.) ossification 5.) consolidation and remodeling
28
P.E should be suspected in a child with a hx of what?
recent surgery, major trauma, prolonged immobilization
29
Sign of P.E.
sudden chest pain and dyspnea
30
Osgood-Schlatter Disease
due to over usage of limb ligaments tear away from the tibial shaft
31
Torticollis "wry neck"
limited neck motion
32
nursing care of child with pavlik harness
check skin 2-4 times a day massage to stimulate circulation avoid lotions and powders place diaper under straps
33
Legg-Calve-Perthes disease
Avascular necrosis of femoral head
34
Therapeutic management for legg-calve-perthes disease
rest and activity restriction give NSAIDs physical therapy to restore ROM possible surgery
35
Two types of osteomyelitis
exogenous hematogenous
36
Exogenous osteomyelitis
infectious agent invades the bone after open fracture or penetrating wound
37
hematogenous osteomyelitis
preexisting infection spreads to bone
38
Juvenile idiopathic arthritis
chronic childhood arthritis, inflammation in surrounding tissues of joints
39
Manifestations of JIA
stiffness of joints in morning swelling loss of mobility warm to touch tender to touch soft tissue contractions
40
Systemic Lupus Erythematosus
chronic autoimmune disease of connective tissues and blood vessels
41
Manifestations of SLE
abdominal pain arthralgia glomerulonephritis
42
Hallmark signs of SLE
butterfly rash photosensitivity oral ulcers
43
Clubfoot
deformity of the ankle and foot
44
talipes varus
inversion (foot bending inward)
45
talipes valgus
eversion (foot bending outward)
46
talipes equinus
"horse foot" plantar flexion where toes are lower than heels
47
talipes equinovarus
toes are facing inward and lower than heel
48
patient education and nursing care for child with clubfoot
encouraging holding and cuddling meet developmental needs perform neurovascular and skin integrity checks
49
what are two effects of casting?
skin breakdown neurovascular alterations
50
s/s of Legg-Calve Perthes disease
hip stiffness limited ROM intermittent painless limp shortening of the affected leg
51
complications of legg-calve perthes
joint degeneration permanent disability
52
Types of Developmental dysplasia of the hip
Acetabular, subluxation, and dislocation
53
Acetabular dysplasia
delay in acetabular development
54
Subluxation
incomplete dislocation of the hip
55
dislocation
femoral head does not have contact with acetabulum
56
risk factors for DDH
birth order family hx breech LGA
57
expected findings for DDH
asymmetry shortening of the femur widened perineum one leg shorter than the other
58
Osteogenesis imperfecta
inherited connective tissue condition that results in bone fractures, deformity and restricted growth
59
expected findings for osteogenesis imperfecta
multiple bone fractures blue sclera hearing loss small, discolored teeth
60
patient education for OI
caution with live vaccines low impact exercises consult with PT
61
complications of OI
disuse osteoporosis hearing loss permanent deformities
62
Cerebral palsy
nonprogressive impairment of motor function
63
s/s of CP
failure to meet milestones choking w/ feeding tongue thrust poor head control rigid posture seizures
64
Spastic CP
muscle tightness or spasticity can present in a extremities gait can appear crouched
65
Dyskinetic CP
non-spastic involuntary jerking movements
66
Ataxic CP
lack of coordination, can't reach an object
67
Medications for Cerebral palsy
baclofen and diazepam
68
Baclofen and what are the nursing actions?
skeletal muscle relaxant monitor for increased fatigue, nausea, or hepatoxicity
69
two complications of cerebral palsy
aspiration and injury
70
Spina bifida
neural tube defect present at birth; failure of the osseous spine to close
71
Spina bifida cystica
protrusion of sac is visible
72
Meningocele
sac contains spinal fluid and meninges risk of infection if ruptures
73
Myelomeningocele
common sac contains spinal fluid, meninges, and nerves
74
risk factors for spina bifida
medications or drugs during pregnancy maternal malnutrition lack of folic acid
75
assessment findings for spina bifida occult
dimpling in lumbosacral area hair tuft
76
assessment findings for spina bifida cystica
flaccid muscles lack of bowel control prolapse of rectum protruding sac
77
nursing care for spina bifida
assess sac assess LOC infection precaution
78
nursing preoperative actions for spina bifida
protect sac apply sterile dressing moist with 0.9% NS place infant in incubator without clothes avoid rectal temps or cuddling don't remove dressing if dry, add more saline
79
complications of spina bifida
increased intracranial pressure, skin ulceration, latex allergy, bladder and/or bowl issues, orthopedic issues
80
Muscular dystrophy
progressive degeneration of skeletal muscle groups
81
expected findings for muscular dystrophy
fatigue unsteady gait muscle weakness delayed motor skill

Pediatrics (17 decks)

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