Week 7

I'm all broken up

100

This fracture type is almost always associated with child abuse

Spiral

200

While performing a neurovascular check on a child with a cast on his arm, you note cold, blue fingers, capillary fill time of 7 seconds and weak pulses.  What is the appropriate action for you to take

This child needs immediate orthopedic evaluation with likely cast removal

300

Describe nursing measures to decrease fear in a 5-year-old child prior to cast removal

cast saw can be put against your own skin

cast saw can be used on a stuffed animal

child can be given an important job, such as holding something for you

400

Appropriate management of a child in a cast will include

 

Pulses, CRT, skin color, and temperature

Palpation of cast for hot spots

Alleviate pressure on nerves, treat pain

Compartment syndrome

Promote nutrition and hydration

Support growth and development

Support family system

500

Pin care and management of skeletal traction will include:

inspection of pin sites for signs of infection

cleansing of sites as ordered

Ensure weights hang freely off the edge of the bed and never rest on the floor or the bed frame -DO NOT ADJUST OR REMOVE TRACTION

I can't move

100

Developmentally speaking, the immobilized child is at greatest risk for 

Regression

200

Physiologically, juvenile idiopathic arthritis involves

Chronic inflammation of synovium with joint effusion, destruction of cartilage, and ankylosis of joints as disease progresses

300

Signs of JIA include (name 5)

Stiffness

Swelling

Loss of mobility in affected joints

Warm to touch

Tenderness

Growth retardation

Symptoms worsen with stress

400

The primary goals of treatment for JIA are (3)

Preserve function 

Prevent deformities

Relieve symptoms

500

Children with spinal cord injuries as well as myelominingoceles are prone to autonomic dysreflexia.  What signs can we see (name 5)

increased BP

headache

bradycardia

profuse diaphoresis

cardiac arrhythmias

flushing

piloerection

blurred vision

nasal congestion

anxiety

visual spots

600

Diagnosis of Duchenne's muscular dystrophy is made by:

Suspected based on clinical appearance

Confirmation by EMG, muscle biopsy, and serum enzyme measurement

Serum CPK and AST levels high in first two years of life, before onset of weakness; levels diminish as muscle deterioration continues

This is twisted

100

The most common cause of scoliosis is

idiopathic

200

What is the correct method to screen for scoliosis 

Bending forward to touch toes, evaluate hip and scapula height as well as palpate for curvature

300

What is the primary concern for an adolescent with scoliosis

body image

400

When and how should an infant be screen for developmental displasia of the hip

At birth with Ortolani and Barlow maneuvers

500

Describe the management of an infant in a Pavlik harness

It must be worn for 23-24 hours per day for 6-12 weeks

Straps are to be adjusted everey 1-2 weeks by physician ONLY

Inspect the skin 2 to 3 times daily for redness or breakdown under the straps.

The infant should wear a soft undershirt and knee-high socks under the harness to prevent the straps from rubbing directly against bare skin.

Always place the diaper under the straps.

Avoid using lotions or powders beneath the device, as they can cake, trap moisture, and lead to skin maceration. 

I'm usually so stiff

100

The most common type of cerebral palsy is

Spastic

200

The most common causes of cerebral palsy are

Any perinatal or neonatal brain lesion or brain maldevelopment, regardless of the cause, may be linked to as many as 80% of the total cases of CP

Prematurity is highly associated

300

Early signs of cerebral palsy

Floppy tone (earliest)

Hypertonicity

back arching

Clenched fists after 3 months

unable to sit without support at 8 months

No smiling by 3 months

Feeding difficulty

excessive irritability

400

Goals of therapy for cerebral palsy are

Establish locomotion, communication, and self-help

Gain optimum integration of motor functions

Correct associated defects as early and effectively as possible

Provide educational opportunities

Promote socialization experiences

There's a hole in the bucket, Dear Liza

100

This defect is incompatible with life

Anencephaly

200

immediate management of a child with a myelomeningocele will include

warm sterile saline soaked gauze to defect

cover with sterile saran wrap

300

All children with myelomeningocele have these associated findings (2)

Hydrocephalus

Latex allergy