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157 Cards in this Set
- Front
- Back
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In hip dysplasia this hip is most commonly involved & which ethnic group
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60% left hip & whites
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Name is this type of Congenital Hip Dysplasia, hypoplasia of the acetabular roof – ball is in the socket
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Preluxation (Acetabular Dysplasia)
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Name this type of Congenital Hip Dysplasia, incomplete dislocation, head is in contact with acetabulum but stretched capsule and round ligament allow the femur head to be partially dislocated
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Subluxation
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Name is type Congenital Hip Dysplasia, femoral is not in contact with the acetabulum
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Dislocation
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What is the cause of Congenital Hip Dysplasia
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Unknown
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Screening for Congenital Hip Signs and Symptoms can be done used which two test
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Ortolanis Maneuver (0-3months), Barlow Test (0-3months)
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Waddling Gait, Asymmertical gluteal & thigh folds, or shortening of extremity are all Signs & symptoms for what
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Congenital Hip Dysplasia.
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An ultra sound is used to DX what , since bones do not ossify for 3-6 months after birth
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Congenital Hip Dysplasia
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Tx for Congenital Hip Dysplasia 0-6 months
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Pavlik Harness to abduct and prevents adduction Tx time frame (3-5mo), Hip spica case (3-6mo)
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Tx for Congenital Hip Dysplasia 6-18 months
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Traction followed by closed or open reduction and casting
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Tx for Congenital Hip Dysplasia in older children
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surgical correction followed by casting.
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What is key nursing care for a child with a hip spica case
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Skin Care, Skin Care, Skin Care
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List Important key elements for Cast Care for a child
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Monitor Temp, Handle cast carefully, Protect integrity of case (dry), Protect skin, Prevent foreign objects.
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List Key NV Checks for child with a cast
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Distal pulse, sensation, movement
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Talipes Equinovarus is
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Congenitla Club Foot
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Talipes Equinovarus is unilateral or bilateral
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unilateral or bilateral
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List three types of Talipes Equinovarus
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Positional, Syndromic, Idiopathic
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Syndromic Talipes Equinovarus is
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related to other abnormalities and often refactory to treatment
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Idiopath Talipes Equinovarus is
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varies in severity and prognosis, unknown
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Positional Talipes Equinovarus is
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related to intrauterine position
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How is Talipes Equinovarus Dx
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Visual Assessment, X-ray or Ultrasound
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TX for Talipes Equinovarus
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Exercise, Serial Casting 8-12 wks, Denis Brown Splint, If alignment not achieve by 3mo consider surgical correction
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LCPD is
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Legg Clave Perthes Disease
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Legg Clave Perthes Disease is a syndrome or idiopathic
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idiopathic Unknown
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Define Legg Clave Perthes Disease
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Idiopathic avascular necrosis of the femoral head
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What is the average age of children with Legg Clave Perthes Disease
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6 years of age
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The flattening of the upper surface of the femoral head is what stage of Legg Clave Perthes Disease
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Stage 1
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The revascularization with fragmentation stage (xray appears mottled) 1 year or more
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Stage 2
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The reparative stage – new bone forms
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Stage 3 Note this stage may go on for many years.
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The regenerative stage – reforming of the femoral head
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Stage 4 Note this stage may go on for many years.
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Legg Clave Perthes Disease Signs & Symptoms
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Limping – particularly in the am or pm,Hip, thigh, & knee pain,Stiffness – constant/intermittent, Limited ROM
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DX & TX for Legg Clave Perthes Disease
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MRI, Xray , Tx -goal of treatment is to keep the head of the femur in the acetabulum, to ¯ hip irritability, restore/maintain ROM of hip, & maintain a well rounded femoral head.
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Assistive devices used for TX
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Rest, Non bearing weight , ROM exercise, Abduction cast, brace, leather harness, surgical reconstruction
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Primary concern for children with LCP
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Developmental concerns for children who must remain inactive
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Postsurgical LCP concerns for NSG
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Cast Care, Wound Care, Drain Care, Pain Mngt, Neurovascular assessment
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SFCE
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Slipped Femoral Capital Epiphysis
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What is Slipped Femoral Capital Epiphysis
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Spontaneous displacement of the proximal epiphyses in an inferior and posterior direction. Widened growth plate and irregular metaphysis
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When does Slipped Femoral Capital Epiphysis occur
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Occurs during growth spurt (10-16), boys – 13, girls- 11
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TX for Slipped Femoral Capital Epiphysis
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Non WT bearing, traction, Surgical pins and screws
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Idiopathic Scoliosis
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Lateral curvature of the spine causing spinal rotation/rib asymmetry and thoracic hypokyphosis
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SX of Scoliosis
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Parent History
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SX of Scoliosis
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Back view asymmetrical scapula, shoulder height, flank shape, hip height
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Dx of Scoliosis
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Xray
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This scale is used to DX Scoliosis
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Risser Scale determines the skeletal maturity
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This is used to determine the degree of curvature of the spine in Scoliosis
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Cobb Technique
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True or False Scoliosis repair can be anterior or posterior to the spine
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True
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True or False the Dwyer/Zielke is the posterior process in which cables or rods and screw into vertebral bodies. Postop plastic bracing for immobilization
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False Anterior
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True or False the Harrington is the anterior process in which –rods, hooks and nuts. Iliac bone chips/strips for fusion. Prolonged immobility
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False posterior
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Name the process that combines the Harrington and Luque to correct Soliosis
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Cotrel-Dubousse
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A flexible L rods with segmental wiring, iliac bone grafts for fusion. Early mobility -risk of spinal nerve damage, Which Scoliosis process is this & is it posterior or anterior
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Luque posterior
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List Pre Operative Nursing Care for Scoliosis
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Working with screening, Developing skin issues with brace, Surgical pre, type and cross, pre op teaching, auto transfusion
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List Post Operative Nursing Care for Scoliosis
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Neurological, Activity (log roll), Luque (Flat X 12 hr) Pain Mngt, Chest Tube Mngt, Blood Vol Issues
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Osteogenesis Imperfecta (OI) is
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Osteoporosis Syndrome
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There are 6 types of OI which is the most common
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Type !
