PEDS EXAM IV

ITP commonly follows which disease process

After an infection

what might a teen girl with scoliosis complain of

"ill fitting clothing"

Cerebral Palsey---Interventions

STIMULATION PT (braces, walkers, bikes, standing devices) OT Speech therapy

Cerebral Palsey---S&S KNOW

Waddling gait Lordosis Frequent falling Abnormal motor performance Hyperactive reflexes stiff and ridged arms or legs

What are signs and symptoms of MD

Waddling gait lordosis frequent falling

ORIF (open reduction internal fixation)

surgical insertion of internal fixation devices, such as rods, wires, or PINS that help maintain alignment while healing occurs

Duchenne muscular dystrophy is an absence of what?

Dystrophin

Moderate to severe hemophilia

Go to the ED for replacement is ANY injury occurs

Most common thrombocytopenia of childhood

ITP

Duchenne Muscular Dystrophy---Cure

NONE help maintain muscle strength

Casts for a fracture

Plaster Spika --Pelvic and leg fractures

What is compartment syndrome?

Too much fascia in the bones, Painful Tx: Fasciotomy

Number one diagnostic test for Epiphyseal fracture

X-RAY

when is scoliosis most noticeable

during growth spirits

Torticollis

limited neck motion

what is the most common spinal deformity

scoliosis

Peek ages of juvenile idiopathic arthritis

1-3 and 8-10

Most common permanent physical disability in childhood

Cerebral Palsey

When should the brace for scoliosis (TLSO) be worn?

24/7

Hip Dysplasia---Teaching to parents

Do not move harness! Bad Bathe --DRY WELL Massage skin under straps to increase circulation Keep small toys away

Hemophilia--Teaching

Do not put the child in contact sports use protective devices!!

A child is placed in skeletal traction for treatment of a fractured femur. The nurse develops a plan of care and includes which intervention? 1. Ensure that all ropes are outside the pulleys. 2. Ensure that the weights are resting lightly on the floor. 3. Restrict diversional and play activities until the child is out of traction. 4. Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied

4- Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied

A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1. Administer an analgesic. 2. Release the skin traction. 3. Apply ice to the extremity. 4. Notify the health care provider (HCP).

4-Notify the health care provider (HCP).

how many CP patients have normal intelligence

50-80%

how many CP patients will be able to reach ambulation

85%

The potential physiologic and psychologic effects of prolonged immobilization on a 9-year-old child who has experienced significant trauma in a motor vehicle crash include which of the following? Select all that apply. A. Orthostatic intolerance B. Deep vein thrombosis C. Pressure ulcer formation D. Pneumonia E. Diarrhea F. Kidney stones G. Sense of euphoria and elation H. Constipation

A, B, C, D, F, H

When parents consider genetic testing, especially after having a child born with an anomaly, which information could the nurse use to further instruct the family? Select all that apply. A. Genetic screening can provide early recognition of a disease, before signs and symptoms occur, for which effective intervention and therapy exists. B. Screening can occur at different times in a person's life: preconceptual, newborn screening, or maternal screening after delivery, depending on the circumstances. C. Genetic testing can help identify carriers of a genetic disease for the purpose of maximizing parenthood planning options. D. A thorough history by the nurse will include the parents' siblings, the parents, and the grandparents. E. Recognizing a genetic disorder can further facilitate a genetic evaluation by collecting pregnancy, labor and delivery, perinatal, medical, and developmental histories.

A, B, C, E

Disordered eating patterns, which may be observed in the female athlete triad, may include which of the following? Select all that apply. A. Use of diet pills and laxatives B. Fasting C. Binge eating D. Restriction of certain foods E. Inadequate caloric intake F. Excessive vitamin consumption

A, B, D, E

Which of these statements accurately describe Duchenne muscular dystrophy? SATA A. The absence of dystrophin leads to muscular fiber degeneration B. DMD is inherited as an X-linked recessive trait C. Cognitive and intellectual impairment are rare in children with DMD D. Affected children have a waddling gait and lordosis and fall frequently E. Ambulation usually becomes impossible by 12 years of age, and affected children are confined to a wheelchair F. Affected children must be hospitalized when ambulation becomes impossible

