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Peds
Peds
162
Nursing
11/13/2010

Additional Nursing Flashcards

 


 

Cards

Term
Hospitalized Infant...

- What is the main stress of the Hospitalized Infant?
Hint: There are two, what are they?
Definition
Stressors:
- Disruption in feeding routines (feeding and napping)
- Disruption in caregivers
Term
Hospitalized Infant...
Q: At what age in infancy can separation be a major issue?
Hint: Infants older than how many months?
Definition
A: Infants older than 7 months, separation is a major issue
Term
Hospitalized Infant...
- What is Erikson's Developmental stage for Infants?
Definition
A: Trust Vs. Mistrust
Term
Hospitalized Toddler...
- What is Erikson's Developmental stage for Toddler?
Definition
A: Autonomy Vs. Shame and Doubt
Term
Hospitalized Pre-Schoolers... - What is Erikson's Developmental stage for Pre-Schoolers?
Definition
A: Initiate Vs. Guilt
Term
Hospitalized School-Ager...
- What is Erikson's Developmental stage for School-Ager?
Definition
A: Industry Vs. Inferiority
Term
Hospitalized Adolescents...
- What is Erikson's Developmental stage for Adolescents?
Definition
A: Identity Vs. Role Confusion
Term
Hospitalized Infant...
Q: When should infant be able to sit without support and be able to drag objects toward themselves?
Definition
A: 7 Months
- Sits without support
- Able to drag objects toward themselves
Term
Hospitalized Infant...
Q: When should infant be able to say "Mama" and "Dada" -- Though no-specific, and be able pass objects from hand to hand?
Definition
A: 8 Months
- Should be able to say "Mama" and "Dada" non-specific and be able to pass objects from hand to hand.
Term
Hospitalized Infant...
Q: When should infant be able to wave goodbye, pick things up with pincher grasps, and be able to crawl well with belly of of the ground?
Definition
A: 10 Months
- Infant should be able to wave goodbye, pick things up with pincher grasp and be able to crawl well.
Term
Hospitalized Infant...
Q: When should infant be able smile, laugh and make noises, lift head and chest up while lying on stomach, turn toward sounds and to follow objects around with eyes.
Definition
A: 2 months
- Infants should be able to mile, laugh and make noises, lift head and chest up while lying on stomach, turn toward sounds and to follow objects around with eyes by 2 months.
Term
Hospitalized Infant...
Q: When should infant be able to eat, cry, sleep, and urinate & defecate?
Definition
A: Birth
- At birth an infant should be able to eat, cry, sleep, urinate & defecate.
Term
Hospitalized Infant...
Q: At birth a babies hands will be closed in a tight fist, when do the infants hands relax and baby will be able to notice them?
Definition
A: 6 Weeks
- At birth the baby's hands will be closed in a tight fist, by 6 weeks the hands relax and the baby will be able to notice them.
Term
Hospitalized Infant...
Q: When should infant have enough head control to merely lift head? ...When will this be well developed?
Definition
A: By 6 weeks, the infant should have enough head control to lift head, this will be well developed by 3 months.
Term
Hospitalized Infant...
Q: When will the infant start to bring things to their mouth?
Definition
A: 4 months
- The baby will begin to bring thing to their mouth by 4 months
Term
Hospitalized Infant...
Q: When will the infant be able to carefully roll over? ...When will the infant be able to roll over just fine?
Definition
A: Well defined 5 months
Carefully at 3-4 months
Term
Neuromuscular Dysfunction...
Q: Which Neuromuscular Dysfunction might an infant be at risk for if they still have poor head control by 3 months?
Definition
A: Cerebral Palsy
Term
Neuromuscular Dysfunction...
Q: Which Neuromuscular Dysfunction might an infant be at risk for if they still cannot sit up 8 months?
Definition
A: Cerebral Palsy
Term
Hospitalized Infant...
Q: What might be a good method to promote development in an infant?

