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98 Cards in this Set
- Front
- Back
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Arthroscopy
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visual examination of the interior of a joint with a fiber optic endoscope
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CT scan
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identifies injuries to soft tissue, ligaments, tendons, and muscle.
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MRI
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cross sectional imaging of bones and joints
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myelography
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invasive procedure, injection of radiopaque contrast into the subarachnoid space
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x rays
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most useful diagnostic tool. identifies joint disruption, calcification, bone deformities, fractures, bone destruction, and bone density
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Definition of scoliosis
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lateral curvature of the spine
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congenital causes of scoliosis
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abnormal formation of the vertebrae or fused ribs during prenatal development
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neuromuscular causes of scoliosis
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poor muscle control or weakness, secondary to another condition (CP, or MD)
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Assessment of scoliosis
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one shoulder higher than the other, uneven waist
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diagnostic tests
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spinal xrays, scoliometer measurement, MRI of the spine
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treatment of scoliosis
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observe curse 25-40 degrees when growth completed.... brace curved 25-30 degrees in a growing child, surgery for curves greater than 40
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Interventions for scoliosis
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assess braces for fit, logroll after surgery, maintain body alignment, keep bed flat
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Definition of fracture
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break in bone integrity
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causes of fractures
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accidents, child abuse, pathologic conditions
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Assessment for fractures
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pain and tenderness, skeletal deformity, swelling, loss of motor function, muscle spasm
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diagnostic tests for fracture
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xray
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treatment for fracture
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reduction and immobilization, casting, surgery
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interventions for fracture
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keep extremity in alignment and positioned above the heart, apply ice, monitor distal pulses q 2-4hr, assess color, temperature, and cap refil
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`cast care definition
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hard mold that encases a body part
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intervention for cast care
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turn the child frequently, expose cast to air, smooth the outer edges, assess circulation, monitor distal pulses q 2-4 hours, assess color, temp and cap refill
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traction definition
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realignment and positioning of the skeleton by pulling on the distal ends of bones
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DIAGNOSTIC TESTS FOR NEUROLOGIC SYSTEM
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level of consciousness assessment, CT scan (3d image with or without contrast), mri, EED, Lumbar puncture, Cerebral angiography, Ultrasound, ICP monitoring, elctromyography, opthalmoscopic exam
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EED
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eletroencephalography, shows the electrical conductivity of the brain
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lumbar puncture
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aspiratio of CSF for analysis and measurement of CSF pressure
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Cerebral angiography
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xray visulatization of cerebral vasculature with contrast
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Ultrasoundography
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high frequency sound waves show blood flow
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ICP monitoring
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direct, invasive monitoring of pressures
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Electromyography
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detects lower motor neuron disorders
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Opthalmoscopic exam
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visualization of eye structures
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Definition of Spina bifida
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exposure of the spinal cord resulting from a defect of the spinal cord and vertebral body. Types spina bifida occulta, spina bifida cystica (myelomeningocele), meningocele, and lipomeningocele
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Assessment for spina bifida oculta
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dimple or tuft of hair on skin over spinal defect, no neurologic dysfuntion but potential for foot weakness or bowel and bladder dysfunction
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Assessment for meningocele
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saclike structure protruding over spine
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assessment for myelomeningocele
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saclike structure protruding over spine, hydrocephalus, permenant neurologic dysfunction, arnold chiari syndrome, curvature of the spine, knee contractures, club foot
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Diagnostic tests for spina bifida before birth
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Elevated alpha-fetoprotein in maternal blood amniocentesis, acetylcholinesterase measurement, fetal karotype
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Diagnostic tests for spina bifida after birth
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spinal xray, ultrasound
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treatment meningocele
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surgical closure of the sac
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treatment myelomeningocele
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repair of the sac
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interventions spina bifida
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assess for signs of hydrocephalus, wound care, passive rojm, monitor I & O, diet high in calories
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Definition of Club foot
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congenital disorder in which the foot and ankle are twisted and cannot be manipulated into correct position. FIVE FORMS
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Causes of club foot
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arrested development in the 9th and 10th week of embryonic life, deformed talus and shortened achilles tendon, genetic disposition, and intrauterine positioning
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Treatment for club foot
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correction with a series of castes, 3 step plan
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Interventions for clubfoot
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ensure that shoes fit correctly, prepare parents for surgical repair
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Cerebral Palsy definition
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neuromuscluar disorder
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Ataxia type cerebral palsy
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least common. disorders of movement and balance
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Athetoid type cerebral palsy
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disorder of motion with varyin degrees of muscle tension
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Spastic type cerebral palsy
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most common, hyperactive stretch, contractions of extensor muscles, scissoring noted
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rigidity type cerebral palsy
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rigid postures and lack of actice movement
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mixed type cerebral palsy
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more than one type, children usually severely disabled
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Causes of cerebral palsy
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anoxia before, during or after birth. Infection, trauma, risk factors: low birth weigh, low apgar at 5 min, metabolic disturbances, seizures
