Chapter 48: Musculoskeletal or Articular Dysfunction by mopac

The child with osteogenesis imperfecta has weak muscles and decreased muscle tone. Because of compression fractures of the spine, the child appears short.

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?

The primary method of treating osteomyelitis is: Intravenous antibiotic therapy. Osteomyelitis is an infection of the bone, most commonly caused by Staphylococcus aureus

Osteosarcoma is the most common bone cancer in children. Where are most of the primary tumor sites? Femur

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome

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

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 caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe Positive Ortolani sign Unequal gluteal folds

Elevate casted arm when resting and when sitting up.

The nurse uses the palms of the hands when handling a wet cast to: Avoid indenting the cast.

The peak incidence is between ages 10 and 25 years. More than half occur in the femur. After the femur, most of the remaining sites are the humerus, tibia, pelvis, jaw, and phalanges.

What is most descriptive of the therapeutic management of osteosarcoma? Treatment usually consists of surgery and chemotherapy.

Which term is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine? Kyphosis

When does idiopathic scoliosis become most noticeable During preadolescent growth spurt

What effect does immobilization have on the cardiovascular system? Venous stasis This can lead to pulmonary emboli or thrombi

Which condition can result from the bone demineralization associated with immobility? Osteoporosis

adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurse's approach should include: Answering questions with straightforward honesty.

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

An important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA) is to: Teach child and family the correct administration of medications.

Which statement is accurate concerning a child's musculoskeletal system and how it may be different from an adult's? Because soft tissues are resilient in children, dislocations and sprains are less common than in adults.

In addition to ice, the extremity should be rested, be elevated, and have compression applied

Which term is used to describe a type of fracture that does not produce a break in the skin? If a fracture does not produce a break in the skin, it is called a simple or closed fracture

Which interaction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy? Arrangements for tutoring and schoolwork

Discharge planning for the child with juvenile arthritis includes the need for: Routine ophthalmologic examinations to assess for visual problems.

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

Four-year-old David is placed in Buck's 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. the nurse do first?

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

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

Growth can be affected by this type of fracture.

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

What would cause a nurse to suspect that an infection has developed under a cast? "Hot spots" felt on cast surface

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

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. What should be included? Return to the clinic every 1 to 2 weeks.

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, the nurse should explain that: Frequent, serial casting is tried first.

Bone demineralization leads to a negative calcium balance, osteoporosis, pathologic fractures, extraosseous bone formation, and renal calculi.

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.

A clinic nurse is conducting a staff in-service for other clinic staff regarding the signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session

Abdominal mass Sore throat and ear pain Ecchymosis of conjunctiva

Notify the practitioner of the changes noted.

An appropriate nursing intervention when caring for a child in traction is to: Assess for tightness, weakness, or contractures in uninvolved joints and muscles.

When assessing the child with osteogenesis imperfecta, the nurse should expect to observe: Discolored teeth.

Children with osteogenesis imperfecta have incomplete development of bones, teeth, ligaments, and sclerae. Teeth are discolored because of abnormal enamel

Legg-Calvé-Perthes is a disease with an unknown etiology. A disturbance of circulation to the femoral capital epiphysis produces an ischemic aseptic necrosis of the femoral head

nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal instrumentation procedure. consideration that the nurse includes? Nasogastric intubation and urinary catheter may be required.

advantage to using a fiberglass cast instead of a plaster cast is that a fiberglass cast: Dries rapidly. A synthetic casting material dries in 5 to 30 minutes as compared with a plaster cast, which takes 10 to 72 hours to dry.

nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized.instructions should be included in the teaching?

When infants are seen for fractures, which nursing intervention is a priority? Assess for child abuse. Fractures in infants are often nonaccidental.

nursing intervention is appropriate to assess for neurovascular in a child who fell off the monkey bars at school and hurt his arm? skin color, temperature, movement, sensation, and capillary refill of the extremity.

The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complications should the nurse monitor?Decreased metabolic rate

with slowing of all systems and a decreased food intake, leads to hypercalcemia, and causes a negative nitrogen balance secondary to muscle atrophy. A decreased production of stress hormones occurs