A. Give infant their space
B. Keep infant sitting or lying while feeding
C. Smile and put face in infants field of vision
D. Lack of routines
Definition
Correct: Smile and put face in infants field of vision (C)

Wrong: (A) Infants need touch, if you give them their space then your not responding to their need to be touched, (B) You should hold infant while feeding, (D) Infants need routine, one of there major stressors are that they have a lack of routine.
Term
Hospitalized Infant...
Q: What should you do if parent has a 6 month old infants and a clown or college mascot has just came to the hospital to visit the children?
Definition
A: Explain to parents the celebrities or costumed characters can be scary to infants less than 8 months old.
Term
Hospitalized Infant...
Q: What would be the best thing to do when giving a physical assessment on an infant and they get mad and start to throw a tantrum?
Definition
A: Model behavior when child gets mad and throws a tantrum
Term
Hospitalized Toddler...
Q: What are the stressors than Hospitalized Toddler's may feel?
Definition
A: Fears loss of bodily control, Physical restriction
Term
Hospitalized Toddler...
Q: What may the hospital due to a toddler as far as their developmental milestones?
Definition
A: Hospitalization may slow development
Term
Hospitalized Toddler...
Q: What kind of people are toddlers the majority of the time (Magical Thinkers, Egocentric, Empathetic)?
Definition
A: Toddlers are very egocentric, although they can be empathetic sometimes
Term
Hospitalized Toddler...
Q: If a toddler told you that they understand why they are at the hospital, what would you most likely infer from their statement?
...That they really know why their at the hospital - or - That they do not really understand why they are at the hospital?
Definition
A: You would infer that the Toddler does not really know why they are at the hospital because Toddlers have a perception of illness unrelated to events
Term
Hospitalized Toddler...
Q: What would be a consideration that you as a nurse would make for a toddler in regard to them being very mobile and enjoying walking, throwing and running?
Definition
A: Provide them an avenue to be mobile even if it is while their in bed.
Term
Hospitalized Toddler... Q: What would be something you could do if you are trying to perform a physical assessment on an Toddler and listen to their breath sounds but they are being uncooperative?
Definition
A: You could let them play with your stethoscope and listen to the lung sounds of a teddy bear -- Toddlers like to manipulate objects.
Term
Hospitalized Pre-Schooler... Q: If a Pre-Schooler got in trouble in school and the next day he was sick and had to come to the hospital, what would be an important thing for the nurse to do to make the Pre-Schooler feel better?
Definition
A: Re-assure Pre-Schooler that they are not a bad kid and that they did nothing wrong to get sick, because Pre-Schooler may think that they are sick because they got in trouble in school.
Term
Hospitalized Pre-Schooler...
Q: What is a major stressor for a Pre-Schooler?
Definition
A: Fear mutilation, Experience Loss of Control and may Feel out of Control
Term
Hospitalized Pre-Schooler...
Q: How do Pre-Schoolers think in terms of their hospitalization? ...Do they understand why they are being hospitalized?
Definition
A: No, Pre-Schoolers think particular to particular, white coat to white coat.
Term
Hospitalized Pre-Schooler...