A, B, D, E

When working with a child with a disability, one of the most important tasks is to promote normal development. The nurse has a role in promotion of meeting these developmental milestones. Which tasks related to development are most important to be aware of in hospitalization or illness of the child with a disability? SATA A. Nurses should work with the parents of a newborn to promote attachment in spite of the disability B. It is important that school-age children understand that this disruption of their daily activities and hospitalization should not be considered a type of punishment C. One of the more crucial effects of chronic illness or disability on preschoolers is the feeling of guilt that they "caused" the illness through an imagined or real misdeed D. Nurses should respond to the school-age child's questions in simple, direct manner E. Nurses can facilitate the adolescents striving for autonomy by allowing and encouraging the adolescents participation in medical decisions

A, C, D, E

Caring for a child with a developmental disability or chronic illness is best accomplished using a team approach. What are some ways the nurse can facilitate this teamwork? SATA A. Understanding as parents become knowledgeable about their child's special health needs, they frequently become experts in providing care. B. In the absence of the child's family during hospitalization, the nurse should take this opportunity to establish new routines to enhance the child's care C. Although the families of the child with a disability are well versed in the care of their child at home, it is unrealistic to ask parents to take part in the hospitalized care D. The best predictors of the well-being of children with special health needs include how well the child can function in the presence of the health care team E. The nurse's role is collaborating, informing, and encouraging an open relationship with the family while caring for the child in the hospital

A, E

Major goals for the therapeutic management of juvenile idiopathic arthritis include? A. Control pain; preserve joint function B. Prevent skin breakdown; relieve symptoms C. Minimize use of joint; achieve cure D. Reduce joint discomfort; regain proper alignment

A. Control pain; preserve joint function

You know that teaching is successful when the parent states that clubfoot is best treated when? A. Immediately after diagnosis, as close to birth as possible B. At about ages 9-12 months, just prior to walking C. At age 4-6 months D. After walking is established, 15-18 months

A. Immediately after diagnosis, as close to birth as possible

Which of the following can result from the bone deterioration associated with immobilization? A. Osteoporosis B. Urinary retention C. Pooling of blood D. Susceptibility to infection

A. Osteoporosis

The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of Vaso-occlusive crisis. Which prescriptions documented in the child's record should the nurse question? SATA A. Restrict fluids B. Position for comfort C. Avoid strain on painful joints D. Apply nasal O2 at 2L E. Provide a high-calorie, high-protein diet F. Give meperidine, 25 mg IV, Q4H PRN pain

A. Restrict fluids F. Give meperidine, 25 mg IV, Q4H PRN pain

Which of the following is the most common type of CP? A. Spastic B. Mixed type C. Ataxic D. Dyskinetic

A. Spastic

Hemophilia---S&S

Abnormal bleeding joint bleeding petechiae epistaxis

Hip Dysplasia---S&S

Abnormal gait, leg turns out, limited ROM POSITIVE Orolani test ("clunk")

A 2-day-old infant in the newborn nursery is diagnosed with developmental dysplasia of the hip, and treatment is started by the orthopedist. The nurse assists the parents by providing home care instructions that include: A. Return to the orthopedist's office in 2 weeks to remove the hip spica cast B. The infant's bilateral foot casts should be elevated on pillows as much as possible C. Remove the Pavlik harness once a day for no more than 2 hours and inspect skin D. Remove the Pavlik harness while the infant is awake to allow "tummy time"

B

When caring for a 4-year-old with a disability, the nurse notes that while encouraging the child to take part in his care, the mother constantly gives in to the child, allowing him to have his own way. What anticipatory guidance can the nurse give to promote normalization in this relationship? A. "Giving in" is not a detriment to the child when he or she has a disability and limitations B. Explain that when parents establish reasonable limits, children are likely to develop independence that is appropriate for their age and achievement equal to their limitations C. Advise the parent to wait to explain any procedure to the child until they are at the healthcare setting or just before the procedure to avoid unduly upsetting the child. D. Have the parent realize that it would be unfair to the siblings to expect similar rules to apply to all of the children in the family

B

The pediatric nurse may be in the unique position to talk with a family about further genetic evaluation of their child. Which assessment findings by the nurse may alert the nurse to this need? SATA A. Digestive difficulties, especially after 6 months of age. B. Skeletal abnormalities: limb abnormalities, asymmetry, hyper-extendible joints C. Recurrent infection or immunodeficiency: ear infections, pneumonia, poor healing of the umbilicus D. Urinary tract issues: recurrent infections, delay in toilet training E. Development and speech delays or loss of developmental milestones

