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44 Cards in this Set
- Front
- Back
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What is osteomyelitis?
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An infection of the bone.
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What are the clinical manifestations of osteomyelitis?
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*Infants: irritablility, lethargy, diarrhea, or poor feeding, temp may be normal or slightly below normal
*Children:constant pain that is localized and increased with movement in the affected limb, edema, restricted movement, heat, erythema, and fever |
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With osteomyelitis, when can bone necrosis occur?
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In 2 weeks.
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What is the treatments used for osteomyelitis?
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*IV and PO meds
*Splinting of the limb |
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What are some nursing interventions for oseomyelitis?
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*Administer analgesics
*NWB on affected limb *Maintain adequate blood levels *Nursing assessment every 4 hours *Family teaching |
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What is septic arthritis?
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Infection of the joint via hematagenous route from another site of infection.
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What is the difference between osteomyelitis and septic arthritis?
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Septic arthritis settles only in the joints.
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What are the most common sites for septic arthritis?
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The hip and knee.
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What would be found on the nursing assessment of someone with septic arthritis?
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*Pain on gentle preseeure
*Localized inflammation *Restricted motion *Swelling of the joint |
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How is septic arthritis treated?
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*Aspiration or surgical drainage of the joint
*IV antibiotics for 4-6 weeks *Immobilization of joint *Pain relief |
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What is clubfoot?
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A congenital anomaly of the foot and the lower leg involving abnomalities of the bony structure and soft tissue.
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How often does clubfoot happen?
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1-2 per 1000 births.
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What are the clinical manifestations of clubfoot?
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*Foot points downwards
*Forefoot turns inward *Sole turns inward *General description of foot: rigid, fixed, small, difficult to move *Achilles tendon always shortened. *Calf muscle thin and athrophic |
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What is the treatment for clubfoot?
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*Serial casting for 3 months
*Botox injections *Surgery |
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How does surgery correct clubfoot?
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Realigns bones which are held in place by pins.
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How does botox help clubfoot?
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It allows the muscles to work and keeps the tendons from pulling back to where they were.
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What are somethings for nurses regarding management of clubfoot?
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*Pre-surgical assessment
*Provide family support and education *Post-surgical assessment and nursing care *Care of the family |
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What is develomental dysplasia of the hip (DDH)?
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The femoral head has an abnomal relationship with the acetablulum.
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What are the risk factors for DDH?
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*Gender
*Birth order *Family history *Intrauterine position *Delivery type *joint laxity *Postnatal positioning |
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What would a nurse find during an assessment of a child with DDH?
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*Unequal leg length
*Asymmetry of the thigh *Asymmetry of the gluteal folds *Limited abduction *Gait abnormalities *Unequal pelvis level |
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What are some methods of treatment for child with DDH?
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*Pavlik Harness
*Bryant skin traction *Hip spica cast |
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What is a Pavlik harness?
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Velcro strips wrapped around the child to hold the leg in position.
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Describe the care of a pavlik harness on an infant.
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Check the straps every 1-2 weeks.
The harness should not be adjusted by parents w/o supervison. |
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What is Duchenne Muscular Dystrophy (DMD)?
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One of a group of progressive degenrative inherited deseases that causes wasting of the muscles.
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What are the clinical manifestations of DMD?
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*Early motor movement
*Pelvic muscles *Gait *Gowers sign *Shoulder girdle muscles *Muscles of the trunk *Pseudohypertophy *Contactures *Resp/Cardiac function |
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What is Gower's sign?
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Weakness of the proximal muscle.
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What is pseudohypertophy?
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Muscles enlarged from fatty deposits.
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What treatments are used for DMD?
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Collaborative care with PT, OT, nutritionist and SW.
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What are some nursing concerns for DMD?
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*Respiratory status
*Sibling needs *Nutrition *Home modifications *B & B *Psychosocial needs *Spiritual needs *Activity |
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What is it that eventually causes death in DMD patients?
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Cardiac and respiratory problems.
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What is scoliosis?
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Lateral curvature of the spine with vertebral body rotation.
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What are the clinical manifestations of scoliosis?
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*Occurs around puberty when growth rate is the fastest
*Shoulders and hips *Scapula: more prominent *Spinal column is curved *Elbow: one closer to iliac crest *When child bends forward, one side of back is higher than other |
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How do they treat scoliosis?
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*Observation
*Bracing *Surgery |
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What are the three braces used for scoliosis?
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1.Boston Brace
2.TLSO custom molded 3.Milwaukee Brace |
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What are some therapeutic managements of soft tissue injuries?
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*Rest
*Ice *Compression *Elevation *Support |
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What are clinical manifestation of fractures?
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*Pain or tenderness
*Edema *Decreased ROM *Obvious deformity *Muscle spasms *Crepitus *Bruising |
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What are the initial nursing management interventions of a fracture?
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*immobilization
*Neurovascular assessment |
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How do you care for a child in a cast?
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*Let the cast dry thoroughly (24-48 hours)
*Use palm ofyourhands to pick up the cast to prevent dents *Elevate the cast on a pillow slightly above heart level *Avoid getting it wet *Petal the edgedto protect the childs skin *Assess every 4 hours |
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What should you assess for when doing a neurovascular assessment of a casted child?
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*Pain
*Skin color *Sensation *Motion *Skin temp *Capillary refill *Pulses |
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Who is at risk for cast syndrome?
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People in a body cast.
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When does cast syndrome occur?
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When a cast is applied too tightly, thus compressing the mesenteric artery against the duodenum
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What are the clinical manifestations of casy syndrome?
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*Nausea/vomiting
*Abdominal pressure *Vague abdominal pain *SOB *Complete GI obstruction |
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What are the primary purposes of traction?
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*Immobilize fracture
*Realign the bone *Decrease muscle spasms *Prevent further tissue damage |
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What are some potential nursing diagnoses for musculoskeletal problems?
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*Impaired physical mobility r/t treatment.
*Altered parenting r/t emotional distress followed birth of a child with a physical defect *Knowledge deficit r/t defomity, treatment, and home care. |