Q: If you are getting ready to perform test and procedures on an infant, would it be beneficial to you to explain the procedure in technical terms? ...If not, then how might you explain this to a Pre-Schooler?
Definition
A: Tell that the test and procedure will make them all better. Explanations should be simple and concrete for Pre-Schoolers.
Term
Hospitalized Pre-Schooler...
Q: What is a major stressor for a Pre-Schooler?
Definition
A: Fear mutilation, Experience Loss of Control and may Feel out of Control
Term
Hospitalized Pre-Schooler...
Q: If a Pre-Schooler is potty trained and uses the bathroom regularly at home, but gets to the hospital and becomes incontinent, what might the nurse do?
Definition
A: The nurse doesn't have to do anything because the hospital may cause regression in Pre-Schoolers.
Term
Hospitalized Pre-Schooler...
Q: Why would it not be a good idea to tell a Pre-Schooler that you are "Going to take his blood"?
Hint: What kind of interpretation do Pre-Schoolers have?
Definition
A: Because Pre-Schoolers take things literally, they have a literal interpretation of things
Term
Hospitalized Pre-Schooler...
Q: What would be the best thing to do when trying to take an un-cooperative Pre-schoolers Blood Pressure?
Definition
A: Use a transitional object to get Pre-Schooler to cooperate.
Term
Hospitalized School-Ager...
Q: What might a nurse do to help a School-Age cope with boredom?
Definition
A: Can use problem solving to help cope with boredom.
Term
Hospitalized School-Ager...
Q: Why does it help promote development in a School-Age child when a nurse involves the child in making things?
Hint: Which Developmental stage does it promote in School-Ager?
Definition
A: It promotes Industry
- A school-Agers Developmental Stage is Industry Vs. Inferiority and when you include them in making thing it promotes their Industry
Term
Hospitalized School-Ager...
Q: What kind of thinkers are School-Agers that makes it able for them to understand some causes of illness and that makes it able for a nurse to explain certain procedures with them.
Definition
A: School-Agers are concrete in understanding which makes them able to reason
Term
Hospitalized Adolescent...
Q: What is the biggest concern in a Hospitalized Adolescent?
Definition
A: They are concerned about their body image
Term
Hospitalized Adolescent...
Q: What would be the best thing a nurse could do with an Adolescent patient while they are at the hospital?
Hint: How do Adolescents like to be interacted with?
Definition
A: The nurse could make the patient feel like a real person and connect with them on their level, because adolescents like to be connected with on their own level.
Term
Hospitalized Pre-Schooler...
Q: Why is it important to give a Pre-Schooler a band-aid?
Hint: What kind of thinkers are Pre-Schoolers?
Definition
A: Because Pre-Schoolers are magical thinkers and they are taught that band-aids will make them feel all better
Term
Hospitalized Adolescent...
Q: Why is it important to constantly stress to Adolescent that they are normal and that they are just fine during hospitalization?
Definition
A: Because Adolescents are concerned about their body image and do not want to feel like they are not "Normal".
Term
Hospitalized Pre-Schooler...
Q: If you told a Pre-Schooler that first they are going to get a band-aid, and then their going to eat lunch, and then their going to get to go play with their doll...Would they be able to understand all that?
Definition
A: Yes! Infants should be able to understand sequencing of events and should know months, days of week, and weather by 5 years old.
Term
Developmental Issues in Hospitalization...