B, C, E

You are discharging a patient with hemophilia. Which of the following responses by the parents indicate an understanding of this disorder? SATA A. "My child should remain active to decrease joint problems, and most children with hemophilia can participate in the same activities as peers" B. "Care should be taken to avoid bleeding of gums, and softening the toothbrush in warm water before brushing or using a sponge-tipped disposable toothbrush may be helpful" C. "Signs of internal bleeding should be recognized, such as a headache, slurred speech, loss of consciousness, and black, tarry stools D. "If there is bleeding in a joint, elevation, ice, and rest should help and may prevent the need for factor VIII replacement" E. "All of my son's teachers need to be aware of what to do if he gets a bloody nose"

B, C, E

children with disabilities or chronic illness and their families may have different methods of coping than those of healthy children. Often they have a resilience that is to be admired. Which of these statements reflect ways that they foster this resilience? SATA A. Protect the child from having to learn about his or her disability or illness on a repeated basis B. Develop relationships with other children and their families with similar circumstances to build support C. The parents set long-term goals to create a sense of hope. D. Focus on the child's strengths and encourage independence E. Accept that chronic illness is a part of living

B, D, E,

A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. The nurse provides instructions to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction? A. "The cast may feel warm as the cast dries". B. "I can use lotion or powder around the cast edges to relieve itching". C. "A small amount of white shoe polish can touch up a soiled white cast". D. "If the cast becomes wet, a blow drier set on cool setting may be used to dry the cast".

B. "I can use lotion or powder around the cast edges to relieve itching".

The nurse is instucting the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? A. Administer the iron at meal times B. Administer the iron through a straw C. Mix the iron with cereal to administer D. Add the iron to formula for every administration

B. Administer the iron through a straw

Which of the following is a physiologic effect of immobilization on children? A. Metabolic rate increases B. Circulatory stasis can lead to thrombus and embolus formation C. Venous return improves, since child is in supine position D. Bone calcium decreases, releasing less calcium in the body

B. Circulatory stasis can lead to thrombus and embolus formation

The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should be included on the list? SATA A. Use the fingertips to lift the cast while it is drying B. Keep small toys and sharp objects away from the cast C. Use a paddle ruler or another padded object to scratch the skin under the cast if it itches D. Place a heating pad on the lower end of the cast and over the fingers if the finders feel cool E. Elevate the extremity on pillows for the first 24-48 hours after casting to prevent swelling F. Contact the HCP if the child complains of numbness or tingling in the extremity

B. Keep small toys and sharp objects away from the cast E. Elevate the extremity on pillows for the first 24-48 hours after casting to prevent swelling F. Contact the HCP if the child complains of numbness or tingling in the extremity

What position is best for an infant whose head is rotated left but side bending to the right? A. Prone B. Left side lying C. Supine D. Right side lying

B. Left side lying

The primary risk factor for the development of cerebral palsy is: A. Maternal chorioamnioitis B. Premature birth C. Birth asphyxia D. Intraventricular hemorrhage

B. Premature birth

the nurse knows that a fracture to the right humerus epiphyseal plate will? A. Create difficulty, since the child is left handed B. Require different management to prevent bone growth complications C. Heal slowly, since this is the weakest part of the bone D. Necessitate complete immobilization of the shoulder for 6 weeks

B. Require different management to prevent bone growth complications

Hip Dysplasia---What is it?

Ball doesnt fit right in the socket!

What is a guaiac test?

Blood in the stool

Treatment of Scoliosis

Brace--> Surgery

As the nurse caring for a culturally diverse population, it is important to understand cultural health beliefs of families. This can best be accomplished by: a. Asking the parents how their extended families feel about their child's illness b. Exploring the use of alternative medicines and therapies c. Understanding the parents' perception of the seriousness or severity of the illness or disability, as well as concerns and worries they have about the condition d. Acknowledging that language constraints may make it necessary for the health care team to make some decisions

C

Following the sudden death of a 14-year-old seemingly healthy basketball player, his parents ask the school administration to install an automatic external defibrillator (AED) in a central area of the athletic center. The school nurse is asked to participate in a meeting with the parents in which the administrators insist such a device is not necessary. The school nurse advocates by providing which information about AEDs and children? A. An AED should be used only by health care persons trained in its use. B. An AED provides too much of an energy shock dose for children under 12 years of age. C. An AED can be effective in the resuscitation of a child or adolescent with a shockable rhythm. D. An AED is more commonly used in adults who have heart attacks than in children with undiagnosed heart conditions.

