ENT
What is strabismus?
Strabismus is a condition where the eyes do not properly align with each other when looking at an object.
Name the five fractures in children
Plastic
Buckle/Torus
Greenstick
Complete
Growth plate → growth deformities affecting child development
What is the other name for clubfoot? What are the three types?
talipes equinovarus
3 types:
Positional
Idiopathic
Teratologic abnormalities (arthrogryposis, spina bifida)
Biggest Risks in Children with Cancer:
Infection (due to neutropenia)
Bleeding (due to thrombocytopenia)
Organ toxicity from chemotherapy
Psychosocial impact on child and family
STRABISMUS s/s
Frequent headaches
Squints Tilts the head to see
Unequal light reflex
What is the therapeutic management for a fracture?
regaining alignment
Treatment of clubfoot
Multiple castings starting at birth if possible (6-10 casts is usual)
Ponsetti method preferred method-gentle manipulation/stretching of foot
-Achilles tenotomy before last cast
Care of child is same as previously mentioned with casts
After casting, patients go into “boots n bar” to help maintain correction
Exceptions are made for those patients with muscular dysfunctions that may cause additional difficulties (low tone)AFO may be used then
Chemotherapy Education. Teach about common side effects:
nausea, vomiting, hair loss, fatigue, immunosuppression, mucositis, and anemia
STRABISMUS TREATMENT
Glasses
Patching (cover good eye)
Atropine drops
Surgery
Assessment of fracture
neuro, pulses, temps, compartment syndrome
Special Equipment Needed for Hip Spica Cast
Cast spreader bar or frame to help with positioning
Special car seat or stroller designed for children with hip spica casts
Diapering supplies: long-handled diapering tools or cast liners
Cast protectors or waterproof covers for bathing
Crib or bed with extra padding and safety rails to prevent falls
Emphasize preventive measures:
antiemetics for nausea, good oral hygiene, infection precautions, balanced nutrition, and rest.
OTITIS MEDIA: EDUCATION
Feeding:
Upright position
Do not prop bottles Immunizations:
Flu annually
Staying current Medications:
Complete course
Relief within 48 hours
What are the 6 P's of compartment syndrome?
pain, pulselessness, pallor, paresthesia, paralysis, pressure
Hygiene and Skin Care for Hip Spica cast
Check skin edges frequently for redness, irritation, or pressure sores
Ensure good diaper hygiene to prevent irritation from urine or stool trapped under the cast
A nurse is educating the parents of a child starting chemotherapy about infection prevention. Which instruction should the nurse emphasize?
A) Allow the child to play in the sandbox to promote outdoor activity
B) Avoid crowds and people who are sick during periods of low white blood cell counts
C) Stop giving the child prescribed antibiotics once symptoms improve
D) Encourage the child to share utensils to build immunity
B) Avoid crowds and people who are sick during periods of low white blood cell counts
Tonsillectomy POST-OP: INTERVENTIONS
Position child prone or side-lying to facilitate drainage
Discourage coughing or throat clearing
Provide cool, clear, non-citrus and non-carbonated drinks
Avoid red liquids and milk products (so you can see blood)
Do not give the child any sharp objects that may be put in the mouth
Administer acetaminophen as needed for pain
Casts should be dried with cool fan or air. T or F
True. No heat!
A nurse is teaching the parents of a toddler who has just been placed in a hip spica cast following surgery for a femur fracture. Which parent statement indicates the need for further teaching?
A) “We will check the edges of the cast daily for any redness or swelling.”
B) “If the child’s toes become cold or blue, we should notify the doctor immediately.”
C) “It’s okay to insert a stick inside the cast to scratch itchy skin.”
D) “We will keep the cast dry during baths by using a waterproof cover.”
C) “It’s okay to insert a stick inside the cast to scratch itchy skin.”
A 10-year-old child receiving chemotherapy is experiencing fatigue and pallor. The nurse notes a hemoglobin level of 7 g/dL (normal 11.5–15.5 g/dL). What is the nurse’s best action?
A) Encourage the child to increase fluid intake
B) Prepare for possible blood transfusion as ordered
C) Administer iron supplements immediately
D) Restrict the child’s activity until hemoglobin normalizes
B) Prepare for possible blood transfusion as ordered
A hemoglobin of 7 indicates significant anemia that may require blood transfusion to improve oxygen delivery. Iron supplements are ineffective for anemia caused by chemotherapy. Activity restriction may be necessary but does not address the underlying problem.