Infant?
Definition
Separation and Disruption of routine
Term
Developmental Issues in Hospitalization...

Toddler?
Definition
Separation, Loss of Control, and Autonomy (Independence)
Term
Developmental Issues in Hospitalization...

Pre-Schoolers?
Definition
Loss of Control, Regression
Term
Developmental Issues in Hospitalization...

School-Ager?
Definition
Loss of Control, Loss of Peers, Lack of Routine
Term
Developmental Issues in Hospitalization...

Adolescents?
Definition
Body Image, Independence, Mobility
Term
Hospitalized School-Ager...
Q: Why is it important to allow Hospitalized School-Ager to play with other kids of the same age/ability?
Definition
A: Because School-Agers fear loss of peers from being different or being hospitalized.
Term
Returning home from Hospital...
Q: How long may regression remain after returning home from Hospitalization?
Definition
A: Regression may remain for up to 6 weeks after Hospitalization
Term
Returning home from Hospital...
Q: What might you expect from a child who took 3 months to be toilet-trained before going into Hospitalization, and is now returning home?
Definition
A: You may expect child to require that same amount of time after Hospitalization before re-establishing bowel and bladder control.
Term
Pain Assessment...
Q: What happens in an infant when they feel pain?
Hint: What happens to BP & Respirations as pain increases?
Definition
A: As pain increases, BP and Respirations increase.
Term
Pain Assessment...
Q: What might you do to tell if an infant is in pain?
Hint: What signs would show that infant is in pain?
Definition
A: Observe for tears, crying, stiff posture, lack of play, fisting, restless, infant is unable to console.
Term
Pain Assessment...
Q: How might you assess the pain of a Toddler or Pre-Schooler? ...What problem may you face when asking a Toddler or Pre-Schooler about their pain?
Definition
A: You could ask them if they feel any pain, but they may have a hard time describing their pain.
Term
Pain Assessment...
Q; What things may an adolescent fear as far as expressing their pain?
Definition
A: They may fear stereo-typing and being labeled a "cry-baby" or "chicken"
Term
Pain Assessment... Q: Which pain assessment scale might you use on a Pre-schooler?
Definition
A: Use wong-baker Scale for a School-Ager
Term
Pain Assessment...
Q: Which pain assessment scale might you use on an Infant?....Why?
Definition
A: Use FLACC Pain Assessment for Infants, because they are non-verbal
Term
Preparation Technique For Pain...
Q: What would be the best methods in preparing an Infant for pain?
Definition
A: Sensory Soothing, Cuddles and Hugs, Touch, Enlist Help of Parents
Term
Preparation Technique For Pain...
Q: What would you use for an Infant who is older than 6 months before giving an IM Injection or an IV?
Definition
A: Massage Cooling or Ice for infant greater than 6 months, or EMLA Cream
Term
Preparation Technique For Pain... Q: What is important to do when preparing an Toddler for pain?
Definition
A: Distraction - Have the child read a picture book or sing a song with you to keep them distracted from the procedure.
Term
Preparation Technique For Pain...
Q: What is important to tell Pre-Schoolers in preparation for their pain, since they are magical thinkers?
Definition
A: Reassure them that their pain is not a punishment and that it's so they can feel better.
Term
Preparation Technique For Pain...
Q: What is important for School-Agers when preparing them for pain? ...They may be scared or have scary thoughts about procedure?
Definition
A: Thought Stopping - Teach them a way of how to stop scary thoughts, tell them to think about Easter, Christmas, or Halloween
Term
Preparation Technique For Pain...
Q: What techniques might you use for an Adolescent in preparing them for pain? ...Do they understand why their getting injection or procedure?
Definition
A: Answer "Why?" Questions, Breathing and Relaxation, Thought Stopping - Tell think to think about swimming at beach with friends.
Term
Q: What is something you should consider when assessing Fontanels on a child for Dehydration?
Hint: When should you check Fontanels?
Definition
A: You should assess Fontanels only if they have not yet closed
Term
Q: When do the Posterior Fontanels close?
Definition
A: 6-8 weeks
Term
Q: When do the Anterior Fontanels close?
Definition
A: 12-18 Months
Term
Q: What are the Clinical Signs of Mild Dehydration? - Skin Color? - Skin Turgor? - Mucous Membranes? - BP? - Pulse? - Cap Refill?
Definition
- Skin Color: Pale - Skin Turgor: Normal - Mucous Membranes: Slightly dry, Thirsty - Urine Output: May be Decreased - Pulse: Normal or Increased - Cap Refill: <2 Seconds
Term
Q: What are the Clinical Signs of Moderate Dehydration?

