Pediatric Musculoskeletal 2

juniperk's version from 2018-03-02 18:19


Question Answer
Developmental dysplasia of the hip (DDH)- dislocation, subluxation, and dysplasiaFrank dislocation of the hip may occur, in which there is no contact between the femoral head and acetabulum. Subluxation is a partial dislocation, meaning that the acetabulum is not fully seated within the hip joint. Dysplasia refers to an acetabulum that is shallow or sloping instead of cup shaped.
What are the clinical manifestations of scoliosis?Unequal- Shoulder heights, Waist angles, Scapula prominences, Rib prominences and Chest asymmetry, Backache, and Fatigue.
Who's at risk for Torticollis?Neck scoliosis. In utero position.
Nursing dx for torticollisRisk of injury
Therapeutic mgmt for torticollisPT and TOT collar (brace)
Therapeutic mgmt for Osteogenesis ImperfectaCalcitonin 2. Bisphosphonates 3. Prevent injury
Nursing mgmt for Osteogenesis ImpefectaProvide gentle handling. 2. Diet low in calories but high in calcium and vitamins C and D. 3. Wear protective gear 4. Encourage normal growth and development (prevent altered bonding)
What is Legg Calve-Perthes disease?Self-limiting disorder in which there is aseptic (not infection, vascular) necrosis of femoral head
Who's at risk for Legg Calve-Perthes disease?4-8 y is most common
Legg Calve-Perthes disease- PathophysiologyDisturbance of circulation to the femoral epiphysis. Ischemic aseptic necrosis develops.
Legg Calve-Perthes disease- Clinical manifestationsOnset often insideous. 2. Mild pain in hip or anterior thigh- Knee/ gait alter 3. Pain is aggravated by increased activity and relieved by rest
Legg Calve-Perthes disease- Nursing dxRisk of injury
Legg Calve-Perthes disease- Therapeutic mgmtSurgical therapy 2. Bedrest 3. Casting and/or bracing- poss hip replacement in future
Legg Calve-Perthes disease- MedicationAnti inflammatory, muscle relaxant
Slipped Capital Femoral Epiphysis (SCFE)- Therapeutic mgmtTraction before surgery to relieve pain. 2 Surgery for pinning
Slipped Capital Femoral Epiphysis (SCFE)- 3 Nursing mgmtStrict bedrest before surgery 2. Adequate nutrition for healing 3. Contact sports prohibited until growth is complete
Slipped Capital Femoral Epiphysis (SCFE)- 3 clinical manifestationsHip pain that may refer to thigh and/or knee 2. Limp 3. Decreased ROM
Slipped Capital Femoral Epiphysis (SCFE)- pathophysiologySlippage of femoral head 2. Femur displaces from epiphysis 3. Untreated can lead to hip deformity
Juvenile Idiopathic Arthritis- SystemicOne or more joints. At least 2 weeks of fever and rash.
Juvenile Idiopathic Arthritis- Oligoarthritis and Polyarthritis1-4 joints. Polyarthritis- affects 5 or more in first 6 months
Juvenile Idiopathic Arthritis- Juvenile Psoriatic arthritisArthritis with psoriasis
Juvenile Idiopathic Arthritis- Enthesitis- related arthritisArthritis and/or enthesitis
Juvenile Idiopathic Arthritis- UndifferentiatedArthritis that does not fit into any of the other categories. Involves symptoms of 2+ subtypes
Juvenile Idiopathic Arthritis- Beside the normal changes in the joints like pain, redness, warmth, stiffness, and swelling What are S/S?Fever 2. Rash 3. Favoring one limb over another 4. Decreased physical activity 5. Fatigue 6. Sleep problems 7. Swollen lymph nodes 8. Reduced appetite and/or weight loss
Juvenile Idiopathic Arthritis- Nursing dxAltered body image. Pain.
Juvenile Idiopathic Arthritis- Therapeutic mgmtNSAID 2. Disease-modifying antirhematic drugs 3. Biologic response modifier 4. Corticosteroids 5. Eye care 6. Dental care 7. Surgery 8. Splints and Orthotics
Juvenile Idiopathic Arthritis- What types of vaccines should these pt avoid?Live vaccines like MMR and Varicella
Juvenile Idiopathic Arthritis- Nursing mgmt 3Heat therapy 2. Frequent rest periods 3. Encourage independence

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