PEDI FINAL: musculoskeletal dysfunctions
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How are young infants tested for DDH?
- Ortolani's Test (positive-click)
- Barlow Test (Unstable)
What is the most commonly broken bone in children?
- forearm fracture also common
- Femoral, neck, and femur in older children
- Knee injuries in adolescents
What are some nursing considerations associated with congenital club foot casts?
- Closely monitor skin and circulation
- Change cast every 1-2 weeks
What are the 3 categories of congenital club foot?
- Positional (mild)- due to intrauteral crowding
- Syndromic (Tetralogic)- associated with other congenital anomalies (spina bifida)
- Congential (Idiopathic)
what are common causes of fractures?
- Pedestrian-auto and bike-auto
- Infants- birth trauma, MVA, abuse
Bone protrudes through skin
Bone fragments damage organs/tissues
bone fragments in surrounding tissue
Fracture fragments are separated
- Fragments remain attached
- Fracture line: transverse, oblique, spiral
bends 45 degrees or more without breaking
Bulging projection due to compression
- Incomplete fracture occurs when bend it too great
- Compressed side of bone bends and tension side of bone breaks
Transverse fracture line.
fracture of long axis of bone
Oblique fracture line.
Slanting but straight (diagonal)
Spiral fracture line.
Slanting and circular- twisting around the bone shaft
What are some complications of Fractures?
- Circulatory impairment
- Nerve compression syndromes
- compartment syndrome
- Volkmann contracture
- Epiphyseal damage
- Kidney Stones
- Pulmonary Emboli
What should a nurse assess when suspecting vascular injuries due to Fractures?
- Pain & point of tenderness
- Pulse-distal to fracture site
- Paresthesia-distal to fracture site
- Paralysis-distal to fracture site
What is most important to promote healing with Fractures?
What is the most important nursing consideration when dealing with osteogenic sarcoma?
Describe the characteristics associated with Type 1 Osteogenesis Imperfecta (OI).
- most common
- variable fractures, little deformity, mild bone fragility, blue sclera, near normal stature, joint laxity
- Hearing loss at age 20-30 years old
What Disorder is associated with complaints of "ill fitting" clothes?
A child being screened for Scoliosis is told that he/she has the disorder as evidence by what distinct finding on the Screening Exam?
If there is a rib hump on back and/or asymmetry seen
What position must a child stand when performing a Scoliosis Screening Test?
bent forward with back exposed
What is a TLSO brace and what is it used for?
- custom molded plastic jacket brace
What disorder is mostly seen in obese children?
(SFCE) Slipped Femoral Capital Epiphysis
What disorder can be caused by ANY organism?
What is the diagnostic criteria for Juvenile Rheumatoid Arthritis?
- Age of onset younger than 16 years old
- Affected joints (one, few, polyarticular)
- Duration of arthritis more than 6 weeks
- Exclusion of other forms of arthritis
What disorder has the best results when treated before the age of 2 months?
Developmental Dysplasia of the Hip (DDH)
What are some S&S of DDH?
- shorter leg on affected side
- prominent greater trochanter
- Trendeleburg Sign (bears weight on affected side, normal side pelvis down)
- Lordosis & waddling gait (bilateral dislocation)
- Positive ortalani and barlow sign (click & unstable)
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