- Skin Color?
- Skin Turgor?
- Mucous Membranes?
- BP?
- Pulse?
- Cap Refill?
Definition
- Skin Color: Gray
- Skin Turgor: Poor
- Mucous Membrane: Very Dry
- Urine Output: Decreased
- BP: Normal or Lower
- Pulse: Slightly Increased
- Cap Refill: 2-3 Seconds
Term
Q: What are the Clinical Signs of Severe Dehydration?

- Skin Color?
- Skin Turgor?
- Mucous Membranes?
- BP?
- Pulse?
- Cap Refill?
Definition
- Skin Color: Mottled, Cool
- Skin Turgor: Tenting
- Mucous Membranes: Parched
- BP: Lowered
- Pulse: Very Rapid, Thready
- Cap Refill: > 3 seconds
- Concern: Hypovolemic Shock
Term
Q: What is the Therapy for Mild Dehydration?
Definition
- ORS (Pedialyte, Infanlyte, Ricelyte)
Plus additional fluid for each stool and emesis
- Continue usual diet, breast milk or formula if tolerated
Term
Q: What is the Therapy for Moderate Dehydration?
Definition
- ORS
Plus additional fluid for each stool and emesis
- Continue usual diet, breast milk or formula if tolerated
Term
Q: What is the Therapy for Severe Dehydration?
Definition
- IVF until pulse & LOC are normal
- Then ORS
Plus additional fluid for each stool and emesis
- Continue usual diet, breast milk or formula if tolerated
Term
Q: How do you calculate Daily Fluid Intake?
Definition
- Calculate wright of Child in Kg
Allow 100 mL for 1st 10 Kg
Allow 50 mL for 2nd 10 Kg
Allow 20 mL for Remaining Weight
- Divide total amount by 24 hrs. = mL/hr
Term
Q: What is the safe dose range for Acetaminophen?
Definition
10-15 mg/kg/dose
Term
Q: What is the safe dose range for Ibuprofen?
Definition
A: 5-10 mg/kg/dose
Term
Q: What should you do when delivering a PO medication liquid to an infant?
Definition
A: Put in syringe and squirt it in infants cheek along the side of their tongue
Term
Q: What is something you could to numb the taste buds in a small child before delivering PO meds?
Definition
A: Give a flavored ice pop to numb the taste buds
Term
Q: What type of syringe would you use when giving an injection if the solution is less than 1 mL?
Definition
A: Use a Tuberculin Syringe
Term
Q: What is the site that should be used in an IM injection for a infant?
Definition
A: Vastus Lateralis - 90 degrees, aspirate, inject
Term
Q: What is the site that should be used in an IM injection for a Adolescent?
Definition
A: Deltoid
Term
Q: What should you do when giving Otic (ear) meds?...Less than 3 years old? ...Greater than 3 years old?
Definition
Less than 3 - Pull pinna down and back
Greater than 3 - Pull pinna up and back
Term
Cerebral Palsy (CP)...
Q: What are some causes of (CP)?
Definition
A: Jaundice, Shaken Baby Syndrome, Stroke as a Baby, Premature Delivery
Term
Cerebral Palsy (CP)...
Q: What is the most important determinant of (CP)?
Definition
A: Premature Delivery
Term
Cerebral Palsy (CP)...
Q: What are the symptoms of (CP)?
Definition
A: Difficulty writing, balance, coordination, uncontrollable drooling, uncontrollable hand movements
Term
Cerebral Palsy (CP)...
Q: What are some physicals symptoms you may see with (CP)?
Definition
A: Floppy or limp posture, Stiff or rigid and legs, Uses one side of body or only arms to crawl
Term
Cerebral Palsy (CP)...
Q: What behaviors might you see that may be possible early signs of (CP)?
Definition
A: Failure to smile by 2 months, Poor head control after 3 months, Feeding Difficulties (gagging, choking, tongue thrust after 6 mo.), Cannot sit up by 8 months, Extreme irritability or crying.
Term
Cerebral Palsy (CP)...
Q: What are some early signs that could possible be (CP) when it comes to motor development?
Hint: Up until what age should child use both hands?
Definition
A: Early sign is hand preference (Should use both hands until 2-3 years old), Abnormal Crawl, Involuntary Movements, Writhing Movements (Athetoid), Poor Suck, Tongue Thrust
Term
Cerebral Palsy (CP)...
Q: in which (CP) might a child have Hypertonic (stiff) arms and legs?
Definition
A: Spastic CP
Term
Cerebral Palsy (CP)...
Q: Which (CP) might a child have Hypotonic (flaccid) arms, legs and head?
Definition
A: Athetoid CP
Term
Cerebral Palsy (CP)...
Q: What is one of the earliest cues of (CP)?
Definition
A: Moro, Tonic Neck, or Grasp Reflex after 6 months
Term
Cerebral Palsy (CP)...
Q: Which part of the brain is affected in Spastic (CP)?
Definition
A: Cortex
Term
Cerebral Palsy (CP)...
Q: Which part of the brain is affected in Athetoid (CP)?
Definition
A: Basal Ganglia
Term
Cerebral Palsy (CP)...
Q: Which part of the brain is affected in Ataxic (CP)?
Definition
A: Cerebellum
Term
Cerebral Palsy (CP)...
Q: What does the Cortex in the brain control?
Definition
A: Cortex controls thought, movement, and sensation
Term
Cerebral Palsy (CP)...
Q: What does the Basal Ganglia in the brain control?
Definition
A: The Basal Ganglia helps movement become organized, graceful, and economical.
Term
