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SAC Peds Exam

Module 15 - rest & exercise

Highest priority w/ cast care? Maintaining Skin integrity
Nursing interventions to minimize swelling and promote circulation w/ casts? ice, elevate, CMS checks, keep dry
Major complication of any constricting cast or splint? Compartment syndrome
How do you handle a wet cast? With open palms, not fingers; to prevent pressure spots
Purpose of traction? Stretch muscles and alignment
Kinds of skin traction? Bryant's - legs straight and 90degrees toward ceiling AND Pugh's - child's wt is counterbalance
What to remember w/ skin traction? never release traction w/o MD order
Why is skin traction used for hemophiliacs? Hemoarthrosis
Most serious complication w/ skeletal traction? Osteomyelitis
5 P's of vascular impairment? Pain, Pallor, Pulselessness, Paresthesia, Paralysis
After traction applied, how often are neurovascular assessments done? q 1-2hrs during first 48hrs, then q 4hr CMS w/ v/s
S/S of Neurovascular impairment? cold, blue, pale, loss of motion, numbness, tingling, sluggish cap refill
How do you assess pain level? Pain scale, vital signs, open ended questions
Cerebral Palsy Neuromuscular disorder resulting from damage to brain from anoxia
S/S of CP Hypertonicity (spasticity), mental retardation (in 18-50%), speech/hearing disturbance, dental anomalies, sz
Interventions for CP? Nutrition, safety, meds
Med for CP? Dilantin, Baclofen
Things to know about Dilantin? s/e = gingival hyperplasia, oral care w/ soft toothbrush
Baclofen - why is it given and how? Given to reduce spasticity and given intrathecally
Priority goal for CP? maintain optimal level of wellness
Developmental Dysplasia of the Hip Abnormal development of head of femur and acetabulum
How do you assess for DDH? +Ortolani's, shorter limb, asymmetrical gluteal skin folds
Intervention for DDH? Plavik Harness for 3mos; hip-spica cast or surgery for older child
Highest priority teaching for DDH? Prevent complications --> proper placement of harness
Highest priority of care for DDH? Prevent skin breakdown
How to assess for scoliosis? Child bends forward w/ knees straight and arms hanging down --> spine fails to straighten; hips, ribs, shoulders asymmetrical
Interventions for scoliosis? Milwaukee brace worn 23hrs/day
Post-op care for scoliosis? Flat, supine position, log roll q 2hrs, NG tube to reduce gas, NPO, incentive spirometer, PCA, strict I&O
Priority Nursing Dx for Scoliosis? Disturbed body image, Pain, Risk for noncompliance
Osteogenesis imperfecta (aka OI or "brittle bones") Autosomal dominant d/o of the connective tissue involving bones, ligaments and sclera
Assessment findings for OI Hx of frequent fractures, blue-tinged sclera, thin skin, blue-gray teeth
Abnormal labs for OI? Precollagen type I
Interventions for OI? Gentle handling, soft environment, parent teaching
Juvenile rheumatoid arthritis Autoimmune disease of connective tissue w/ chronic inflammation of the synovia and possible joint destruction
Assessment findings of JA? elevated ESR, +antinuclear antibody (ANA), +rheumatoid factor
What can influence JA exacerbations? stress, climate, genetics
what meds are given for JA? low-dose corticosteroids, NSAIDS (naproxen, ibuprofen)
Important thing to remember when administering JA meds? admin w/ food
What do you do if child feels pain in joints? If stiff, may need heat; if swollen, may need ice
Muscular dystrophy Genetic, sex-linked recessive trait, mostly in males d/t absence of protein in muscles
Assessment findings w/ MD? Pelvic girdle weakness, waddling gait, falls, difficulty climbing stairs, +Gowers sign
Diet for MD? high fiber, High fluid, high protein, low Cal diet
Priority Nursing Dx for MD? Risk for injury, Impaired physical mobility, risk for constipation, disturbed self esteem
Created by: cobedad