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True or False Osteogenesis Imperfecta (OI) is autosomal dominate
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True
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Which type of OI is fatal
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Type 2
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List SX of OI Type I that a child might present with
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Blue Sclera, Hearing Impairment
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Nursing Care priority for OI involves
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Light wt brace and splinting, Protection Education, Genetic Education, PT & OT for strength, Developmental Issues
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What is the best treatment for OI, but the least convenience
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Pamidorante IV – via infusion center.
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True or False Biphosphonates are a good PO TX for OI
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True
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You have a 3 yr old in a hip spica case give NSG priorities
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Resp, Wound & Skin Care, V/S, NV checks, I/O, Pain Mngt, Cap Refill, F & E Balance, Compartment Syndrome
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How should you hand a plaster cast
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With Flat palms to prevent pressure points
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You have given 3yr MS & Valium, what is your primary nursing concerns
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Resp & Gi Motility
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What is important to know about cast care
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Support Cast, NV Check 6 Ps, Monitor Temp, Cast Clearance, Resp
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True or False a NG is put down to relieve abdominal distention and for edema
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False DD, Suction or Feeding
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Normal CVP Range
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2-6 measures venous pressure
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If a post spinal fusion PT has his central line removed and the complains of chest pain & soa what should you do first
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Roll to left side, Apply O2 possible DVT, PE or Blew a clot!
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In Peds which two types of traction are used
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Bucks& Russels
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Which type of traction is the most restrictive
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Russels, splint under the knee
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What type of traction is peds traction skin or bone traction
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Skin
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With skin traction what two element s are key
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Tissue Damage, Short Term
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What is the most common LMW Heparin given
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Lovenox
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Does puberty put PT at a higher or lower rich for DVT
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Higher
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What does FTT stand for
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Failure to Thrive
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Infant weight that falls below 5% on the growth chart is known as
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FTT
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FTT can be the result of Nonorganic issues, list
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lack of bonding, knowledge deficit, improper feeding tech, lack of finances
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True or False Cleft Lip is more common in girls
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False boys
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True or False an infant can have Cleft lip and Cleft Palate
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True
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When does surgery occur for PT with cleft lip
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10lb – 10weeks of age
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Should an infant in post op cleft lip surgery be placed supine or prone
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Supine, No Prone might damage sutures.
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True or False you will massage the scar tissue of the cleft lip to decrease the amount of scar tissue
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True
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Elbow restraints are used with what type of surgeries
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Cleft Palate, Cleft Lip
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True or False Cleft Palate is more common among girls
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True
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At what age range are children candidates for Cleft Palate repair
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12-15 months
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Post Op NSG care should include
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no spoons, no straws, no tongue blades, elbow restraints
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Children that present with EA or TFA will have all of the following
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Drooling, Coughing, Choking, Frothy Secretions.