Cerebral Palsy (CP)...
Q: What does the Cerebellum in the brain control?
Definition
A: The Cerebellum coordinates movement, posture, and balance
Term
Cerebral Palsy (CP)...
Q: What types of problems might a Spastic (CP) patient have?
Hint: "S" for Spastic
Definition
A: Scissoring, Stiffening, Speech Problems
Term
Cerebral Palsy (CP)...
Q: What might you do to a Spastic (CP) child to help their condition?
Hint: Think toys and play
Definition
A: Offer toys on affected side to challenge the muscle group
Term
Cerebral Palsy (CP)...
Q: What are the types of Spastic (CP)? ...Hemiparesis?...Quadriparesis?...Diplegia?
Definition
A: Hemiparesis - One side of body is affected
Quadriparesis - All 4 extremities, Speech Dysarthic, Swallowing Impaired
Diplegia - Similar parts of both sides of body affected
Term
Cerebral Palsy (CP)...
Q: What is a concern with Athetoid (CP) patients?
Hint: Think about their constant involuntary movements...
Definition
A: You have to worry about their calorie intake, because they have constant involuntary movements so they are constantly burning calories
Term
Cerebral Palsy (CP)...
Q: What are some of the symptoms of Athetoid (CP)?
Definition
A: Involuntary writhing movement, Hearing impairment, Involuntary drooling
Term
Cerebral Palsy (CP)...
Q: In Athetoid (CP) there is involuntary drooling, what could this lead to?
Definition
A: Skin breakdown
Term
Cerebral Palsy (CP)...
Q: What is affected in Ataxic (CP)?
Definition
A: Affects sense of balance (wide gait), posture, depth perception (vision)
Term
Cerebral Palsy (CP)...
Q: What might you see in a Ataxic (CP) patient?
Hint: Think taxi
Definition
A: Wide gait (need taxi), Disintegration of upper extremities (can't wave for taxi), Nystagmus - Clinical movement of eyeball (can't see taxi)
Term
Cerebral Palsy (CP)...
Q: What are the Classifications of (CP)?
- Mild?
- Moderate?
- Severe?
Definition
- Mild: Impaired fine motor
- Moderate: Gross & fine movement & Speech impairment
- Severe: Unable to perform usual ADL's
Term
Cerebral Palsy (CP)...
Q: What could be used in Spastic (CP) to relieve spasticity?
- Why wouldn't you use Skeletal muscle relaxants?
Definition
A: Botox, produces a paralytic effect to relieve spasticity.
- Skeletal muscle relaxants for Spastic (CP) have little affect
Term
Cerebral Palsy (CP)...
Q: What could be used to treat symptoms of Athetoid (CP)?
Definition
A: Anti-anxiety is used in Athetoid (CP) to relieve excessive motion -- mainly for older children
Term
Cerebral Palsy (CP)...
Q: Impaired Speech is in which type of (CP)?
Definition
A: Spastic (CP)
Term
Cerebral Palsy (CP)...
Q: Impaired Vision is in which type of (CP)?
Definition
A: Ataxic (CP) -- Nystagmus & Amblyopia
Term
Cerebral Palsy (CP)...
Q: Impaired Hearing is in which type of (CP)?
Definition
A: Athetoid (CP)
Term
Q: What is the difference between Muscular Dystrophy and Cerebral Palsy?
Definition
A: In Muscular Dystrophy, child meets milestones but then starts to regress at 3-5 years of age, in Cerebral Palsy child reaches milestones slowly or not at all.
Term
Q: Is Muscular Dystrophy Progressive or Non-Progressive? ...Is Cerebral Palsy Progressive or Non-Progressive?
Definition
A: Muscular Dystrophy - Progressive
Cerebral Palsy - Non-Progressive
Term
Duchenne Muscular Dystrophy...
Q: With there being a decline in motor development, what are the first symptoms noted in Duchenne Muscular Dystrophy?
Definition
A: Difficulty running, Riding bike, Climbing stairs
Term
Duchenne Muscular Dystrophy...
Q: When is the ability to ambulate generally lost in a child with Duchenne Muscular Dystrophy?
Definition
A: Ability to ambulate generally lost by 12 years
Term
Duchenne Muscular Dystrophy...
Q: Why are there contractures in kids with Duchenne Muscular Dystrophy?
Definition
A: Because part of the muscle is wasting but doesn't all waste out at the same time so one will be stronger than the other causing contractions
Term
Duchenne Muscular Dystrophy...
Q: What are some labs that may be used to diagnose Duchenne Muscular Dystrophy?
Definition
A: Elevated CPK - (Serum Creatinine Phosphokinase)
Elevated SGOT - (Serum Glutamic-Oxaloacetic Transaminase)
Term
Duchenne Muscular Dystrophy...
Q: What is the primary goal in dealing with a person with Duchenne Muscular Dystrophy?
Definition
A: The primary goal is to maintain function in the unaffected muscles as long as possible
Term
Spina Bifida...
Q: What is Spina Bifida?
Definition
A: A malformation of the spin in which the posterior portion of the lamina fails to close, failure of the neural plate to develop into a tubular structure
Term
Spina Bifida...
Q: What is the cause of Spina Bifida?
Definition
A: Inadequate consumption of the B Vitamin Folic Acid before Conception during the first trimester
Term
Spina Bifida...
Q: What is Spina Bifida Occulta?

