Chapter 29: The Child with Musculoskeletal or Articular Dysfunction ANS

The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe? (Select all that apply.)

Positive Ortolani click Unequal gluteal folds

A school nurse is conducting a staff in-service to other school nurses on idiopathic scoliosis. During which period of child development does idiopathic scoliosis become most noticeable?

Preadolescent growth spurt

The nurse uses the palms of the hands when handling a wet cast for which reason?

To avoid indenting the cast

Which is an appropriate nursing intervention when caring for a child in traction?

ssess for tightness, weakness, or contractures in uninvolved joints and muscles.

An adolescent with juvenile idiopathic arthritis (JIA) is prescribed abatacept (Orencia). Which should the nurse teach the adolescent regarding this medication? (Select all that apply.)

Avoid receiving live immunizations while taking the medication. Before beginning this medication, a tuberculin screening test will be done.

Which is a type of skin traction with legs in an extended position?

Buck extension

Which should cause a nurse to suspect that an infection has developed under a cast?

"Hot spots" felt on cast surface

A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement?

"We're glad there is a cure for this disorder."

The nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal instrumentation procedure. Which consideration should the nurse include?

A chest tube and urinary catheter may be required.

The nurse should monitor for which effect on the cardiovascular system when a child is immobilized?

Venous stasis

The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complication should the nurse monitor related to the child's immobilization status?

Venous stasis leading to thrombi or emboli formation

The nurse is caring for an adolescent with osteosarcoma being admitted to undergo chemotherapy. The adolescent had a right above-the-knee amputation 2 months ago and has been experiencing "phantom limb pain." Which prescribed medication is appropriate to administer to relieve phantom limb pain?

Amitriptyline (Elavil)

The nurse is caring for a preschool child immobilized by a spica cast. Which effect on metabolism should the nurse monitor on this child related to the immobilized status?

Decreased metabolic rate

The nurse is conducting a staff in-service on casts. Which is an advantage to using a fiberglass cast instead of a plaster of Paris cast?

Dries rapidly

The nurse is conducting teaching to parents of a 7-year-old child who fractured an arm and is being discharged with a cast. Which instruction should be included in the teaching?

Elevate casted arm when resting and when sitting up.

A neonate is born with bilateral mild talipes equinovarus (clubfoot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation?

Frequent, serial casting is tried first.

The nurse is taking care of an adolescent diagnosed with kyphosis. Which describes this condition?

Increased convex angulation in the curve of the thoracic spine

A school-age child is diagnosed with systemic lupus erythematosus (SLE). The nurse should plan to implement which interventions for this child? (Select all that apply.)

Instructions to avoid exposure to sunlight Teaching about body changes associated with SLE

An adolescent with a fractured femur is in Russell's traction. Surgical intervention to correct the fracture is scheduled for the morning. Nursing actions should include which action?

Maintaining continuous traction and checking position of traction frequently

A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate, immediate action by the school nurse is to:

apply ice.

Four-year-old David is placed in Buck extension traction for Legg-Calvé-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first?

Notify the practitioner of the changes noted.

Which can result from the bone demineralization associated with immobility?

Osteoporosis

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse is caring for a 12-year-old child with a left leg below the knee amputation (BKA). The child had the surgery 1 week ago. Which intervention should the nurse plan to implement for this child?

Encourage the child to use an overhead bed trapeze when repositioning.

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement?

Growth can be affected by this type of fracture.

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which should be included?

Return to clinic every 1 to 2 weeks.

Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

Russell

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome? (Select all that apply.)

Severe pain not relieved by analgesics Tingling of extremity Inability to move extremity

Which term is used to describe a type of fracture that does not produce a break in the skin?

Simple

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. Which should the nurse suggest to remove this material?

Soak in a bathtub.

The nurse is caring for a school-age child diagnosed with juvenile idiopathic arthritis (JIA). Which intervention should be a priority?

Teach the child and family correct administration of medications.

A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations should include which action?

Teaching the family the care and management of the corrective appliance