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What is unique about a Omphalocele
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It is covered w/ memebrane
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True or False a Omphalocele may appear as a bulge in the umbilical cord
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True
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The Gastrochisis does or does not have a membrane covering
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Does NOT
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The absence for ganglion cells is which disease
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Hirschsprungs Disease
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Neonate SX of Hirschsprungs
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Abd distention, vomiting, no meconium stool in first 48 hr, constipation
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Remnant fetal omphalomesenteric sac
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Meckels Diverticulum
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Jelly like stool with blood dark or fresh is characteristic of
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Meckels Diverticulum
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True or False All Babies have reflux
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True
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Permanent intestinal intolerance to dietary wheat gliadin is related to which disease process
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Celiac Disease ( Celiac Sprue) (Family related)
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When Celiac flare up occurs what is the recommended diet
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High protein & Carlories LOW FIBER also supplement with Vitamins
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When does Celiac disease usually present
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Toddlers 2-3 when table food introduced
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True or False an Infant will show signs of Celiac while breast feeding
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False
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This has a sudden onset and usually occurs in the first 2-8 weeks of age
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Hypertropic Pyloric Stenosis
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Projectile Vomiting is a Key sign
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Hypertropic Pyloric Stenosis
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Telescoping of proximal bowel into distal portion is know n as
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Intussusecption
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Age range of children affected by Intussuseption
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3 mo to 3 years
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True or False and Enema may relieve the extreme abd pain the child is having with Intussuseption
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True
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Give Nursing Interventions for GERD
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Add cereal to formula, Positioning, Meds,
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Inflammation of the vermiform appendix is called
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Appendicitis
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What causes appendicitis
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obstruction fecal content, parasites, microbe, tissue necrosis
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Appendicitis pain in kids is localized or unlocalized, give area
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Unlocalized Belly Button
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Give Location of McBurney’s Point
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Localized to RLQ
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If pain in abdomen should suddenly stop this is the result of what
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Rupture of appendix
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Dx of appendicitis is generally done with these test
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UA, CBC, Sono & CT
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Tx for appendicitis is always
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Surgical
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Children has an increase metabolic rate which requires more
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Glucose, O2, & Water
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True or False The GI tract is larger in Infants increasing losses
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True
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True or False the Blood Brain Barrier in an infant stops water and medications from passing
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False
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An Infant is getting IV fluids for dehydration what should the NS contain
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Electrolytes D5
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True or False Infant urine has a very high concentration
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False, not concentrated at all
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List things to Assess when child is dehydrated
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Strict I&O, Fontanel (sunk in), Wt Changes, Perfusion, Tearing, Mucous membranes, CVP, Pulse, Blood Pressure
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Etiology of FVD
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N/V, Diarrhea, Polyuria, Hemorrhage, Iatrogenic
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List three type of dehydrations
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Isotonic, Hypotonic, Hypertonic
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When the Anion Gap increases, Acidosis or Alkalosis
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Acidosis
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ICP can increase with this type of dehydration
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Hypertonic
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What is the most common Diarrhea Organisms
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Rotavirus- fecal & oral
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Lower UTI involve
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Urethra & bladder
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Upper UTI involves
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Uretters, Renal Pelvis, Clayces, Renal Parechyma
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Pyelonphritis
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is an ascending urinary tract infection that has reached the pyelum (pelvis) of the kidney.
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Hydronephrosis
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is distension and dilation of the renal pelvis calyces, usually caused by obstruction of the free flow of urine from the kidney
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True or False UTI’s are more common in Newborn Males
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True
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The prostate gland antibacterial secretions to help prevent what
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UTI’s
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True or False urine above 37 degree C or (98.6) promotes bacteria
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True
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Number One causative organism of UTI
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E Coli (80%)
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Bath time Play should be before what is introduced to water
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Soap
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UTI can change Nitrates to
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Nitrites
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Cold Stander for UA Culture Collection
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Straight Catheter (sterile)
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VUR
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Vesicoureteral Reflux
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True or False Reflux with Sterile urine does not cause scarring
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True
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Grade of VUR’s – reflux to the ureter only
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Grade I VUR’s
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Grade II VUR’s
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reflux into the ureter & renal pelvis without distention
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Grade of VUR’s – reflux into the ureter & renal pelvis causing mild hydronephrosis
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Grade III VUR’s
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Grade V VUR’s
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Severe hydronephrosis & twisting of the ureters
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Grade IV VUR’s
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Moderate hydronephrosis
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TX for VUR’s
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Antibiotics, Culture urine every 2-3 mo or PRN if Fever
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True or False Grade I & II will generally resolve or outgrow
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True
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Name the antispasmodic given for bladder activity
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Ditropan or B&O Supp
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True or False The maintenance fluids for a child with VUR’s is 1.5 to 3x the calculated maintenance fluid
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False 1.5 to 2 x maintenance fluid volume
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A thick ventral fibrous band creating a curvature
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Chordee
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Urethra is located below the glans and along the vental side of the penis
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Hypospadius
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Surgical repair of a Hypospadius is generally done at what age range
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3-12mo
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Goal of Surgical repair of Hypospadius
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Voiding while standing, Cosmetic, Preserve sexual function
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True or False Male Infants with Hypospadius should be circumcised immediately
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False, Do Not Circumcise, the skin will be needed for repair.
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With Hypospaidus repair when can child return to baths
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Not until diversion is out.
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Urethral opening on the dorsal side of the penis
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Epispadius
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Undescended testicles
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Cryptorchidism
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Undescenced testicles usually descend within what time frame
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1 year*
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Orchiopexy
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Surgical descent of testicles
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Exstrophy
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bladder and urinary tract are exposed to the outside
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This is associated with pelvic bone separation
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Exstrophy
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With Exstrophy sphincter repair and bladder retraining a occurs at what age
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3-5 yr
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