- Where is the Defect?
- Is it Visible?
- Is there any Neurological Involvement?
- Where is the Defect most common?...L(?) and S(?)
Definition
A: Opening of Malformation in Vertebrae

- Defect is only in vertebrae, spinal cord and meninges are not affected
- Defect is not visible externally
- Generally have to Neurological Involvement
- Most common at L5-S1
Term
Spina Bifida...
Q: What does Spina Bifida Cystica mean?
Definition
A: Spina Bifida Cystica refers to a saclike protrusion
Term
Spina Bifida...
Q: What is the Difference between Meningocele and Myelomeningocele?
Definition
Meningocele is a closed fluid sac and Myelomeningocele is an open fluid sac containing meninges, spinal cord, and nerves (More Sever)
Term
Spina Bifida...
Q: What determines the degree of Neural Deficit in myelomeningocele?
Definition
A: Location and Size of Lesion Determines Degree of Neurological Deficit.
Above: LS (Worse)
Below: S3
Term
Spina Bifida...
Q: What is the goal of a pre-op Myelomeningocele patient?
Definition
A; Prevention of infection, Protect sac, Put patient in abducted knee position with knees out life a frog on stomach facing down to protect sac, Catheterize patient to decrease risk of urine and bowel infection to sac
Term
Spina Bifida...
Q: What is the goal of a post-op Myelomeningocele patient?
Definition
A: Vital Signs, Weight, I&O, Assess for Pain, Observe incision, Prone feed when Awake.
Term
Casts...
Q: What are some complications of Casts?
Definition
A: Infection, Circulation Impairment, Peripheral Nerve Damage, Complications of Immobility (Atrophy, Increase workload of Heart, Skin Breakdown, One Degeneration)
Term
Casts...
Q: What would you do to assess for Cast Care?
Definition
A: Check 5 P's
Pain, Pulse, Pallor (Check Skin & Cap. Refill), Paralysis (ask to wiggle finger or toes -- Call M.D. if something is wrong), Paresthesia (numbness or tingling)
Term
Traction Care...
Q: What should you assess when maintaing Traction Care?
Definition
A; Maintain correct balance traction, Care of Weights, Pin Care, Skin Inspection
Term
Traction Care...
Q: What are the 3 Types of Traction's?
Definition
A: Russell's, Bryant's, Buck's Extension
Term
Traction Care...
Q: What is a Russell's Traction used for?
Definition
A: Used to immobilize hip and knee
- Femur Fracture
- Hip & Knee Contractures
Term
Traction Care...
Q: How many lines of pull does a Russell's Traction have?...What needs to be under clients knee?
Definition
A: Russell's Traction has 2 lines of pull, with a pad under patients knee
Term
Traction Care...
Q: What is a Bryant's Traction used for?
Definition
A: Used for DDH or Fractured Femur
- 90 Degree hip flexion
Term
Traction Care...
Q: What is the Buck's Extension Traction used for?...What are the legs doing in a Buck's Extension Traction?
Definition
A: Used for short-term, pre-op fro dislocated hip or DDH.
- Legs extended, Uses a boot
Term
Traction Care...
Q: What do you do in care of a client on a Traction?
Hint: What does each letter of the acronym "TRACTION" stand for?
Definition
T - Temperature
R - Ropes hanging Freely
A - Alignments
C - Circulation (Check 5 P's)
T - Type and Location of Fracture
I - Increase Fluid Intake
O - Overhead Trapeze
N - No weights on bed or floor
Term
Developmental Dysplasia of the Hip (DDH)...
Q: What is Dysplasia?
Definition
A: Femur doesn't fit properly in Acetabulum, because Acetabulum is shallow and oblique - (mild)
Term
Developmental Dysplasia of the Hip (DDH)...
Q: What is Subluxation?
Definition
A: The Femur is partially dislocated
Term
Developmental Dysplasia of the Hip (DDH)...
Q: What is Dislocation?
Definition
A: The Femur completely Dislocated - (Severe)
Term
Developmental Dysplasia of the Hip (DDH)...
Q: What are the Clinical Manifestations of (DD) in an Infant?
Definition
A: Asymmetry, Limited Abduction, Galleazzi sign (Test performed by flexing an infant's knees in the supine position that the ankles touch the buttocks, if the knees are not level then the test is positive, indicating DDH), Ortolani Test (Test by examiner by flexing an infants hips & knees in supine position to 90 degrees, the examiner places index fingers on greater trochanter, gently & smoothly abducting infants legs, a positive sign is a distinctive "clunk" as femoral head relocates anteriorly to Acetabulum)
Term
Developmental Dysplasia of the Hip (DDH)...
Q: What are the Clinical Manifestations of (DD) in an Older Child?
Definition
A: Trandeleburg Sign (Positive if when standing on one leg, the pelvis drops on the opposite to the stance leg, the weakness is present on the side of the stance leg), Waddling Gait, Limp
Term
Developmental Dysplasia of the Hip (DDH)...
Q: What is a Treatment for a 0-6 month Infant with (DDH)?
Definition