C

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The paretns ask the nurse if the child can perfrom range-of-motion exercises at this time. The nurse should make which response? A. "Avoid all exercise during painful periods" B. "Range-of-motion exercises must be performed every day". C. "Have the child perform simple isometric exercises during this time" D. " Administer additional pain medication before performing range-of-motion exercises"

C. "Have the child perform simple isometric exercises during this time"

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction? A. "I will encourage my child to perform prescribed exercises" B. "I will have my child wear soft fabric clothing under the brace" C. "I should apply lotion under the brace to prevent skin breakdown" D. "I should avoid the use of powerer because it will cake under the brace"

C. "I should apply lotion under the brace to prevent skin breakdown"

The parents of a child recently diagnosed with CP ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? A. An infectious disease of the CNS B. An inflammation of the brain as result of a viral illness C. A chronic disability characterized by impaired muscle movement and posture D. A congenital condition that results in moderate or severe intellectual disabilities

C. A chronic disability characterized by impaired muscle movement and posture

A child is admitted to the pediatric unit. The mother reports that the doctor says her son is anemic. What lab findings/manifestations would the nurse expect to see to confirm iron deficient anemia? A. Cyanosis, due to inadequate O2 sat of existing hemoglobin B. A decrease reticulocyte count C. A total iron-binding capacity (TIBC) that is elevated above the normal range D. Decreased BP changes, which are an early sign becuase of the compensatory mechanisms

C. A total iron-binding capacity (TIBC) that is elevated above the normal range

A 10-year-old with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? A. Injection of Factor X B. IV infusion of iron C. IV infusion of factor VIII D. IM injection of iron using Z-teack method

C. IV infusion of factor VIII

A child has sustained a closed fracture and has just had a cast applied to the affected arm. The child is complaining of intense pain. The nurse evaluates the limb, applies an ice bag, and administers an analgesic with little relief. Which problem may be causing this pain? A. Infection under the cast B. The anxiety of the child C. Impaired tissue perfusion D. The recent occurrence of the fracture

C. Impaired tissue perfusion

Which is the most accurate genetic explanation for a family with hemophilia? A. It is a Y-linked dominant disorder B. It is equally distributed among men and woman C. It is an X-linked recessive disorder D. It is an autosomal recessive disorder

C. It is an X-linked recessive disorder

The nurse us assisting the HCP examining a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the HCP to assess? A. Babinski's Sign B. The Moro Reflex C. Ortolani's Maneuver D. The palmar-plantar grasp

C. Ortolani's Maneuver

A 2 day old infant in the newborn nursery is diagnosed with developmental dysplasia of the hip and treatment is started by the orthopedist. The nurse assists the parents by providing home care instructions that include: A. Return to the orthopedist's office in 2 weeks to remove the hip spica cast B. The infant's bilateral foot casts should be elevated on pillows as much as possible C. Remove the Pavlik harness once a day for no more than 2 hours and inspect the skin D. Remove the Pavlik harness while the infant is awake to allow "tummy time"

C. Remove the Pavlik harness once a day for no more than 2 hours and inspect the skin

The most common approach to the treatment of clubfoot management is? A. Pavlik harness B. The latex fixation approach C. Serial cast D. Boston brace

C. Serial cast

The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child? A. Soccer B. Basketball C. Swimming D. Field Hockey

C. Swimming

Cerebral Palsey---Diagnosis

Can not diagnosis until 2 years of age MRI

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? A. Administer an antiemetic B. Increase the IV fluids C. Place the child in a Sims' position D. Notify the HCP

D. Notify the HCP

A 12-year-old who was in an ATV accident has a long-leg fiberglass cast on his left leg for a tibia-fibula fracture. He requests pain medication at 2 :00 am for pain he rates at a 10/10 on the Numeric Scale. The nurse brings the pain medication and notes that he has removed the pillows that kept his leg elevated. He complains of pain in the left foot, and she notes that there is 3+ edema in the exposed leg and foot and she is unable to slip a finger under the cast. The nurse's priority interventions in this situation should include: A. Administer the pain medication and elevate the child's leg on the pillows B. Elevate the leg on the pillows and follow up within 2 to 3 hours to see if the edema has decreased C. Let the child know he cannot have any additional pain medication until 6:00 am D. Notify the surgeon of the findings immediately

