NSG 502 Exam 4
developmental dysplasia of the hip (DDH/hip dysplasia) - ANS-- subluxation or dislocation of
the head of the hemur from the acetabulum
- females affected more than males
developmental dysplasia of the hip etiologies - ANS-generally unknown, but multiple
possibilities:
- maternal hormone secretion
- positioning (breech or tight infant swaddling)
- genetics
developmental dysplasia of the hip treatments/considerations - ANS-- pavlik harness worn 24
hr/day
- only the provider may adjust the harness
- may use regular car seat
- check for skin breakdown where harness touches skin
- sitting upright is a major milestone (<6 months), need to promote normal activities/play
talipes equinovarus (clubfoot) - ANS-- congenital malformation of the lower extremity
- foot and ankle "turns inward"
- occurs in 1/1000 live births
- males affected more than femals
- etiology unknown - possibly related to restricted mobility in utero
- deformity is apparent at birth
talipes equinovarus (clubfoot) therapeutic management - ANS-- treatment is started as soon as
possible after birth
- goal is to gently stretch the tightened ligaments and tendons
- serial stretching, manipulation, and casting are performed at least weekly
- caregiver may soak off cast (plaster) in AM before appointments
- if not corrected within 3-6 months, surgery is usually indicated
talipes equinovarus (clubfoot) nursing considerations - ANS-- maintain skin integrity
- assess circulation distal to the cast
- pain management
- parental support
- facilitate normal growth and development
- rare long term affects are calf muscle atrophy and small foot
osgood shlatter disease (OSD) - ANS-- most frequent cause of knee pain in children
,- most often occurs between 9-16 years, can be earlier
- males and females affected equally
- associated with overuse
- caused by irritation of the patellar ligament at its attachment point at the tibial tuberosity
what is RICE - ANS-- rest
- ice
- compression
- elevation
very common in MSK issues
Osgood-Shlatter Disease nursing interventions - ANS-- RICE
- taping, bands, braces
- time off sports
- education r/t better shoes, etc, and you will return to normal with proper rest
- educate that a bony prominence my occur in the area
scoliosis - ANS-- abnormal lateral curvature of the spine
- adolescent idiopathic
- occurs during growth spurt
- females affected more than males
scoliosis clinical manifestations - ANS-- uneven fit of clothing
- uneven hem length
- shoulder asymmetry
- prominent scapula and hip
- spinous process misaligned
scoliosis complications - ANS-- respiratory issues: lungs cannot fully expand
- GI/GU issues
- mobility limitations
scoliosis treatment/management - ANS-- serial radiographs
- bracing
- traction
- surgical spine fusion
scoliosis nursing interventions - ANS-- prevent neurological deficits (weakness and
paresthesias may occur)
- promote mobility
- pain management
- promote social interaction
- promote body image positivity
, - skin integrity (2/2 braces)
- promote optimal nutrition
scoliosis (really all spinal fusion) post operative care - ANS-- neuro assessment (focus on
below the affected spinal section)
- incontinence care
- pain
- log rolls only for reposition
- no bending, lifting, twisting (BLT)
- head of bed remains flat
- respiratory assessment
fracture - ANS-- complete or partial break of the bone
open fracture - ANS-bone is exposed through the skin
closed fracture - ANS-The bone is broken but the skin is intact
general considerations for fractures - ANS-- ulna, clavicle, tibia, and femur are common fracture
sites in both adults and children
- manifests as site pain, immobility, deformity, edema
- treated by reduction and immobilization
considerations for fractures in children - ANS-- a fracture in infant or child under 1 year is
uncommon (rubber bones)
- MUST be evaluated for potential abuse
- children's bones have less ossification and bend more before breaking
- growth plates are a common site of fracture
common adult fractures r/t trauma - ANS-- clavicle
- tibia/fibula
- femur
- pelvis
common adult fragility fractures - ANS-caused by fall from standing height or less
- wrist
- hip
- pelvis
- vertabral
pathological fractures - ANS-- fractures caused by weakened bone tissue
- usually r/t tumor
treatment of fractures - ANS-- closed reduction