A: Pavlik Hairness -- Puts pressure of the Femur Head to keep it in the Acetabulum
Term
Developmental Dysplasia of the Hip (DDH)...
Q: What is a Treatment for a 6-18 month child with (DDH)?
Definition
A: Pre-Op Traction (3 weeks) - Buck's or Russell, Hip Spica Cast (2-4 months until hip stable)
Term
Congenital Clubfoot...
Q; What is Congenital Clubfoot?
Definition
A: Clubfoot is when the foot turns inward & downward, it is a Congenital Condition which means it is present at birth.
Term
Congenital Clubfoot...
Q: What are some Therapeutic Managements for Congenital Clubfoot?
Definition
A: Serial Casting (8-12 weeks) - Gradual Manipulation, Surgery to Sever Tendons + Casting
Term
Osteogenesis Imperfecta (OI)...
Q: What is Osteogenesis Imperfecta often referred to as?
Hint: What kind of Disease is it?
Definition
A: Referred to as the "Brittle Bone Disease"
Term
Osteogenesis Imperfecta (OI)
Q: What are some Clinical Manifestations of (OI)?
Definition
A: Bone Fragility and Deformity, Blue Sclera, Bruising and Recurrent Epistaxis (Nose Bleeds), Pre-Senile Hearing Loss, Thin Skin, Mild Hyperpyrexia (Fever greater than 106.7 Degress)
Term
Legg-Calve Perthes...
Q: What is Legg-Calve Perthes?
Definition
A: Idiopathic (Spontaneous), self-limiting aseptic (sterile) necrosis of the Femoral Head -- Usually Unilateral
Term
Legg-Calve Perthes...
Q: What is the objective of treatment for Legg-Calve Perthes?
Definition
A: Objective - Keep the Head of the Femur (Abduction) contained in the Acetabulum to preserve it's Spherical Shape and Prevent Flattening
Term
Legg-Calve Perthes...
Q: What are some Symptoms of Legg-Calve Perthes?
Definition
A: Most evident upon Arising & End of the day, Hip, Knee, or Thigh Pain, Intermittent limp on affected side (+ Trandelenburg Sign), Decreased Joint ROM
Term
Scoliosis...
Q: What is Scoliosis?
Definition
A: A Complex Spinal Deformity, The Most Common Spinal Deformity is a Lateral Curvature (S-Shape), and Thoracic Kyphosis (Bowing of the Back, which leads to Hunchback or Slouching)
Term
Scoliosis...
Q: What are some Clinical Manifestations of Scoliosis?
Definition
A: Asymmetry of Hips, Unequal Scapula Prominences, Unequal Rib Prominences, Asymmetry of Abdominal SKin Folds
Term
Scoliosis...
Q: What is Mild Scoliosis?...What do you do to Treat it?
Definition
A: Mild (<20 Degree Curve)
- Observation, Evaluate every 3-12 months
Term
Scoliosis...
Q: What is Moderate Scoliosis?...What do you do to Treat it?
Definition
A: Moderate (20-40 Degree Curve)
- Bracing (Milwaukee Brace, Boston Brace)
Term
Scoliosis...
Q: What is Sever Scoliosis?...What do you do to Treat it?
Definition
A: Sever (>40 Degree Curve)
- Surgical Spinal Fusion with instrumentation (Harrington or Luque Rod, Dwyer Cable)
Term
Juvenile Idiopathic Arthritis...
Q: What is Juvenile Idiopathic Arthritis?
Definition
A: Chronic Inflammation of Synovium (Soft Tissue that lines surfaces in Joints)
Term
Juvenile Idiopathic Arthritis...
Q: What is the Difference between Pauciarticular and Polyarticular in Juvenile Idiopathic Arthritis?
Definition
A: Pauciarticul - <5 Joints (Affects less than 5 joints), Can lead to blindness
Polyarticular - 5 or > joints (Affects 5 or more Joints), Spinal and hip Involvement, Can lead to Crippling
Term
Juvenile Idiopathic Arthritis...
Q: What are the Goals in Therapeutic Management of Juvenile Idiopathic Arthritis?
Definition
A: Goal - Get Inflammation under control and then ROM, Preserve Joint Function (Swim, Play -- Need to Wiggle, Lie Prone while Watching T.V.)
Term
Osteomyelitis...
Q: What is Osteomyelitis?...And what Organism causes it?
Definition
A; Osteomyelitis is an infectious process of bone caused by any organism, The most common Organsim in Older Children is Staphylococcus Aureas
Term
Physical Assessment...
- How would you most accurately take a temperature on Child if sick?
- How would you take Temperature on Child if not sick?
- What are would you not take a Temperature on a Child until they were 3 or 4 years old?
Definition
- Most Accurately if Sick: Rectal Temperature
- If Not Sick: Axillary Temperature
- Place Not To Take Temperature: Oral, Wont Take Oral Temperature until 3 or 4 years old.
Term
Physical Assessment...
- Where would you take an Infants Pulse?
Definition
- Brachial, Apical Pulse
Term
Physical Assessment...
- What are the 1st to things you should start with during assessment on a child if you enter the room and they are resting and being quiet?
Definition
- Respirations & Pulse
Term
Physical Assessment...
- Where Would you take a pulse on a Toddler & Older?
Definition
- Radial, Brachial, or Apical
Term
Pain Assessment...
- What type of Pain Scale would you use for a School-Age Child?
Definition
- Visual Analog Scale