Term
|
Definition
| Monitor VS, respiratory, I&O, observe bleeding, encourage deep breathing, administer pain meds |
|
|
Term
| Muscle Spasms are associated w/...... |
|
Definition
| Excessive everyday activities and sports |
|
|
Term
|
Definition
| Injury to muscle->inflammation->irritation to nerve endings-> MUSCLE SPASMS->additional pain->repetitive cycle |
|
|
Term
| CL. Man. of Muscle Spasms |
|
Definition
| Pain, palpable, tense, firm muscle mass, diminished ROM, limited ADLs or occupational activities. |
|
|
Term
| Pharmacologic Mgmt. of Muscle Spasms |
|
Definition
| Mild analgesics, NSAIDS, muscle relaxants |
|
|
Term
| Options for Mgmt. of Muscle Spasms |
|
Definition
| PT, heat/ice, exercise, massage, hydrotherapy, ultrasound, manipulation, bracing |
|
|
Term
| Fractures-Defiition of... |
|
Definition
| Break in structure of bone |
|
|
Term
|
Definition
| Type, communication, non-communication, anatomic location, stable, unstable, open, closed (communication with external environment) |
|
|
Term
|
Definition
| piece of periosteum is intact across fx; Transverse, spiral or greenstick |
|
|
Term
|
Definition
| bone grossly displaced during injury site of poor fixation; comminuted or oblique |
|
|
Term
|
Definition
| Immediate localized pain, decreased function, unable to use-decreased weight baring, guarding |
|
|
Term
|
Definition
| Immobilize - in position it was found |
|
|
Term
|
Definition
| hematoma, granulation tissue, callus formation, ossification, consolidation, remodeling |
|
|
Term
| Stage of healing fx: hematoma |
|
Definition
| Bleeding at fractured end of the bone-forming hematoma, blood changes from liquid to clot, occurs initial 72 hours after injury |
|
|
Term
| Stage of fx healing: granulation of tissue |
|
Definition
| Hematoma organizes into fibrous network->granulation of tissue produces basis for new bone substance Called OSTEOID during days 3-14 post injury |
|
|
Term
| Stage of fx healing: Callus formation |
|
Definition
| Osteoblasts invade, collagen strands lengthen, deposit of calcium, appears at the end of the 2nd week of injury; confirmed by x-ray |
|
|
Term
| Stages of Fx healing: Ossification |
|
Definition
| New bone is built up as osteoclasts destroy dead bone-occurs 3wks to 6m post injury and continues until fx is healed |
|
|
Term
| Stages of Fx healing: Consolidation |
|
Definition
| Callus continues to develop, distance b/t bone fragments diminishes and eventually closes. |
|
|
Term
| Final stage of Fx healing: Remodeling |
|
Definition
| excess callus is reabsorbed & trabecular bone is laid down. |
|
|
Term
| Factors that contribute to healing fx |
|
Definition
| Age, site, blood supply to area, immobilization, infection, hormones |
|
|
Term
|
Definition
| Healing of fx may not occur in expected time (delayed) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Healing time of fx's increases with age
***newborn healing 3 wks; adult-20 weeks |
|
|
Term
| Fractures & Electrical Stimulation |
|
Definition
| stimulate bone healing in nonunion or delayed union fxs=bone remodeling; 10-12 hours a day (while sleeping) |
|
|
Term
|
Definition
| realignment of bone fragments, immobilization to retain alignment, restore normal/near normal function of injured part. Nursing goals-healing w/no complications, satisfactory pain relief, max rehab |
|
|
Term
|
Definition
| nonsurgical manual realignment of bone fragments; performed under local anesthesia |
|
|
Term
|
Definition
| Correction of bone alignment through surgical incision; uses wires, screws; risk for infection increases, early ROM is indicated |
|
|
Term
| PURPOSE of Traction (a pulling force) |
|
Definition
| reduce muscle spasm, immobilize joint or body part, reduce fracture or dislocation, treat joint condition, provide immobilization to prevent soft tissue damage, expand joint space. |
|
|
Term
| Characteristics of a cast |
|
Definition
| temporary circumferential immobilzation, tx of closed reduction, patient performs many ADLs, sufficient immobilization for stability, encompass joints above and below fracture. |
|
|
Term
| External fixation indicators |
|
Definition
| simple fx (open/closed), complex fx with extensive soft tissue damage, correct bony defects, nonunion, malunion, or limb lengthening. This procedure can save limbs that would otherwise be amputated. Rods/screws on the outside |
