Chapter 50 The Child with a Musculoskeletal Alteration

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Chapter 50 The Child with a Musculoskeletal Alteration Elsevier items and derived items ©

Chapter 50 The Child with a Musculoskeletal Alteration Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc.

Immobilizing Devices Splints Casts Traction Skin Ø Skeletal Ø External fixation devices Elsevier items

Immobilizing Devices Splints Casts Traction Skin Ø Skeletal Ø External fixation devices Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 2

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 3

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 4

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 5

Neurovascular Assessment Skin color Capillary refill time Temperature Sensation Movement of digits Pulse distal

Neurovascular Assessment Skin color Capillary refill time Temperature Sensation Movement of digits Pulse distal to the site Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 6

Evaluation of Neurovascular Status The Five Ps of ischemia Pain Ø Pallor Ø Pulselessness

Evaluation of Neurovascular Status The Five Ps of ischemia Pain Ø Pallor Ø Pulselessness Ø Paresthesia Ø Paralysis Ø NOTE: Pain or a burning sensation may indicate tissue ischemia. Prompt intervention is crucial and requires referral to the physician. Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 7

Consequences of Immobility Alterations in systems Integumentary Ø Gastrointestinal Ø Genitourinary Ø Respiratory Ø

Consequences of Immobility Alterations in systems Integumentary Ø Gastrointestinal Ø Genitourinary Ø Respiratory Ø Musculoskeletal Ø Growth and development Ø Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 8

Fractures Trauma Ø Increased mobility puts young children at risk. • Inadequate motor and

Fractures Trauma Ø Increased mobility puts young children at risk. • Inadequate motor and cognitive skills • Frequent falls Nonaccidental trauma Ø Evaluate for child abuse. Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 9

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 10

Treatment of Fractures Reduction Ø Repositioning of the bone fragments into normal alignment Retention

Treatment of Fractures Reduction Ø Repositioning of the bone fragments into normal alignment Retention Once aligned to the fracture site must be protected Ø Application of splint, cast, traction, or external fixator Ø Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 11

Question Kristin, age 10, sustained a fracture in the epiphyseal plate of her right

Question Kristin, age 10, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, what should the nurse consider? Healing is usually delayed in this type of fracture. B. Bone growth can be affected by this type of fracture. C. This is an unusual fracture site in young children. D. This type of fracture is inconsistent with a fall. A. Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 12

Soft Tissue Injuries Sprains Strains Contusions Dislocation Elsevier items and derived items © 2013,

Soft Tissue Injuries Sprains Strains Contusions Dislocation Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 13

Treatment of Soft Tissue Injuries: RICE and ICES R= I = C= E= rest

Treatment of Soft Tissue Injuries: RICE and ICES R= I = C= E= rest ice compression elevation I = C= E= S= ice compression elevation support Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 14

Osteomyelitis Bacterial infection of the bone Nursing care Assessment and documentation of the child's

Osteomyelitis Bacterial infection of the bone Nursing care Assessment and documentation of the child's status Ø Pain management Ø Administration of antibiotics without iatrogenic injury Ø Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 15

Musculoskeletal Developmental Disorders Scoliosis Limb differences Developmental dysplasia of the hip Legg-Calvé-Perthes disease Slipped

Musculoskeletal Developmental Disorders Scoliosis Limb differences Developmental dysplasia of the hip Legg-Calvé-Perthes disease Slipped capital femoral epiphysis Clubfoot Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 16

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 17

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 18

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 19

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 20

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 21

Therapeutic Management Each condition often requires long-term treatment including the following: Splinting Ø Traction

Therapeutic Management Each condition often requires long-term treatment including the following: Splinting Ø Traction Ø Bracing Ø Casting Ø A combination of the above Ø Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 22

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Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 23

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 24

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 25

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of

Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 26

The Child with Muscular Dystrophy Nursing outcomes Maintaining physical activity Ø Promoting respiratory function

