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Ped Muscuskeletal
Pediatric Musculoskeletal disorders.
| Question | Answer |
|---|---|
| What makes children susceptible to fractures? | Spontaneous exercise; not fully coordinated; tramps, skateboards exc..... |
| How are children's bones different? | growing; flexible; thicker periosteum; growth plate; heal faster; remodel easier. |
| What are the most common sites of fractures in children? | Ulna, clavicle, tibia, elbow and femur. |
| What are the types of fractures and what do they look like? | Torus = Buckle; greenstick; Spiral; Oblique; Transverse; Comminuted. |
| What are the reduction methods of closed and open fractures? | Closed: Manual alignment of the fragments followed by immobilization; Open: Surgical insertion of internal fixation devices, such as rods, wires, or pins to help maintain alignment. |
| What are the retention methods for fractures? | Align fracture, then maintain position and protect fracture site through the application of a cast or traction. |
| What are some nursing interventions for a trauma fracture? | Assess A,B,C's; Hx of circumstances; Examine site; Immobilize affected extremity; If compound splint extremity and cover the wound w/ sterile dressing. |
| What are the three types of types of traction and describe them? | Manual (use hand placed distally to site), Skin (Buck's extension, Russell traction, Cervical), Skeletal (metal device inserted into the bone Crutchfield Tongs, 90/90 Femoral, Dunlop, balanced suspension). |
| Skin traction should not be used when child has skin infection open wound or extensive tissue damage. T/F | True. |
| Skin traction is best for which age and weight of child? | 2-3yrs old or less than 30lbs. |
| What is a major complication with skeletal traction? | Osteomyelitis. |
| What are the five P's | Pain, Pallor, pulselessness, paresthesia, paralysis. |
| What are the Interventions for immobility? | Constipation, skin, urinary retention, respirations, disuse of limbs. |
| What is Scoliosis? | Idiopathic (mostly in adolescent girls); Congenital (result of vertebral anomalies); Neuromuscular (common in those with conditions such as cerebral palsy, muscular dystrophy, paraplegia). |
| What are the signs and symptoms of Scoliosis? | Back pain, fatigue, unequal pelvic and shoulder heights, different leg length. |
| What are the measurements for mild and severe scoliosis? | less than 20 degrees is mild; greater than 40 degrees is severe. |
| What are the treatments for Scoliosis? | Bracing 18-23hrs/day; Surgery Spinal fusion. |
| What is Juvenile Ideopathic Arthritis (JIA)? | Systemic inflammatory disease that involves the joints, connective tissue, and viscera. |
| What is the gel phenomenon? | Morning stiffness in a child with JIA |
| How do you test for Developmental Dysplasia of the Hip (DDH)? | Ortolani and Barlow tests positive or CT and MRI (not definitive). |
| What are some treatments for DDH? | Pavlik harness; Closed reduction and a spica cast; Open reduction. |
| What is clubfoot? | Failure of the ankle joint to develop during fetal life, the foot is abducted and twisted inward. |
| What are the treatments for clubfoot? | Stretching exercises, casting, surgery. |
| What is Legg-Calve-Perthes Disease? | Caused by diminished blood supply to femoral epiphysis resulting in necrosis and degeneration of the femoral head. |
| Who is most at risk for LCP Disease? | Boys between 4-8 with average onset at 6 |
| What are the S/S for LCP Disease? | Painful Limp; hip; thigh or knee soreness or stiffness. |
| What are the treatments for Legg-Calve-Perthes Disease? | Bed rest w/ROM; Bracing; Surgery. COMPLIANCE is important. |
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