D. Notify the surgeon of the findings immediately

The nurse analyzes the lab results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? A. Platelet count B. Hematocrit Level C. Hemoglobin Level D. Partial thromboplastin time

D. Partial thromboplastin time

Parents of special needs children experience sorrow. This is characterized by: A. Lack of acceptance of child's limitations B. Periods of intense sorrow when experiencing anger and guilt C. Lack of available support to prevent sorrow D. Periods of intense sorrow at certain times of child's development

D. Periods of intense sorrow at certain times of child's development

Lab studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the lab results, knowing which result indicates this type of anemia? A. Elevated hemoglobin level B. Decrease reticulocyte count C. Elevated RBCs D. RBCs that are microcytic and hypochromic

D. RBCs that are microcytic and hypochromic

Clubfoot---What is it?

Deformity of the foot twisting

Cerebral Palsey

Disorder characterized by impaired movement and posture resulting from an abnormality in the extrapyramidal or pyramidal motor system

Most sever and most common Muscular Dystrophy in childhood

Duchenne Muscular Dystrophy

Duchenne Muscular Dystrophy---Diagnosis

Elevated CK Muscle biopsy EMG

iron deficient anemia--Interventions for an infant

Iron-fortified formula delay infroduction to cow milk

What are some post-op interventions for spinal fusion

LOG ROLL NEUROLOGIC STATUS PT 2 PERSON ASSIST-ONE BEHIND BACK AND ONE UNDER LEGS

Torticollis---Treatment

Lay on affected side (probably left) PT @ home---gentile stretching Surgery is PT does not work (12-18 months)

When it ITP dianogised

Majority less than 10 years (peek 1-5 years)

what do you give iron supplements with

Multivitamin or fruit juice (VITAMIN C INCREASES ABSORBTION) DO NOT GIVE WITH milk or antacid because they decrease absorbtion

The larges and most important single group of muscle diseases of childhood

Muscular Dystrophy

Post-op Fracture Interventions

Neurovascular checks Pressure ulcers Muscle loss skin breakdown kidney stones PE COMPARTMENT SYNDROME

How do you want to treat a disabled/immobilized child?

Normalizing!!! Promote Independence Mainstreaming Self-Care Let him/her pick out what they will be wearing or what their daily schedule will look like

Epiphyseal fracture---Treatment

ORIF (Open reduction internal fixation)

Kyphosis Causes

Osteoporosis, compound fracture, TB

Every newborn gets what kind of test? How is it measured

PKU Can be false positive Heel stick

Muscular Dystrophy---Interventions

PT, OT, ventilator support MAINTAIN INDEPENDENCE

Five P's of fracture assessment

Pain Pulse Pallor Paresthesia Paralysis

juvenile idiopathic arthritis---S&S

Pain stiffness swelling loss of function

iron deficient anemia---S&S

Pallor Weakness and fatigue Low hemoglobin and hematocrit RBC THAT ARE MICROCYTIC AND HYPOCHROMIC

Hip Dysplasia---Treatment

Pavlik harness! Worn for about 6-12 months 24/7

Fractures---Interventions

RICE

Hemophilia---Treatment

Replacement of the missing clotting factor Corticosteroids

Clubfoot---Interventions

SERIAL CAST Begin as soon as the child is born 8-12 Weeks----Cast needs to be refitted every week

juvenile idiopathic arthritis---Excerbation---what should the patient do?

Simple isometric exercises

juvenile idiopathic arthritis---Interventions

Sleep on soft/foam mattress

MOST common type of CP

Spasmic

Patients with MD should do what to preserve muscle strength?

Take frequent rest periods

Lordosis Causes

Trauma, Obesity

Cerebral Palsey--Cause

Traumatic Brain Injury

ITP--causes

Unknown

What to consider for an immobile child?