The Child with Muscular Dystrophy Nursing outcomes Maintaining physical activity Ø Promoting respiratory function Ø Managing weight Ø Reducing the impact of the disease on the child's development Ø Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 27

Juvenile Idiopathic Arthritis Nursing outcomes Keeping the child free from injury Ø Controlling pain

Juvenile Idiopathic Arthritis Nursing outcomes Keeping the child free from injury Ø Controlling pain Ø Enhancing physical mobility Ø Promoting age-appropriate developmental behaviors Ø Elsevier items and derived items © 2013, 2009, 2005 by Saunders, an imprint of Elsevier Inc. 28

Chapter 21 Musculoskeletal System Musculoskeletal System The musculoskeletalChapter 21 Musculoskeletal System Musculoskeletal System The musculoskeletal
Musculoskeletal System Overview of musculoskeletal system Musculoskeletal ofMusculoskeletal System Overview of musculoskeletal system Musculoskeletal of
Aqueous Alteration on Mars Importance Some background AlterationAqueous Alteration on Mars Importance Some background Alteration
Memorandum of Association Alteration of Memorandum Alteration OfMemorandum of Association Alteration of Memorandum Alteration Of
Unit IX Alteration in Musculoskeletal Function NSG 203Unit IX Alteration in Musculoskeletal Function NSG 203
Chapter 15 Musculoskeletal System Musculoskeletal System 1 BonesChapter 15 Musculoskeletal System Musculoskeletal System 1 Bones
36 Musculoskeletal Systems Chapter 36 Musculoskeletal Systems Key36 Musculoskeletal Systems Chapter 36 Musculoskeletal Systems Key
Alterations of Musculoskeletal Function Chapter 42 1 MusculoskeletalAlterations of Musculoskeletal Function Chapter 42 1 Musculoskeletal
Chapter 29 Musculoskeletal Care 29 Musculoskeletal Care ObjectivesChapter 29 Musculoskeletal Care 29 Musculoskeletal Care Objectives
Chapter 27 Musculoskeletal Conditions Assessment of Musculoskeletal ProblemsChapter 27 Musculoskeletal Conditions Assessment of Musculoskeletal Problems
Chapter 9 Musculoskeletal System Disorders Review of MusculoskeletalChapter 9 Musculoskeletal System Disorders Review of Musculoskeletal
36 Musculoskeletal Systems Chapter 36 Musculoskeletal Systems Key36 Musculoskeletal Systems Chapter 36 Musculoskeletal Systems Key
Chapter 44 The Child with a Genitourinary AlterationChapter 44 The Child with a Genitourinary Alteration
Chapter 46 The Child with a Cardiovascular AlterationChapter 46 The Child with a Cardiovascular Alteration
Chapter 44 The Child with a Genitourinary AlterationChapter 44 The Child with a Genitourinary Alteration
Chapter 46 The Child with a Cardiovascular AlterationChapter 46 The Child with a Cardiovascular Alteration
Chapter 55 The Child with a Sensory AlterationChapter 55 The Child with a Sensory Alteration
Chapter 46 The Child with a Cardiovascular AlterationChapter 46 The Child with a Cardiovascular Alteration
Chapter 45 The Child with a Respiratory AlterationChapter 45 The Child with a Respiratory Alteration
Chapter 52 The Child with a Neurologic AlterationChapter 52 The Child with a Neurologic Alteration
Chapter 42 The Child with an Immunologic AlterationChapter 42 The Child with an Immunologic Alteration
Chapter 49 The Child with an Alteration inChapter 49 The Child with an Alteration in
Chapter 43 The Child with a Gastrointestinal AlterationChapter 43 The Child with a Gastrointestinal Alteration
Basic MRI Musculoskeletal Anatomy Musculoskeletal MRI Indications SportBasic MRI Musculoskeletal Anatomy Musculoskeletal MRI Indications Sport