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Exam 1,2,3

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4432 Pediatrics

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South College

This is a study guide for exam 3 pediatrics exam

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exam 3 study guide

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Exam 3 Pediatric Study Guide
 Osteogenesis Imperfecta
o Brittle bone disease is characterized by bones that break easily
(fracture) often from little or no apparent cause.
o Main goal of treatment: Prevent deformities and fractures.
o Lifelong condition.
o Signs and symptoms
 Easily broken bones
 Bone deformities (bowing of the legs)
 Discoloration of the white of the eye (sclera), may be blue
or gray in color.
 Barrel-shaped chest
 Curved spine
 Triangle-shaped face
 Loose joints
 Muscle weakness
 Easily bruising
 Soft, discolored teeth
o Nursing interventions: Protect from injury (support the trunk and
extremities when moving; patients do not need to participate in
contact sports)  at risk for injury related to fragile bones;
increase strength and function of affected and/or compensatory
body part  impaired physical mobility related to loss of integrity
of bone structures.
 Pediatric Fractures
o Greenstick Fracture
 One side of the bone is broken, causing the other side to
bend (one bone bends and one just partially breaks);
resembles a broken tree branch; the branch cracks on one
side, but remains partially intact on the other.
o Spiral Fracture
 Arise because of twisting force applied to the bone; creates
a fracture line that wraps around your bone and looks like a
corkscrew.
o Complete Fracture
 Occurs when both sides of the bone are broken in two; less
stable and require more involved treatment and close
monitoring to ensure they heal in the preferred alignment.
o Plastic deformation (bend)
 The bone is bent no more than 45 degrees without
breakage

, o Buckle (torus)
 Compression of the porous bone resulting in a bulge or
raised area at the fracture site.
o Transverse
 Break is straight across the bone
o Oblique
 Break is diagonal across the bone
o Physeal (growth plate)
 Injury to the end of the long bone on the growth plate
o Stress
 Small fractures/ cracks in the bone due to repeated muscle
contractions during weight bearing activities.
o Incomplete
 Bone fragments are still attached.
o Closed or Simple
 The fracture occurs without a break in the skin
o Open or compound
 The fracture occurs with an open wound and bone
protruding
o Complicated
 The fracture results in injury to other organs and tissues
o Comminuted
 The fracture includes small fragments of bone that lie in
surrounding tissues.
o Complications of fractures: Compartment syndrome, Renal
calculi, Embolism (fat and pulmonary), Osteomyelitis
 Juvenile Idiopathic Arthritis (JIA)
o Autoimmune or autoinflammatory diseases. That means the
immune system, which is supposed to fight invaders like germs
and viruses, gets confused and attacks the body’s cells and
tissues. This causes the body to release inflammatory chemicals
that attack the synovium (tissue lining around a joint). It
produces fluid that cushions joints and helps them move
smoothly. An inflamed synovium may make a joint feel painful or
tender, look red or swollen or difficult to move.
o The word “idiopathic” means unknown, and researchers aren’t
sure why kids develop JIA. They believe kids with JIA have certain
genes that are activated by a virus, bacteria or other external
factors. But there is no evidence that foods, toxins, allergies or
lack of vitamins cause the disease.
o Signs and Symptoms:

,  Joint pain or stiffness; may get worse after waking up or
staying in one position too long; Red, swollen, tender or
warm joints; Feeling very tired or rundown (fatigue); Blurry
vision or dry, gritty eyes; Rash; Appetite loss; High fever
o Nursing Interventions:
 Application of moist heat packs with a compress or warm
tub bath upon awakening will help lessen stiffness in the
morning
 Regular Exercise such as: Low-impact, joint friendly
activates such as walking, swimming, biking, or yoga
 NSAIDs (Nonsteroidal anti-inflammatory drugs)
 Scoliosis
o A condition that causes the spine to curve sideways; more
common in females; peak incidence at 8-15 years of age; as the
child is growing, the spinal curve will become more severe (which
is why the symptoms become most marked at prepuberty  a
time of rapid growth)
o Testing for Scoliosis:
 Look for asymmetries: Is one shoulder or shoulder blade
higher than the other? Are the hips uneven? Is there more
space between one arm and the torso than the other?
 Uneven shoulders, prominent shoulder blade, or an
uneven waist, uneven leg length, elevated hips, etc.
 Ask your patient to lean forward and try to touch his or her
toes (known as the Adams Forward Bend Test); the back
will be toward the nurse and when the patient bends
forward, look for a curve
o Scoliosis Complications
 Breathing difficulties (with severe curvatures)
 Lowered self-esteem
 Post op complications
 Spinal cord or neurologic injury
 Pneumothorax (Decreased mobility)
 Hypotension (blood loss)
 Atelectasis (decreased mobility)
 Ileus (decreased mobility)
 Infection (wound)
 Superior mesenteric artery syndrome  Compression of
the duodenum by the aorta and superior mesenteric artery
that leads to an obstruction.
 Osteomyelitis
o Is an infection in the bone; most common in long bones

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