|
|
Term
|
Definition
| infection (exudate, erythema, tenderness, pain- device may have to be removed) |
|
|
Term
|
Definition
| Many Drs. have their own; standard=1/2 strength normal peroxide with NS |
|
|
Term
| Internal fixation placement verification |
|
Definition
|
|
Term
| Fractures and Drug therapy |
|
Definition
| Pain meds r/t muscle spasms, edema, nerve injury following muscle injury can cause spasm, Muscle relaxants prescribed |
|
|
Term
|
Definition
| Drowsiness, HA, weakness, fatigue, blurred vision, stomach upset. |
|
|
Term
|
Definition
| Protein, vitamins (BCD), calcium, phosphorus, magnesium; three well balanced meals per day, fluids=2000-3000 ml/day (to maintain optimal bladder/bowel function), fluid + fiber prevent constipation |
|
|
Term
| Nutrition/bed riden w/body jacket or hip cast patient instruction |
|
Definition
| eating 6 small meals - do not overeat to avoid abdominal pressure or cramping |
|
|
Term
|
Definition
| assess for pain, neurovascular, limitations of movement, positioning and affected extremity, dressing/cast assessment, drainage (significant increase needs to be reported), drainage system patent |
|
|
Term
| FX classification according to communication with external environment |
|
Definition
|
|
Term
| What hurts when you Fx a bone? |
|
Definition
| Periosteum-Has more nerves than the bone itself |
|
|
Term
|
Definition
| Use until skeletal traction/surgery can be performed...48-72 hours |
|
|
Term
|
Definition
| Long term use, used to align injured bones/joints, treat joint contractures & congenital hip dysplasia |
|
|
Term
| Neurovascular assessment consists of what...? |
|
Definition
| Color, temperature, cap refill, peripheral pulses and edema |
|
|
Term
| Peripheral assessment is what....? |
|
Definition
| sensation, motor function, and pain |
|
|
Term
|
Definition
| Activity limitations post surgery, assurance of pain meds, skin prep by the nurse |
|
|
Term
|
Definition
| monitoring VS, frequent neuro checks of affected extremity, assess pain (movement/activity, turning, positioning, and extremity support can be r/t pain), signs of drainage/bleeding (a significant increase should be reported), if drain system - make sure patent & measure |
|
|
Term
| Other post-op complications |
|
Definition
R/T immobility-constipation-increase activity, increase fluids >2500 mls/day, increase high bulk rouphage (fruits and veggies).
If above doesn't work-warm water, stool softeners, laxatives or suppositories may be necessary.
ACID in urine-cranberry juice |
|
|
Term
| Fx and Cardiopulmonary system-Prolonged bed rest |
|
Definition
can cause orthostatic HTN, decreased lung expansion.
Allow ptnt to dangle legs over bed, perform transfers |
|
|
Term
|
Definition
| Keep dry, do not stick long objects b/t skin and cast-can cause skin breakdown, observe for rough edges, warm areas on cast=infection inside |
|
|
Term
|
Definition
| Complication of fx; too much stuff in compartment, something restricting like a cast or splint. Patient states pain feels "different" |
|
|
Term
| S/S of Compartment Syndrome |
|
Definition
| The 6 Ps-pallor, pulselessness, pain, paralysis, pressure, paresthesia |
|
|
Term
| LATE signs of Compartment Syndrome |
|
Definition
| Paralysis and pulselessness |
|
|
Term
| DONT'S OF Compartment Syndrome |
|
Definition
|
|
Term
| Treatment of Compartment Syndrome |
|
Definition
Remove splint, dress, call MD-its a 911
MD will do fashiotomy and leave open for decompression and fluid level to go down |
|
|
Term
| What is another complication of compartment syndrome-when there is muscle damage involved |
|
Definition
| Renal Failure---S/S=dark, reddish brown urine; will increase BUN/Creatinine levels = ATN (Acute tubuler nercrosis) |
|
|
Term
|
Definition
| Veins of lower extremities are highly susceptible to thrombus formation after fx |
|
|
Term
| TX of venous thrombosis-fx |
|
Definition
| wear compression stockings, use sequential compression devices, move the fingers/toes of affected extremity, perform ROM. Prophylactic anticoagulant drugs may be ordered. |
|
|
Term
|
Definition
| Long bones; ie. ribs, tibia, and pelvis |
|
|
Term
CL Man. of Fat Embolism Syndrome
12-72 hours post-surgery |
|
Definition