Who is at home, What are their Roles and who is the main Caregiver? Location of home finances

Diagnosis of Scoliosis

X-RAY!!!!!!!!!! Shoulders/hip may not be symmetrical

Duchenne Muscular Dystrophy ---Causes

X-linked Recessive trait (ALL GENETIC IN ORGIN)

Hemophilia is transmitted by

X-linked recessive disorder

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition? a. Limited ROM in the affected hip b. An apparent lengthened femur on the affected side c. Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed d. Symmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table.

a. Limited ROM in the affected hip

Which of the following explains why iron deficiency anemia is common during infancy? a. cow's milk is a poor source of iron b. Fetal iron stores are depleted by 1 month of age c. Iron cannot be stored during fetal development d. Dietary iron can not be started until 12 months of age

a. cow's milk is a poor source of iron

How do you want to talk to a disabled child

at their developmental age level

the best therapy for a joint injury for a child with moderate hemophilia is? a. Nonsteroidal antiinflammatory drugs (NSAIDS) b. Intravenous (IV) infusion of factor VII concentrates c. DDAVP (synthetic vasopressin) d. evaluation and application of ice to involved joint

b. Intravenous (IV) infusion of factor VII concentrates

What MD is seen in patients over 8 and affects proximal muscles of both pelvic and shoulder girdles? a. Becker b. Limb Girdle c. Duchenne d. Fasciocapulohumeral

b. Limb Girdle

Acute form of immune thrombocytopenia occurs most commonly after all except? a. after infection with HPV b. severe sunburn due to over exposure c. upper respiratory tract infections d. childhood diseases of measles, mumps, rubella, or chicken pox

b. severe sunburn due to over exposure

When/ how do you administer iron supplements

between meals through a straw

Number one reason school age children get injured

bicycles

What may a person with scoliosis be worried about

body image

Complicated

bone fragments have damaged other organs or tissues

Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? a. "Treatment needs to be started as soon as possible" b. "I realize my infant will require follow-up care until fully grown" c. " I need to bring my infant back to the clinic in 1 month for a new cast" d. "I need to come to the clinic every week with my infant for the casting"

c. " I need to bring my infant back to the clinic in 1 month for a new cast"

Number one broken bone in children

clavicle

Greenstick

compressed side of bone bends, but tension side of bone breaks, causing incomplete fracture

when will parents of a disabled child be most upset?

during times of developmental milestones

Duchenne Muscular Dystrophy--Prognosis

early onset: 3-5 years Loss of independence ambulation by 9-12 years of age (death in adolescence due to cardiac or respiratory failure) "Gower sign"--Difficulty in raising from a sitting position using hands on legs to rise

Three purposes of screening

early recognition carriers population data

Most common type of hemophilia

factor VIII (hemophilia A or classic hemophilia) and factor IX deficiency (hemophilia B or christmas disease)

Epiphyseal fracture

fracture of the growth plate weakest point of long bones

Compound/Open

fractured bone protrudes through the skin

juvenile idiopathic arthritis---consequences

growth retardation

Most prevalent nutritional disorder worldwide

iron deficient anemia

A patient with CP should do speech therapy to preserve

jaw movements and feedings

Clubfoot---more common in males or females?

males

How much is "too much" milk-----leading to iron deficient anemia

more than 24oz of cows milk per day Only breast milk after 6 months

If an infant has a broken bone and its not from abuse what may it be from

motor vehicle accident

Torticollis-----S&S

neck is in a flexed position mass on the sternocleidomastoid muscle

ITP--Diagnosis

no definitive test abnormal terniquete test bleeding time clot reaction time platelet level of <20,000

juvenile idiopathic arthritis----Dx testing

none

juvenile idiopathic arthritis---treatment

none

Hemophilia--Diagnosis

pTT Factor VII & IX test

support groups for parents of a disabled child

parent-to-parent

what is the ternique test? when is it used?

piachae developes after after a terniquate of BP cuff is put on Determines that someone may have ITP

Most common type of kyphosis

postural

Younger children heal ________________ than older children

quicker

iron deficient anemia---Causes

rapid growth excessive milk intake blood loss sever iron deficiency in mother fetal blood loss before delivery

Comminuted

small fragments of bone are broken from fractured shaft and lie in surrounding tissue

How do you want to discipline a disabled child

the same as the other children

Why might a patient with ITP have a sleenecotmy?

to preserve platelets

leading cause of death in children older than one

trauma

Baclofen pump

tube inserted into the spine to delivered anti-spasms drugs

CP affects what neurons

upper neuron dysfunction

Does clubfoot run in families

yes