Flashcard Set Preview
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DDH
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1-2 in 1000 live births-shallow acetabulum, subluxation, or dislocation-more common in females,...
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Acetabular dysfunction
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-mildest-shallow acetabulum--->easier for ball of femur to pop out of socket-femoral head...
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Subluxation
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-most common-head of the femur is partially displaced-stretched capsule and ligamenture teres
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Dislocation
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-most severe form-femur head loses contact with the acetabulum-round ligament of femur is elongated...
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DDH: signs and symptoms
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-Ortalani's maneuver- "click" or limited movement felt-asymmetry of gluteal thigh folds-apparent...
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DDH: Management- newborn to 6 mos
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-Pavlik harness- most commonly used- holds femoral head in acetabulum-acts to prevent hip adduction...
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DDH: Management- 6 to 18 months
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-not recognized until the child begins to stand and walkGradual reduction by traction-purpose...
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DDH: Management- older child
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-even more forceful management neededOperative open reduction required-preoperative traction...
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DDH: Nursing Care
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- PHYSICAL ASSESSMENT-Parent teaching- about compliance and follow-up care-sponge bath recommended-check...
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| 10 |
Congenital Talipes Equinovarus (clubfoot)
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1 in 700-1000 live births-deformity of the ankle and foot -requires early evaluation and treatment-no...
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Clubfoot- Management (stages)
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1) correct deformity-casting (while bone is still pliable)-change casts initially q1-2 days,...
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Clubfoot- Nursing care
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-Assess skin and circulation frequently-Teach cast care- keep clean and dry, etc.
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| 13 |
Scoliosis
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-lateral curvature of the spine-most common deformity seen in children and adolescents-most...
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Scoliosis: Screening
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-shoulders symmetrical?-symmetry of the hips?-symmetry of the thorax?-head tilts to unaffected...
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Scoliosis: Management
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Functional- exercise to strengthen musclesStructural- Bracing, Electrical stimulation, operation
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Scoliosis: Bracing (not curative)
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TLSO- Thoraco-Lumbo-Sacral Orthosis- custom mold of the child's body-halts progression of curve-worn...
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Scoliosis: Surgery
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Harrington Rod Placement- realignment and straightening-internal fixation
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Scoliosis: preoperative
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-inform what to expect after the surgery----deep breathing, and logrolling, etc
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Scoliosis: Postoperative
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-Pain- PCA-Brace- to stabilize surgical area-NG to decompress stomach---shift of blood supply...
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Osgood Schlatter Disease
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"overuse injury"- gymnast, ect.circulatory disturbance in the tibial tuberosity of the knee-----aseptic...
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Osgood Schlatter Disease: S/S
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-tenderness, pain, swelling of anterior knee and TT-eliminated stressful activities for 4-6...
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| 22 |
Legg-Calve Perthes disease
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-avascular necrosis of the femoral head (hip joint)-onset 5-9 years3 stages1) Asceptic necrosis2)...
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Legg-Calve Perthes disease: treatment
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-traction (sometimes)-bedrest-abduction braces (keep femoral head in acetabulum)
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Fractures
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Complete- all the way through the boneIncomplete- fragments are still attachedTransverse- at...
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Fractures: Skin traction
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Bryants- for children <2 years-hips flexed at 90 degrees and knees extendedBucks-short term...
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Fractures: Skeletal Traction
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Ninety- ninety- 90 degree flexion of hip and knee-femur fracture-use of pins
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Fractures: Postop nursing care
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-maintain traction (weights OFF floor)-good body alignment-neuro checks to extremityComplications:-pulmonary/fat...
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Fractures: Cast care
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-elevate leg-neurovascular checks-keep dry-check for cast warmth (infection)
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Juvenile Rheumatoid Arthritis (JRA)- pathophys
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chronic inflammation of the synovium with joint effusion and eventual erosion, destruction,...
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JRA: Signs and symptoms
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-stiffness-swelling-loss of motion-warm to touch-morning stiffness
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JRA: therapy goals
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1) control pain2) preserve joint range of motion and function3) minimize effects of inflammation4)promote...
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JRA: Medication
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1) NSAIDS- immediate analgesic effects---take for at least 3 wks before determining effectiveness2)...
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JRA: nursing care plan
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-releive pain-diet- high in protein and high calories-iron supplement-exercise-adequate sleep...
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| 34 |
Muscular Dystrophie (MD)
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-largest group of muscle diseases in children-genetic origin-supportive treatment measures
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MD: Duchenne MD
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most severe and most common-X linked inheritance pattern-muscle weakness in 3rd-4th year-difficulty...
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MD: Complications
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1)contractures- hips, knees and ankles (PROM)2)disuse atrophy- PT3)infections- respiratory...
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