Podcast
Questions and Answers
What is the primary concern associated with dislocation in children?
What is the primary concern associated with dislocation in children?
Which condition is NOT a common reason for childhood immobility?
Which condition is NOT a common reason for childhood immobility?
What describes the nature of a contusion?
What describes the nature of a contusion?
Which of the following best describes a sprain?
Which of the following best describes a sprain?
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Which aspect is most crucial when managing family-centered nursing care for children with musculoskeletal disorders?
Which aspect is most crucial when managing family-centered nursing care for children with musculoskeletal disorders?
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What is the primary difference between a sprain and a strain?
What is the primary difference between a sprain and a strain?
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Which type of fracture is characterized by the fractured bone protruding through the skin?
Which type of fracture is characterized by the fractured bone protruding through the skin?
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What is the weakest point of long bones that is frequently damaged during trauma?
What is the weakest point of long bones that is frequently damaged during trauma?
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What is the typical healing time for fractures during early childhood?
What is the typical healing time for fractures during early childhood?
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Which of the following is NOT one of the 'Six Ps' used in the assessment of fractures?
Which of the following is NOT one of the 'Six Ps' used in the assessment of fractures?
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What is the primary goal of fracture management?
What is the primary goal of fracture management?
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Which treatment method may be included to prevent growth disturbances in children with growth plate injuries?
Which treatment method may be included to prevent growth disturbances in children with growth plate injuries?
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What important aspect should be monitored in cast care immediately after casting?
What important aspect should be monitored in cast care immediately after casting?
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Study Notes
Children with Musculoskeletal or Articular Dysfunction (Part 1)
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This is a chapter focusing on children with musculoskeletal or articular problems
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The chapter objectives include analyzing history and physical findings related to intracranial pressure, neuromusculoskeletal, and endocrine disorders
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Objectives also include analyzing diagnostic data, managing family-centered care for these children, and examining nursing considerations for pediatric medications
Effects of Immobilization
- Immobilization is a significant aspect of illness in children
- Common reasons for immobilization:
- Congenital defects
- Degenerative disorders
- Infections or injuries affecting integumentary, neurologic, or musculoskeletal systems
- Therapies that prolong immobility
Soft-Tissue Injury
- Types of soft tissue injuries are illustrated:
- Tendon (strain)
- Muscle and soft tissue (contusion)
- Ligament (sprain)
- Joint (dislocation)
- Epiphysis (separation)
Contusion
- Results from damage to soft tissue, subcutaneous tissue, and muscle
- Blood escapes into tissues, causing ecchymosis (bruising)
- Symptoms include swelling, pain, disability, and in some cases, crush injuries
Dislocation
- Displacement of opposing bone ends, or of bone ends to the socket
- Caused by a significant force on ligaments
- Symptoms include pain that increases with movement and possible loss of blood supply to affected areas (ex. hip dislocation may cause blood supply issues to the head of the femur).
Sprain vs. Strain
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Sprain:
- Trauma to a joint from partially or completely torn/stretched ligaments
- Can involve damage to blood vessels, muscles, tendons, and nerves
- Often associated with joint laxity (a sign of severity)
- Rapid onset of swelling and disability
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Strain:
- Microscopic tears to musculotendinous units
- Similar symptoms to sprains (swelling, pain)
- Usually caused over time
Fractures
- Common in children
- Treatment methods differ between children and adults
- Rare in infants, requiring investigation
- Distal forearm is the most common broken bone in childhood
Types of Fractures
- Simple/Closed: Does not break the skin
- Open/Compound: Fractured bone protrudes through the skin
- Complicated: Bone fragments damage other organs/tissues
- Comminuted: Small bone fragments separate from the fractured shaft and reside around the injury site
Fracture Lines
- Includes different types of fracture lines (visuals are provided in the slideshow)
- Plastic deformation
- Buckle
- Greenstick
- Complete
- Complete with periosteal hinge
Growth Plate Injuries
- The epiphyseal plate (growth plates) is the weakest point in long bones, and frequent trauma sites
- These injuries can affect future bone growth
- Treatments may involve surgical open reduction and internal fixation to prevent future issues
Bone Healing and Remodeling
- Bone healing in children is generally rapid
- Healing times:
- Neonatal: 2-3 weeks
- Early childhood: 4 weeks
- Later childhood: 6-8 weeks
- Adolescence: 8-12 weeks
Diagnosis and Management of Fractures
- Diagnostic approach includes radiographs and history taking, particularly when a young child refuses to walk or crawl
- Goals for management:
- Reduction and immobilization of the fracture
- Restoring function
- Preventing deformities
Assessment of Fractures: The Six Ps
- Pain: Location and intensity of pain
- Pallor: Paleness of the affected area
- Pulselessness: Absence of pulse in the injured area
- Paresthesia: Loss of sensation in the area distal to the fracture
- Paralysis: Loss of movement in the area distal to the fracture
- Pressure: Determining if there is excessive pressure on the area
Cast Care
- Elevate the casted extremity for the first day
- Monitor for swelling and discoloration of fingers or toes
- Assess movement and sensation of fingers or toes
- Do not allow the child to put anything inside the cast
- Consider using a cool hair dryer to manage itching
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Description
Explore the critical aspects of children experiencing musculoskeletal or articular dysfunction in this insightful chapter. Key topics include assessment of intracranial pressure, diagnostic data analysis, and management of family-centered care. Understand the implications of immobilization and types of soft-tissue injuries commonly encountered in pediatric patients.
