When taking care of a child in a cast, what should you do?
Support the skin, do a pulse check, nuero check on the fingers, and educate the patient not to stick anything down the cast or use lotions.
Child in traction
Skin: a non-invasive process
Skeletal: Stick pins and needles into bones (invasion process)
What is the TRACTION acroynm?
Temperature, Ropes hanging freely, alignment, circulation, types and location, increase fluid intake, overhead trapeze, no weights on bed/floor
What is the most frequent broken bone in children?
Forearm
What is the second most common broken bone in children?
Clavicle
Transverse fracture
Oblique fracture
Spiral fracture
Comminuted
Greenstick
Straight across the bone
Angle fracture (compound on big bones)
Spiral along bone (check the story)
Bone fragments lie in surrounding tissue
Compression on side of bone
How long does it take for a bone to heal in neonates?
2-3 weeks
How long does it take for a bone to heal in early childhood?
4 weeks
How long does it take for a bone to heal in later childhood?
6-8 weeks
How long does it take for a bone to heal in an adolescent?
8-12 weeks
What is the best way to diagnose a fracture?
X-Ray
The F P's of a fracture?
Pain
Pulse
Parasthesia
Paralysis
Pallor
What is the blood test that measures muscle breakdown?
CPK
Compartment syndrome
condition caused by pressure buildup from internal bleeding or swelling of tissues that puts pressure on nerves and deprives muscle of nutrients
S/S of compartment syndrome
severe pain, sensation of pins and needles, and weakness of the affected area.
RICE acroynm
Rest
Ice (no more than 30 minutes at a time)
Compression (wet elastic bandage)
Elevation (above the heart)
ICES acronym
Ice
Compression
Elevation
Support (casts/splints)
What is the most common stress fracture?
Tibial fracture
Seen with sports such as basketball/running/gymnastics. Seen from repeated muscle contraction
Torticollis "wry neck"
Cannot turn your neck one way because your muscles are to stiff. Necks are usually stuck on one side of the body and painful to move to other
Kyphosis
Abnormal convex curvature of the thoracic area of spine (Hunchback of Notre Dame appearance)
Most common form is postural and be from TB, arthritis, osteodystrophy, compression fracture
Lordosis
Abnormal curvature of your cervical spine (Looks like they try to show but off since bottom of spine is curved inwards)
Scoliosis
MOST COMMON spinal deformity
spine looks like a snake on the radiographs
When does scoliosis become noticeable?
Preadolescent growth spurt, they may complain of "ill fitting clothes."
How long does a person have to wear a brace for scoliosis?
For 3-5 years 23/24 hours a day
Make sure they have tight fighting clothes underneath
What is DDH?
Developmental dysplasia of Hip
DDH
Hip instability after birth (from breech birth usually)
What are the test used to determine DDH?
Ortolani (Neonate period; they spread hips out to see if symmetrical) and Barlow (pushs the hips in to see if symmetrical)
Also, you can use Galeazzi (Push hips up and see if legs are asymmetrical)
Osteomyelitis
Inflammation and infection of bony tissues
Osteomyelitis S/S
Severe pain, fever, irritability
resemble arthritis and leukemia
Need a bone culture, start IV antibiotics for 3-4 weeks, x-rays screenings
What is septic arthritis also called?
Suppurative, pyrogenic, or purulent arthritis
Most common places: Knee, hip, shoulder
S/S of septic arthritis
Joint is warm, painful, swollen, fever, leukocytosis, inc. sedimentation rate
Seen after traumatic injury
What is a frequent cause of septic arthritis in sexually active teens?
Neisseria gonorrhea
Osteogenesis Imperfecta
Brittle bone syndrome
INHERETED disease
What type of OI is the most common?
Type 1: blue sclera, normal teeth, presenile deafness, mild bone fragility
Juvenile Idiopathic Arthritis (JIA)
Rheumatoid arthritis in kids
Peaks between ages 1-3 and 8-10
What percent of children have a negative rheumatoid factor with JIA?
90%
What are the years of a school age child?
6-12 start at the shedding of deciduous teeth, and stops when permanent teeth come in and start of puberty
What are the biological developments for a school age child?
2-3 kg per year
2 in per year
height between males and females will differ
What are the average age of puberty? When does prepubescence occur?
Females-12
Males-14
Usually, 2 years before puberty
What stage of Erikson are school age children at?
Fourth stage: Industry vs. Inferiority
Industry ex: CHild encourage to try new things and explore
Inferiority ex: CHild is discouraged from trying new things
What is a strong motivator for school age children?
Peer approval
Still seek parents approval but older they get they want to be more independant from parents and seek approval from their peers
What can a 6-7 year old help with?
Wipe tables and counters, put laundry away, and swwp floors
What can a 7-9 year old help with
Load and unload dishwasher, pack their own lunch, and help makes meals
What can a 10-11 year old help with
Change their sheets, clean the kitchen and bathrooms, and do yard work
Kohlberg Moral Development
6-7 years old: Reward and punishment guide choices
Older school age: Able to judge an act by the intentions that prompted it
Rules and judgments become more founded on needs and desires of others