PEDS Final- Musculoskeletal

The correct answer is "muscle spasms and pain can occur after traction but will diminish over time." This answer is correct because it accurately describes a common side effect of traction. Traction is a therapeutic technique used to treat various musculoskeletal conditions by applying a pulling force to the affected area. This pulling force can cause muscle spasms and pain initially, but these symptoms usually improve and diminish over time as the body adjusts to the traction. It is important for the nurse to educate the patient about this potential side effect to ensure they are prepared and know what to expect during the traction treatment.

Osteogenesis Imperfecta is a genetic disorder that affects the development of teeth, bones, and ligaments. It is characterized by brittle bones that are prone to fractures, as well as other skeletal abnormalities. This condition is caused by a defect in the production of collagen, which is an important protein for the strength and structure of bones. Due to the incomplete development of teeth, bones, and ligaments, individuals with Osteogenesis Imperfecta may experience frequent fractures, joint laxity, and dental problems.

Neurovascular checks are performed on fracture patients to assess the circulation and nerve function in the affected limb. Pain is included in the checks because it can indicate nerve damage or compromised blood flow. Pallor, which refers to paleness in the skin, is important to monitor as it can indicate poor circulation. Pulselessness is included as the absence of a pulse can suggest arterial occlusion. Paresthesia, the sensation of tingling or numbness, is important to assess nerve function. Paralysis is included as it can indicate severe nerve damage. Polyps and prosthesis are not relevant to neurovascular checks for fracture patients.

Compartment syndrome is a condition in which increased pressure within a muscle compartment impairs blood flow and can lead to tissue damage. It is characterized by symptoms such as pain, swelling, and sensory changes. Dehydration, although it can cause various complications, is not directly associated with compartment syndrome. The other options, including decreased circulation, risk for infection, and motor weakness, are all commonly observed in patients with compartment syndrome.

After corrective surgery for clubfoot, the affected foot may be 1/2 size smaller because the surgery involves realigning the bones, tendons, and ligaments in the foot to correct the deformity. This may result in a decrease in the overall size of the foot.

Immobility can lead to various complications such as atelectasis, renal calculi, constipation, fat embolism, and sudden chest pain. When a person is immobile for an extended period, they may have difficulty expanding their lungs fully, which can result in atelectasis. Immobility can also contribute to the formation of renal calculi due to decreased fluid intake and urinary stasis. Constipation can occur due to reduced physical activity and slower bowel movements. Fat embolism can happen when fat particles from bone marrow enter the bloodstream after a fracture or trauma. Sudden chest pain can be a result of immobility-related complications such as pulmonary embolism or myocardial infarction.

Osteomyelitis is a bone infection that causes inflammation and can lead to various symptoms. Pallor, which refers to paleness of the skin, is not typically associated with osteomyelitis. Instead, common symptoms include elevated temperature (fever), non-weight bearing limb (due to pain or swelling), and irritability (especially in children).

Barlow's sign is a test used to detect developmental dysplasia of the hip (DDH) in infants. It involves gently adducting the hips and applying pressure to the femoral head. If a "clunk" is felt, it indicates that the femoral head is dislocated from the acetabulum, suggesting a positive Barlow's sign and a possible hip dislocation. This sign helps in diagnosing and managing DDH at an early stage, allowing for appropriate treatment and preventing long-term complications.

When educating the patient and family on the treatment of Osteomyelitis, the nurse should not mention that the antibiotics will slowly increase. This is because antibiotics for osteomyelitis are usually given at a consistent dose throughout the treatment duration, rather than gradually increasing the dosage. The correct answer emphasizes the importance of providing accurate information to the patient and family to ensure they have a clear understanding of the treatment process.

Proximal limb weakness is not a clinical sign of fractures. Clinical signs of fractures typically include guarding the site, edema, ecchymosis (bruising), impaired range of motion (ROM), and impaired neurovascular status. Proximal limb weakness may be indicative of other conditions or injuries, but it is not directly associated with fractures.

The nurse must promote independence in a Duchenne's patient to encourage their autonomy and self-care abilities. Recognizing anticipatory grieving is important as Duchenne's is a progressive and debilitating disease, and patients and their families may experience emotional distress. Using high top sneakers can help prevent foot drop, a common complication in Duchenne's patients. Restricting fluids is not necessary or relevant to the care of a Duchenne's patient.

Duchenne's presents with positive Gower sign and proximal limb weakness. The positive Gower sign refers to the characteristic way in which individuals with Duchenne muscular dystrophy use their hands and arms to push themselves up from the floor due to the weakness of their hip and thigh muscles. Proximal limb weakness is also a common feature of Duchenne's, where the muscles closer to the body, such as the shoulders and hips, are weaker compared to the distal muscles. The other options, bowing limbs and affected myocardium, are not typically associated with Duchenne's.

When a fracture patient enters the emergency room, the nurse should immediately provide rest, ice, compression, and elevation. These steps are commonly referred to as the RICE method and are essential in managing fractures. Resting the affected area helps prevent further injury and promotes healing. Applying ice reduces pain and swelling. Compression with a bandage helps control swelling and provides support. Elevation helps reduce swelling by allowing fluid to drain away from the injured area. By following these steps promptly, the nurse can effectively manage the patient's fracture and provide immediate relief.

Osteogenesis Imperfecta is a genetic disorder characterized by brittle bones, which can lead to frequent fractures. The term "bowing" refers to the abnormal curvature of the limbs that is commonly seen in individuals with this condition. The word "hypoplastic" describes underdeveloped or small teeth, which is another common feature of Osteogenesis Imperfecta.