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SAC Peds Exam
Module 15 - rest & exercise
| Question | Answer |
|---|---|
| Highest priority w/ cast care? | Maintaining Skin integrity |
| Nursing interventions to minimize swelling and promote circulation w/ casts? | ice, elevate, CMS checks, keep dry |
| Major complication of any constricting cast or splint? | Compartment syndrome |
| How do you handle a wet cast? | With open palms, not fingers; to prevent pressure spots |
| Purpose of traction? | Stretch muscles and alignment |
| Kinds of skin traction? | Bryant's - legs straight and 90degrees toward ceiling AND Pugh's - child's wt is counterbalance |
| What to remember w/ skin traction? | never release traction w/o MD order |
| Why is skin traction used for hemophiliacs? | Hemoarthrosis |
| Most serious complication w/ skeletal traction? | Osteomyelitis |
| 5 P's of vascular impairment? | Pain, Pallor, Pulselessness, Paresthesia, Paralysis |
| After traction applied, how often are neurovascular assessments done? | q 1-2hrs during first 48hrs, then q 4hr CMS w/ v/s |
| S/S of Neurovascular impairment? | cold, blue, pale, loss of motion, numbness, tingling, sluggish cap refill |
| How do you assess pain level? | Pain scale, vital signs, open ended questions |
| Cerebral Palsy | Neuromuscular disorder resulting from damage to brain from anoxia |
| S/S of CP | Hypertonicity (spasticity), mental retardation (in 18-50%), speech/hearing disturbance, dental anomalies, sz |
| Interventions for CP? | Nutrition, safety, meds |
| Med for CP? | Dilantin, Baclofen |
| Things to know about Dilantin? | s/e = gingival hyperplasia, oral care w/ soft toothbrush |
| Baclofen - why is it given and how? | Given to reduce spasticity and given intrathecally |
| Priority goal for CP? | maintain optimal level of wellness |
| Developmental Dysplasia of the Hip | Abnormal development of head of femur and acetabulum |
| How do you assess for DDH? | +Ortolani's, shorter limb, asymmetrical gluteal skin folds |
| Intervention for DDH? | Plavik Harness for 3mos; hip-spica cast or surgery for older child |
| Highest priority teaching for DDH? | Prevent complications --> proper placement of harness |
| Highest priority of care for DDH? | Prevent skin breakdown |
| How to assess for scoliosis? | Child bends forward w/ knees straight and arms hanging down --> spine fails to straighten; hips, ribs, shoulders asymmetrical |
| Interventions for scoliosis? | Milwaukee brace worn 23hrs/day |
| Post-op care for scoliosis? | Flat, supine position, log roll q 2hrs, NG tube to reduce gas, NPO, incentive spirometer, PCA, strict I&O |
| Priority Nursing Dx for Scoliosis? | Disturbed body image, Pain, Risk for noncompliance |
| Osteogenesis imperfecta (aka OI or "brittle bones") | Autosomal dominant d/o of the connective tissue involving bones, ligaments and sclera |
| Assessment findings for OI | Hx of frequent fractures, blue-tinged sclera, thin skin, blue-gray teeth |
| Abnormal labs for OI? | Precollagen type I |
| Interventions for OI? | Gentle handling, soft environment, parent teaching |
| Juvenile rheumatoid arthritis | Autoimmune disease of connective tissue w/ chronic inflammation of the synovia and possible joint destruction |
| Assessment findings of JA? | elevated ESR, +antinuclear antibody (ANA), +rheumatoid factor |
| What can influence JA exacerbations? | stress, climate, genetics |
| what meds are given for JA? | low-dose corticosteroids, NSAIDS (naproxen, ibuprofen) |
| Important thing to remember when administering JA meds? | admin w/ food |
| What do you do if child feels pain in joints? | If stiff, may need heat; if swollen, may need ice |
| Muscular dystrophy | Genetic, sex-linked recessive trait, mostly in males d/t absence of protein in muscles |
| Assessment findings w/ MD? | Pelvic girdle weakness, waddling gait, falls, difficulty climbing stairs, +Gowers sign |
| Diet for MD? | high fiber, High fluid, high protein, low Cal diet |
| Priority Nursing Dx for MD? | Risk for injury, Impaired physical mobility, risk for constipation, disturbed self esteem |
Created by:
cobedad
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