musculoskeletal

A parent calls the clinic nurse to say the child has shin splints after playing soccer. What instructions should the nurse provide this parent?

"Applying ice to the area will reduce the pain and swelling."

The nurse is speaking with the parents of a child who has a cast. The parents state that the child reports itching in the area of the cast. What is the best response by the nurse?

"Blowing cool air with a fan or hair dryer may relieve the feeling."

A nurse is assisting the parents of a child who requires a Pavlik harness. The parents are apprehensive about how to care for their baby. The nurse should stress which teaching point?

"It is important that the harness be worn continuously."

An adolescent with scoliosis is refusing to wear the prescribed body brace. Which instruction is best to progress the adolescent to the treatment goals?

"It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms."

The nurse has cared for a family of two boys with a progressive form of muscular dystrophy. The oldest boy died three years ago from complications of his condition at the age of 15. The younger boy is now 14. He confides to the nurse that he is becoming depressed and scared as he approaches the same age that his brother died. How should the nurse address the boy's concerns?

"Let's look at your health and how it differs from your brother's."

A nurse is providing instructions for home cast care. Which response by the parent indicates a need for further teaching?

"Pale, cool, or blue skin coloration is to be expected."

The nurse is speaking with a parent of a child diagnosed with scoliosis. The parent states, "I hate to think about my child having to wear a huge brace to treat this disorder. My best friend growing up had to wear one and she hated it." What is the best response by the nurse?

"The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be."

The nurse is caring for an infant girl in an outpatient setting. The infant has just been diagnosed with developmental dysplasia of the hip (DDH). The mother is very upset about the diagnosis and blames herself for her daughter's condition. Which response best addresses the mother's concerns?

"This is not your fault and we will help you with her care and treatment."

A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction?

"When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."

The nurse is caring for a 10-year-old boy who plays on two soccer teams. He practices four days a week and his team travels to tournaments once a month. He has been diagnosed with a stress fracture in one of his vertebrae. Which instruction is most important to emphasize to the boy and his parents?

"You and your coaches need to understand that you cannot play soccer for at least six weeks."

A nurse is conducting an in-service program for a group of pediatric nurses about pediatric rehabilitation and habilitation. When describing the differences between pediatric and adult services, which of the following would the nurse identify as the primary difference?

Adults have reached a level of physical and mental maturity.

A nurse is performing a physical assessment of the musculoskeletal system of Manuel, a 31/2-year-old. Which assessment technique would be most appropriate for this child?

Assess Manuel while he sits in his parent's lap.

The nurse is caring for a child with a fractured femur in traction. Which action will the nurse complete while caring for this client?

Ensure traction weights are hanging freely, not touching the bed or floor.

The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in performing which action with this child?

Handling the cast with open palms when moving the arm.

The student nurse is developing a care plan for a child who suffered a fractured tibia and will have a cast on his lower leg for approximately 6 weeks. Which nursing diagnosis would be the priority for this client?

Impaired physical mobility related to a cast on the leg

The school nurse is doing a presentation to a group of caregivers of children diagnosed with scoliosis. One of the caregivers asks the nurse about structural scoliosis. Which condition is involved with the diagnosis of structural scoliosis?

Rotated and malformed vertebrae

The young boy has fractured his left leg and has had a cast applied. The nurse educates the boy and his parents prior to discharge from the hospital. The parents should call the physician when which incidents occur? Select all that apply.

The boy's toes are light blue and very swollen. The boy has had a fever of greater than 102° F (38.9°C) for the last 36 hours. New drainage is seeping out from under the cast.

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease (LCPD). What is the most important nursing intervention for the nurse to include in working with this child and his caregivers?

The nurse should help the caregivers to understand and help the child to effectively use the corrective devices.

A 14-year-old adolescent is suspected of having scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note?

The posterior spine when bending forward

A 14-year-old male is brought to the ER by his parents with a suspected fracture of the arm sustained while playing soccer. An x-ray shows a comminuted fracture. Which of the following best describes this type of fracture?

There are three or more fracture fragments.

The nurse is caring for an 8-month-old infant in Bryant traction for developmental dysplasia of the hip (DDH) and is monitoring for complications. Which assessment finding most concerns the nurse?

a weak pedal pulse

The nurse is assessing a child and notes S-shaped curvature of the spine. What terminology would the nurse use when documenting this assessment finding?

idiopathic scoliosis

In understanding the function of the musculoskeletal system, the nurse recognizes that which of the following allows for movement of the body parts?

joints

The nurse is caring for a child who had a cast on his lower leg placed two hours ago. When assessing the child's foot, the nurse notes that the toes are cool and the child reports extreme pain. What is the best action by the nurse?

notify the health care provider of the findings immediately

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is:

skeletal traction

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

spica cast

A child is admitted to the pediatric unit with osteomyelitis. The child is to be placed on antibiotics. The nurse expects antibiotic coverage to include which of the following as the most common cause of osteomyelitis?

staphylococcus aureus

An adolescent wears a body brace for scoliosis. Which client education should the nurse provide?

to continue with age-appropriate activities

After teaching a group of nursing students about osteogenesis imperfecta (OI), the instructor determines that the teaching was successful when the group identifies which type as the most common?

type I

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which situation?

A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.

The mother of a child who has sustained a fractured leg is worried how long her child will be unable to walk without crutches. The nurse would explain to the mother that the child should be walking independently soon due to what reason?

children's bones heal faster than adults

The type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this?

greenstick

The nurse is caring for a child who has just received a cast for a broken wrist. Why should the nurse elevate the limb onto a pillow?

to prevent edema

A nurse caring for a child wearing a brace to correct scoliosis provides client and family teaching for home care of the brace. Which of these are accurate interventions for this situation? Select all that apply.

Avoid sitting in one position for long periods of time. Tell the client to loosen the brace during meals if necessary. Wear a 100%-cotton T-shirt under the brace to absorb moisture

The nurse is doing neurovascular checks on a child who has had a cast applied to treat a fracture. The nurse observes for diminished or absent sensation and numbness or tingling. In doing this the nurse is monitoring for which symptom?

paresthesia

A nurse caring for a patient with slipped capital femoral epiphysis (SCFE) notes that the condition is classified as an acute slip, Grade II. Which of the following describes this stage of SCFE?

The femoral neck is displaced from the femoral head by up to one third.

A physician orders a Pavlik harness for an infant with developmental dysplasia of the hip. When applying this brace, the nurse would integrate knowledge of which of the following?

The hip flexion should be set at 100 to 110 degrees and the abduction should be set at 50 to 70 degrees.

An adolescent girl has spinal instrumentation surgery at 16 years of age. Immediately after this procedure, the nurse would teach her to:

wait to be log rolled from one side to the other

In understanding the development of the musculoskeletal system, the nurse recognizes that what is implanted in a gel-like substance during fetal life?

cartilage

The nurse is working with a group of caregivers of school-aged children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be:

complete