Exam (elaborations)
NURS 471 Module 4: NeuroMuscular and Musculoskeletal Pediatric Disorders
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NURS 471 Module 4: NeuroMuscular and Musculoskeletal Pediatric Disorders
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NURS 471 Module 4: NeuroMuscular and MusculoskeletalPediatric Disorders
-plegias Correct Answers Monoplegia - one arm or one leg
Hemiplegia - one side
Diplegia - symmetrical parts of body
Quadriplegia - affects the whole body
Assess for five P's of ischemia Correct Answers acute onset of
progressive pain in the affected limb (pain), pulselessness,
pallor, paresthesia, and paralysis.
Assess the fingers and toes of the cast, make sure that there is
the right color and temperature, pulse, wiggle their toes, normal
feelings
Pain
Pulse
Pallor
Paresthesia
Paralysis
Ataxic CP (5-10%) Correct Answers Damage to the cerebellum
Clinical manifestations
Poor balance & muscle coordination
- Appear clumsy at first
Unsteady, wide-based gait
Appears clumsy
,Tends to fall & stumble
Athetoid/Dyskinesia CP (10-20%)
+ clinical manifestations Correct Answers Damage to the basal
ganglia
Clinical manifestations
Involuntary, uncoordinated motion occurs with varying degree
of muscle tension
Slow writhing uncontrolled movements involving all extremities
when voluntary movement is attempted
Facial grimacing
Poor swallowing
- Affects the HEENT system
Drooling
Speech impairment
- Motion and HEENT
barlow's sign Correct Answers femoral head can be felt as it
slips out onto the posterior lip of acetabulum
Put the knees and push then towards the head
Can feel the femoral head slip out of the lip of the socket
,Positive = clunk
casting Correct Answers Handle wet cast with palms of hands
Keep elevated for first day to decrease edema
Nothing in cast
- Do not try to itch it
"Hot spot" and foul-smelling areas indicate infection
- Notice a foul order or parent is complaining of pain that might
be a sign of infection
Cerebral Palsy Correct Answers Cerebral palsy is caused by an
abnormality or disruption in brain development, usually before a
child is born. In many cases, the exact trigger of this
abnormality isn't known.
Most common permanent physical disability of childhood
Early onset and impaired movement and posture
Abnormal muscle tone and coordination
Nonprogressive
- What ever the child presents with, it will not get worse
May be accompanied by perceptual problems, language deficits
and intellectual involvement
, club foot - nursing care Correct Answers Neurovascular checks
during casting
Cast care
- Infection
- circulation
club foot - treatment Correct Answers Goal: Functional foot
Starts soon after birth
Manipulation with serial casting
- Do multiple casts (change every 2 weeks)
- Each cast is going to move their foot more and more into
position
Corrective shoes or bracing
Surgical release
- Release the tight tendon in the ankle
Club Foot (Talipes Equinovarus (TEV)) Correct Answers
Congenital Club Foot
Resembles a Golf Club
- Inverted heel
- Ankle equinus
- Forefoot Adduction & supination
-- Feet are always turned inwards
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