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assessment for cerebral palsy
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abnormal muscle tone
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diagnostic tests for cerebral palsy
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genetic evaluation, abnormal MRI, abnormal metabolic studies
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Treatment for cerebral palsy
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braces, splints, and ROJM exercises
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Pediatric assessment HISTORY
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ask parents how often the child has URI, find out if he child has had other respiratory signs and symptoms such as cough, dyspnea, wheezing, rhinorrhea and stuffy nose. Ask if the symptoms appear to be related to activites or to seasonal changes
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Pediatric assessment inspection
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Normal: respirations regular and effortless, no nasal flaring, grunting or retractions present. Abnormal: presence of nasal flaring, expiratory grunting and retractions are signs of respiratory distress in children. Look for retractions in the following areas: clavicular, suprasternal, intercostal, substernal, and subcostal
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Pediatric Assessment Palpation
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Normal: chest wall expansion symmetrical on inspiration, tactile fremitus is palpable, and no rubs or vibrations are present
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Percussion Pediatric assess ment
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Normal: resonance is heard over most lung tissue, dullness is normal over the heart area
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Auscultation pediatric assessment
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Normal: breath sounds normally sound louder and harsher than in adults due to the closeness of the stethoscope to the origins of the sound
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Peristalsis starts
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within 2.5-3hrs of neonatal feeding....3-6 hours in older children
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Neonatal gastric capacity
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30-60Ml,
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Neonatal abdomen is
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larger than chest until 4-8 weeks of age
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saliva production starts
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at approx 4 months
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anal sphincter innervations and myelination completed at
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24 months
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What are the 5 P's of musculoskeletal injury
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Pain: assess for location, severity, and quality. Parethesia: Loss of sensation or abnormal sensation indicated neurovascular involvement. Paralysis: Inability to move indicates nerve or tendon damage. Pallor: paleness, discoloration, coolness indicate neurovascular compromise. Pulse: decreased or absent pulses indicate an altered blood supply
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Bone healing takes
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1 week(approx) for every year of life up to age 10
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Bones lengthen in the
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epiphyseal plates...they close when bone growth stops
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Breath Sound: Tracheal
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Quality: harsh, high pitched. Location: over trachea
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Breath sound: bronchial
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QUality: Loud, high pitched
Location: Next to trachea |
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Breath sound: Bronchovesicular
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Quality: medium loudness and pitch
Location: Next to sternum |
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Breath SOunds: Vesicular
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Quality: Soft. low pitched.
Location: remainder of lungs |
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Croup assessment
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barky brassy cough, inspiratory stridor. Treatment: cool mist, inc fluids, rest
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4 D's of epiglotittis
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Difficult painful swallowing (dysphaga), Drooling, dysphonia, and drop to tripod position
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Diagnostic test for epiglottitis
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Thumbprint xray
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Status asthmaticus
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potentially intubated and continuous short acting nebulizer treatments
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Acyanotic heart disease
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Shunt blood from the left to the right side of the heart
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ASH (persistent foramen ovale or incomplete closure
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Mild defects close spontaneously or patch. Acyanotic heart disease
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VSD repair
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patch if necessary, pulmonary banding to prevent heart failure. Acyanotic heart disease
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Corarctation of the aorta
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Narrowing of the aortic arch, usually distal to the ductus arteriosis beyond the left subclavian artery. REPAIR: inoperable if proximal to PDA: stent placement, closed heart resection if distal. Acyanotic heart disease
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Aortic stenosis
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narrowing or fusion of the aortic valves: repair: valvulotomy or commissurotomy. Acyanotic heart disease
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PDA failure
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closure after birth. REPAIR: ligation in closed heart procedure. Acyanotic heart disease
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Pulmonary artery stenosis
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narrowing or fusion of the valve leaflets. REPAIR: open heart to separate leaflets. Acyanotic heart disease
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Signs and symptoms of Acyanotic heart disease
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congested cough, diaphoresis, fatique, macine like heart murmur with PDA, mild cyanosis, respiratory distress, tachycardia and pnea, poor PO intake, freq resp infections
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Transposition of both great arteries and coronary arteries
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REPAIR: arterial switch surgery in first days of life, palliative surgery, open communication
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Tet: pulm artery stensosis, VSD, RT vent hypertrophy, overriding aorta
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REPAIR: complete or palliative: bypass pulmonary stenosis with Blalocktassig anastomsis of right pulm artery to right subclavia artery. oxygen therapy
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Psychosocial theory Infancy
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Trust vs mistrust
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Psychosocial theory toddler
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Autonomy vs shame and doubt
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Psychosocial theory preschooler
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initiative vs guilt
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Psychosocial theory school aged
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industry vs inferiority
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Psychosocial theory adolescence
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identity vs role confusion
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cognitive theory infancy
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sensorimotor
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cognitive theory toddler
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sensorimotor til 2 then preoperational
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cognitive theory preschooler
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peroperational (2-7yrs)
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cognitive theory school aged
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concrete operational (7-11 yrs)
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cognitive theory adolescence
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formal operations (11-15)
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Psychosexual theory infancy
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oral
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Psychosexual theory toddler
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anal
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Psychosexual theory preschooler
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phallic
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Psychosexual theory school aged
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latency
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Psychosexual theory adolescence
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genitalia
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