Unit 3: Musculoskeletal/nervous System Disorders (Pediatrics)

Front 1

-Genu varum

Back 1

-bow legged

Front 2

-Genu vaigum

Back 2

- knock kneed

Front 3

What are the 5 P's when treating a skeletal fracture?

Back 3

1.) Pain
2.) Pallor
3.) Pulses
4.) Paralysis
5.) Parasthesia

Front 4

Which is able to be corrected if caught?

-Strabismus or Amblyopia

Back 4

-Strabismus; if untreated (with patches) will lead to amblyopia (lazy eye)

Front 5

This form of spina bifida:
-skin depression or dimple
-dark tufts of hair
-bladder and bowel sphincter disturbances
-gait disturbances with foot weakness

Back 5

-Spina bifida occulta

Front 6

Hernial protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord and its nerves:

Back 6

-Myelomeningocele (think myelin sheath)

Front 7

Hernial protrusion of a saclike cyst containing meninges and spinal fluid
-does not have nerve involvement

Back 7

-Meningocele

Front 8

This form of spina bifida consist of a saclike protrusion that may or may not have nerve involvement
-depending on severity will have bladder and bowel deficits
-may have flaccid legs or simple motor impairment

Back 8

-Spina bifida cystica

Front 9

Inability to express bladder:

Back 9

-neurogenic bladder (treated w/ Ditropan and automatic latex allergy)

Front 10

Describe s & s of cerebral palsy:

Back 10

-delayed gross motor development (not reaching expected development)
-abnormal motor performance (always using left or right hand)
-rigid muscle tone (not bending at the hip; difficulty going from sitting to standing)
-reflex abnormalities (palmar grasp extends)
-associated disabilities (seizures)

Front 11

Symptoms of increasing ICP:

Back 11

-Infants: bulging anterior fontanel, separated cranial sutures, irritability, high-pitched neuro cry, setting sun eyes

-Children: restless, drowsiness, increase in sleep, nausea and vomiting esp in the am, dyplopia

-LATE signs: cushing's triad, fixed dilated pupils, decorticate postioning

Front 12

Imbalance in the production and absorption of CSF in the ventricular system:

Back 12

-hydrocephalus

Front 13

Name common causes of meningitis:

Back 13

-bacterial: Hib, pneumonia, meningococcal, pneumococcal

-TB

-Viral

Front 14

At what degree do febrile seizures usually occur?

Back 14

-above 39 degrees C

Front 15

Caused by stretching, compression, and tearing of nerve fibers in the area of the brainstem:
-common causes are MVA, falls, and bicycles
-children are more susceptible due to small bodies and large heads
-instruct parents to wake child q2h
-increases blood flow which increases cerebral edema which leads to increased ICP

Back 15

-concussion

Front 16

Bruising of the brain
-coup-countercoup injuries
-shaken baby syndrome

Back 16

-contusion

Front 17

Hematoma between the dura and skull
-arterial in nature
-increases ICP
-quick symptoms

Back 17

-Epidural hematoma

Front 18

Hematoma between the dura and brain
-venous in nature
-gradual symptoms
-decrease O2, increase swelling, increase ICP
-shaken baby

Back 18

-Subdural hematoma

Front 19

What is the criteria for the diagnosis of ADHD?

Back 19

-Symtoms must have been present b4 the age of 7
-Symptoms must be present in at least 2 settings
-Symptoms must be present for >6 months

Front 20

What is the formula for finding BSA?

Back 20

-ht (cm) x wt (kg) / 3600 then square root

Front 21

This test for meningitis:
-bend hip and knee toward the chest
-then try to touch the ceiling with toes
-positive indicates severe thigh pain

Back 21

-Kernig's sign

Front 22

This test for meningitis:
-lie supine
-flex neck forward
-positive indicates leg bending

Back 22

-Brudzinki's sign

Front 23

At what degree of curvature must be present in order for it to be diagnosed as scoliosis?

Back 23

-at least 10 degrees

Front 24

At what age are girls tested for scoliosis?

Back 24

-Between 5th and 6th grade
-Must be caught and tested during puberty
-Boys are not typically tested

Front 25

Describe nursing actions for a newborn born with spina bifida:

Back 25

-#1: cover sac with sterile, moist dressing
-NEVER remove the dressing without an order
-Keep is prone position
-Inspect sac for leaks or signs of infection
-Begin prophylactic antibiotic therapy as ordered
-observe for signs of infection (increased or decreased temp [sepsis is low], lethargy, restlessness, poor feeding/suck)
-No diapers
-No rectal temps
-Tactile stimulation such are touch and warmth to promote bonding

Front 26

Describe nursing actions for a child with hydrocephalus:

Back 26

-Monitor OFC (2x/day)
-Monitor neurological status
-Palpate fontanel
-Monitor VS
-Assess for S & S of increased ICP
-Support the head
-Give small frequent feedings
-No scalp IV

Front 27

Describe postoperative nursing actions for a child who received a VP shunt:

Back 27

-Position on unoperated side
-Keep child flat
-Pain management
-Assess dressings
-Observe for signs of increased ICP and infection
-Monitor drainage

Front 28

The entire surface of the brain is covered with a thick layer of purulent exudate
-As infection extends to the ventricles, the exudate occludes the narrow passages, obstructing flow of CSF = increased ICP

Back 28

-Meningitis

Front 29

Describe treatment of meningitis:

Back 29

-C & S
-antibiotics (gentamycin and tobramycin x 10d)
-pain meds
-isolation immediately (contact and droplet)
-also treat those in contact also
-IV fluid replacement
-monitor breathing
-quiet environment
-neuro check (increased risk of seizures)

Front 30

-Linear-fracture line of the skull
-Depressed-bone is broken, irregular fragments are pushed inward and caused pressure on the brain
-Increased risk for intracranial bleeding
-Surgical reduction and burr holes with removal of fragments is needed

Back 30

-CHI-Fracture

Front 31

Describe treatment for a child with a CHI-fracture:

Back 31

-stabilize spine
-NEVER place an NGT (could have opening to brain thru nasal passages)