Test 3

Question 1

Nursing care of musculoskeletal issues

Answer 1

Careful skin care
Encourage fluids
Provide diversion
ROM
Small frequent meals
Increased fiber

Question 2

Management of musculoskeletal issues

Answer 2

RICE

Question 3

Reasons fractures are common in child

Answer 3

Increased mobility
Limited coordination
More easily injured

Question 4

Healing time children

Answer 4

Neonate S 2-3wks
Young kids 4wks
Older kids 6-8
Teens 8-12

Question 5

Bends

Answer 5

May bend up to 45 degrees and straighten slowly

Question 6

Buckle fracture

Answer 6

Raised or bulging projection

Question 7

Green stick

Answer 7

Incomplete

Like a new twig when bent

Question 8

Fractures

Answer 8

Bones grow faster than in adults
Bones are more porous
Healing is rapid
 Stiffness in unusual
Fracture along epiphysis may impact bone growth

Question 9

Treatment goals of fractures

Answer 9

Control pain, hemorrhage and edema
Relief of spasms
Realignment of fracture
Promote healing
Immobilization

Question 10

Fiberglass casts

Answer 10

Light weight
Dry quickly
Can get a bit wet
Don’t mold as well

Question 11

Plaster of Paris cast

Answer 11

Heavier and longer to dry
Mold easily
Can’t get wet

Question 12

Treatment of fractures

Answer 12

With casts
Elevate above heart
Check pallor, pulses and pain
If edges rough, petal
May need to be bivalved for pressure
Watch for compartment syndrome

Question 13

Traction

Answer 13

Needed to reduce a fraction that cannot be cared for simply
May help with muscle spasm
Keep alignment and immobilization

Question 14

Dysplasia of the hip

Answer 14

Imperfect or abnormal hip development
Dislocation of femoral heads
More common in females

Question 15

Signs of dysplasia of the hip

Answer 15

Asymmetrical gluteal thigh folds
Uneven length of the femur
X-Ray
Ultrasound under 4months

Question 16

Treatment of hip dysplasia

Answer 16

Under 6 months-harness of brace to keep hip abducted

Over 6 months-surgery and spica cast

Question 17

Club foot

Answer 17

Congenital skeletal deformity of the foot
Foot twisted out of normal position
Cannot be manipulated into normal position

Question 18

Treatment of club foot

Answer 18

Serial casting until defect correct

Surgery if casting unsuccessful

Question 19

Scoliosis

Answer 19

Complex spinal deformity with lateral curvature of the spine, spinal rotation and thoracic hypo kyphosis

Question 20

Causes of scoliosis

Answer 20

Abnormal formation
Trauma
Muscle weakness

Question 21

Diagnosis of scoliosis

Answer 21

Screening-without shirt and bend

X Ray to confirm

Question 22

Treatment of scoliosis

Answer 22

Observe if 10-15
Braces 23hrs a day through growth under 40
Surgery if above 45

Question 23

Scoliosis post op

Answer 23

Neuro assessment important
Pain control
Keep flat-log roll
Up with brace in a day

Question 24

Osteomyelitis

Answer 24

An infection of the bone

Question 25

Symptoms of osteomyelitis

Answer 25

``` Irritable Restless Increased temp Localized tenderness Warmth and swelling over affected bone Guarding ```

Question 26

Treatment of osteomyelitis

Answer 26

IV antibiotics-long term PO Immobilization and no weight Surgery to prevent pus from spreading

Question 27

Osteopegenic sarcoma

Answer 27

Surgery and chemotherapy

Question 28

Ewing sarcoma

Answer 28

Intensive radiation and chemo | Usually saves limb

Question 29

Juvenile RA

Answer 29

``` Autoimmune inflammatory disease Children under 16 Stops after 2-3 years May last 8-10 years Girls 1-3yrs of age most common ```

Question 30

Symptoms of RA

Answer 30

Stiffness Swelling Loss of motion

Question 31

Meds for RA

Answer 31

NSAIDS Methotrexate Corticosteriods Adilimumab

Question 32

Treatment of RA

Answer 32

``` PT and OT Promote and maintain ADLS Exercise Heat Support ```