Test 3 Flashcards by Ashley swets

Nursing care of musculoskeletal issues

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

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Management of musculoskeletal issues

RICE

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Reasons fractures are common in child

Increased mobility
Limited coordination
More easily injured

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Healing time children

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

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Bends

May bend up to 45 degrees and straighten slowly

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Buckle fracture

Raised or bulging projection

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Green stick

Incomplete

Like a new twig when bent

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Fractures

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

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Treatment goals of fractures

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

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Fiberglass casts

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

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Plaster of Paris cast

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

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Treatment of fractures

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

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Traction

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

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Dysplasia of the hip

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

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Signs of dysplasia of the hip

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

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Treatment of hip dysplasia

Under 6 months-harness of brace to keep hip abducted

Over 6 months-surgery and spica cast

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Club foot

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

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Treatment of club foot

Serial casting until defect correct

Surgery if casting unsuccessful

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Scoliosis

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

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Causes of scoliosis

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Abnormal formation
Trauma
Muscle weakness

Diagnosis of scoliosis

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Screening-without shirt and bend

X Ray to confirm

Treatment of scoliosis

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

Scoliosis post op

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

Osteomyelitis

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An infection of the bone

Symptoms of osteomyelitis

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

Treatment of osteomyelitis

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

Osteopegenic sarcoma

Surgery and chemotherapy

Ewing sarcoma

Intensive radiation and chemo | Usually saves limb

Juvenile RA

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

Symptoms of RA

Stiffness Swelling Loss of motion

Meds for RA

NSAIDS Methotrexate Corticosteriods Adilimumab

Treatment of RA

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

Systemic lupus erythematosus

Chronic autoimmune disease of the connective tissue and blood vessels Inflammation in any body tissue

Symptoms of SLE

``` Rash Photosensitive Oral ulcers Renal problems Seizures Hematologic and immune problems ```

Treatment of SLE

``` Meds and supportive care Corticosteriods Antimalarials NSAIDS Nutrition Rest Exercise ```

ADHD

Developmentally inappropriate degrees of inattention, impulsiveness and hyperactivity Must have symptoms before 7 years old in at least 2 settings 6% school age children 1/3 may outgrow

Symptoms of ADHD

``` Difficulty in school Distractible Impulsive Aggressive May develop maladaptive coping skills ```

Criteria for ADHD

Hyperactivity, impulsivity | Look at history

Treatment

Meds Counseling Environmental

Cognitive impairment

Any time of mental difficulty or deficiency | IQ

Primary prevention for cognitive impairment

``` Rubella immunization Genetic counseling Folic acid during pregnancy Education about no alcohol Prenatal care Reduction of head injuries ```

Secondary prevention of cognitive impairment

Identify early and start treatment | Newborn screenings

Tertiary prevention of cognitive impairment

Treatment to minimize long-term consequences | Early rehab and treatment

Assessment of cognitive impairment

``` Irritable with contact Abnormal eye contact when feeding Gross motor delay Decreased alertness to voice Language difficulties Feeding difficulty ```

Down syndrome

Most common chromosome abnormality Trisomy 21 Older moms

Symptoms of Down syndrome

``` Low normal to severely impaired 2-3 years behind mental age 40% have CHD Eye and ear problems Growth reduced ```

Fragile X syndrome

``` Abnormal gene X linked dominate Treated with tegretol or Prozac to control violent outbursts Clonidine to improve attention span Speech and language therapy ```

Autism spectrum disorder

Complex neuro development disorder Alterations in social interactions Verbal impairment Repetitive, restricted stereotype behavior

Test 3 Flashcards

(48 cards)