developmental dysplasia of the hip (DDH/hip dysplasia) - ANS-- subluxation or dislocation of
the head of the hemur from the acetabulum
- females affected more than males
developmental dysplasia of the hip etiologies - ANS-generally unknown, but multiple
possibilities:
- maternal hormone secretion
- positioning (breech or tight infant swaddling)
- genetics
developmental dysplasia of the hip treatments/considerations - ANS-- pavlik harness worn 24
hr/day
- only the provider may adjust the harness
- may use regular car seat
- check for skin breakdown where harness touches skin
- sitting upright is a major milestone (<6 months), need to promote normal activities/play
talipes equinovarus (clubfoot) - ANS-- congenital malformation of the lower extremity
- foot and ankle "turns inward"
- occurs in 1/1000 live births
- males affected more than femals
- etiology unknown - possibly related to restricted mobility in utero
- deformity is apparent at birth
talipes equinovarus (clubfoot) therapeutic management - ANS-- treatment is started as soon as
possible after birth
- goal is to gently stretch the tightened ligaments and tendons
- serial stretching, manipulation, and casting are performed at least weekly
- caregiver may soak off cast (plaster) in AM before appointments
- if not corrected within 3-6 months, surgery is usually indicated
talipes equinovarus (clubfoot) nursing considerations - ANS-- maintain skin integrity
- assess circulation distal to the cast
- pain management
- parental support
- facilitate normal growth and development
- rare long term affects are calf muscle atrophy and small foot
osgood shlatter disease (OSD) - ANS-- most frequent cause of knee pain in children
,- most often occurs between 9-16 years, can be earlier
- males and females affected equally
- associated with overuse
- caused by irritation of the patellar ligament at its attachment point at the tibial tuberosity
what is RICE - ANS-- rest
- ice
- compression
- elevation
very common in MSK issues
Osgood-Shlatter Disease nursing interventions - ANS-- RICE
- taping, bands, braces
- time off sports
- education r/t better shoes, etc, and you will return to normal with proper rest
- educate that a bony prominence my occur in the area
scoliosis - ANS-- abnormal lateral curvature of the spine
- adolescent idiopathic
- occurs during growth spurt
- females affected more than males
scoliosis clinical manifestations - ANS-- uneven fit of clothing
- uneven hem length
- shoulder asymmetry
- prominent scapula and hip
- spinous process misaligned
scoliosis complications - ANS-- respiratory issues: lungs cannot fully expand
- GI/GU issues
- mobility limitations
scoliosis treatment/management - ANS-- serial radiographs
- bracing
- traction
- surgical spine fusion
scoliosis nursing interventions - ANS-- prevent neurological deficits (weakness and
paresthesias may occur)
- promote mobility
- pain management
- promote social interaction
- promote body image positivity
, - skin integrity (2/2 braces)
- promote optimal nutrition
scoliosis (really all spinal fusion) post operative care - ANS-- neuro assessment (focus on
below the affected spinal section)
- incontinence care
- pain
- log rolls only for reposition
- no bending, lifting, twisting (BLT)
- head of bed remains flat
- respiratory assessment
fracture - ANS-- complete or partial break of the bone
open fracture - ANS-bone is exposed through the skin
closed fracture - ANS-The bone is broken but the skin is intact
general considerations for fractures - ANS-- ulna, clavicle, tibia, and femur are common fracture
sites in both adults and children
- manifests as site pain, immobility, deformity, edema
- treated by reduction and immobilization
considerations for fractures in children - ANS-- a fracture in infant or child under 1 year is
uncommon (rubber bones)
- MUST be evaluated for potential abuse
- children's bones have less ossification and bend more before breaking
- growth plates are a common site of fracture
common adult fractures r/t trauma - ANS-- clavicle
- tibia/fibula
- femur
- pelvis
common adult fragility fractures - ANS-caused by fall from standing height or less
- wrist
- hip
- pelvis
- vertabral
pathological fractures - ANS-- fractures caused by weakened bone tissue
- usually r/t tumor
treatment of fractures - ANS-- closed reduction
