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