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parent/child: ch 48
| Question | Answer |
|---|---|
| Contusion | Bruise |
| Ecchymosis | Black-and-blue discoloration |
| Dislocation | Occurs when the force of stress on the ligament is so great as to displace the normal position of the opposing bone ends or the bone end of the socket (Common in children younger than 5 - hip dislocation) |
| Sprains | Occurs when trauma to a joint is so severe that a ligament is partially or completely torn or stretched by the force created as a joint is twisted or wrenched, often accompanied by damage to associated blood vessels, muscles, tendons, & nerves |
| Strains | Microscopic tear to the musculotendinous unit & has features in common with sprains |
| Therapeutic management | RICE: Rest Ice Compress Elevate ICES: Ice Compression Elevation Support |
| Bone fractures | Occur when the resistance of bone against the stress being exerted yields to the stress force |
| Plastic deformation fracture | Occurs when the bone is bent but not broken |
| Buckle, or torus, fracture | Appears as a raised or bulging projection at the fracture site |
| Greenstick fracture | Incomplete |
| Complete fracture | Divides the bone fragment; can happen with periosteal hinge |
| Fracture therapeutic management | - Reduction to regain alignment & length of the bony fragments - Immobilization to retain alignment & length - To restore function to the injured parts - To prevent further injury & deformity |
| Compartment syndrome evaluation (6 P’s) | 1) Pain 2) Pulselessness 3) Pallor 4) Paresthesia 5) Paralysis 6) Pressure |
| Cast teaching | - Use palms not fingers - Don’t stick anything in it - Monitor for compartment syndrome |
| Cast removal | Not painful |
| Developmental dysplasia of the hip | Describes a spectrum of disorders related to abnormal development of the hip that may occur at any time during fetal life, infancy, or childhood |
| Diagnostic evaluation of developmental hip dysplasia | The Ortolani (abduction) & Barlow (adduction) tests |
| Therapeutic management of developmental hip dysplasia | Treatment varies with the child’s age & the extent of the dysplasia; newborn to 6 months - Pavlik harness (22 to 24 hours for 6 to 12 weeks); 6 to 24 months - spica cast for 12 weeks; older children - surgery |
| Clubfoot | Complex deformities of the ankle & foot that includes forefoot adduction, midfoot supination, hind foot varus, & ankle equinus |
| Clubfoot therapeutic management | 1) correction of the deformity 2) maintenance of the correction until normal muscle balance is regained 3) follow-up observation to avert possible recurrence of the deformity; Ponseti method: serial casting is begun shortly after birth |
| Nursing care management of clubfoot | Cast care |
| Osteogenesis imperfecta | Rare genetic disorder characterized by bones that fracture easily |
| Nursing care management of OI | Careful handling to prevent fractures - should never be held by the ankles when changing their diapers, but gently lifted by the buttocks or supported with pillows |
| Legg-Calve-Perthes Disease | “Leave it alone;” self-limiting disorder in which there is avascular necrosis of the femoral head; most cases occur as an isolated event in boys; s/s: limping; therapeutic management: NSAIDs for pain relief |
| Slipped Capital Femoral Epiphysis | “Surgery;” refers to the spontaneous displacement of the proximal femoral epiphysis in a posterior & inferior direction; nursing care management: prep the child & family for the surgical procedure & recovery; manifestations: pg. 1474 box 48.8 |
| Idiopathic scoliosis | Complex spinal deformity; diagnostics: @ school-age; bending forward; definitive by radiographs & the use of the Cobb technique; curves between 10 & 25 degrees - mild & do not require treatment; curves between 25 to 45 degrees use a brace; > 45 = surgery |
| TSLO brace | Wear for 23 hours per day |
| Juvenile idiopathic arthritis | Cause is unknown; therapeutic management: control pain, preserve joint ROM & function, minimize effects of inflammation, & promote normal growth & development: meds: NSAIDs, DMARDs, & glucocorticoids; pool therapy; still need to go to school |
| Juvenile idiopathic arthritis cont. | Rolling backpacks are encouraged; heat not ice; effective approach is to wake child an hour early to take meds then go back to sleep then hot bath or shower with exercises then go about day |
Created by:
tatianalopez03
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