| chest pain, tachypnea, cyanosis, dyspnea, apprehension, tachycardia, PAO2, change in mental status, memory loss, restlessness, confusion, elevated temp, HA, PETECHIAE. Patient has feeling of impending disaster, skin color changes |
|
|
Term
|
Definition
| Prevention 1st-by immobilization, administration of O2, hydration, coughing/deep breathing, reposition as little as possible |
|
|
Term
| Common indicators for amputation |
|
Definition
| circulatory impairment, peripheral vascular disorder, traumatic injuries, malignant tumors, infection.....loss of sensation, inadequate circulation, pallor, local or systemic manifestations of sepsis. |
|
|
Term
|
Definition
| remove all the infected, pathologic or ischemic tissue and keep as much of the limb as possible |
|
|
Term
|
Definition
| Open, closed, disarticulation |
|
|
Term
|
Definition
| leaves a surface of the residual limb that is not covered by skin---left open to close later |
|
|
Term
|
Definition
| done to create weight-bearing residual limb; skin flap sutured posteriorly |
|
|
Term
| Disarticulation amputation |
|
Definition
| Amputation done through the joint |
|
|
Term
| Overall goal for ptnts with amputation |
|
Definition
| adequate relief from underlying health problem, satisfactory pain control, maximum rehab potential, cope with body image changes, satisfying lifestyle adjustments |
|
|
Term
| Care of prosthesis w/amputation |
|
Definition
| clean socket w/soap & water, keep leather/metal parts dry, consideration of shoe----badly worn may alter gait |
|
|
Term
|
Definition
| teaching re: prosthesis, mobility, & U arm strength |
|
|
Term
|
Definition
| Phantom limb sensation, prevent flexion contractures, limb care, prosthesis care & adjustements |
|
|
Term
|
Definition
| Pain at the limb even tho it was removed-pain is real...relieved by pain meds; usually resolves over time |
|
|
Term
| Positioning of residual limb |
|
Definition
| Lie flat, no pillows, avoid sitting in chair for more than 1 hour, lie on stomach for 30 min 3-4x/day, position hip in extension |
|
|
Term
|
Definition
| Bandaging helps shape the residual limb-use compression stocking or elastic bandage in figure 8. Wear all of the time xcept when receiving therapy & bathing. Once healed, bandage only worn when patient not wearing prosthesis |
|
|
Term
| Definition of Arthroplasty |
|
Definition
| reconstruction/replacement of a joint |
|
|
Term
|
Definition
| provides relief of pain, improves function to ptnts with RA & OA |
|
|
Term
| DONTS of hip arthroplasty |
|
Definition
| Internal rotation, adduction, 90 degree flexion - avoid for 4-6wks post-op |
|
|
Term
| Modifications for Hip surgery ptnt |
|
Definition
| No flexion past 90 degrees; raised toilet seat, foam abduction pillow b/t legs to prevent dislocation, chair alterations, no bath tubs or driving for 4-6 wks. Reachers-to avoid bending over, shoehorns-to put on shoes-no bending over, never cross legs, no twisting behind |
|
|
Term
|
Definition
|
|
Term
| Home care for hip replacement |
|
Definition
Manage pain, infection prevention, & DVT
Prophylactic antibiotics prior to dental work |
|
|
Term
|
Definition
| metal device inserted into the bone and attached to external rods to stabilize fx as it heals |
|
|
Term
|
Definition
| pins, plates, rods and metal screws surgically implanted at the time of realignment; placement verified by xray |
|
|
Term
|
Definition
| two parts, opening to fix and internal fixation |
|
|
Term
| HIP FX (occur within hip joint capsule---called intracapsular fx) |
|
Definition
| Associated with Osteoporosis and minor traumaCL |
|
|
Term
|
Definition
| External rotation, muscle spasms, shorting of the affected limb, severe pain/tenderness...could have avascular necrosis |
|
|
Term
| Preferred mgmt and method for intracapsular fx |
|
Definition
| Surgery--early mobilization and decreased risk of complications |
|
|
Term
Hip precautions - The DON'TS of HIP Prosthesis
R/T hip replacement |
|
Definition
| force hip >90 degrees (chairs/toilet seats), force abduction, adduction, internal rotation, cross legs, bend over to put shoes/socks on until 8wks post-op, |
|
|
Term
| The DO's of HIP Prosthesis |
|
Definition
| elevate toilet seat and chairs, place chair in shower and remain seated while washing, put pillow b/t legs when lying on "good" side, keep hip neutral when sitting, notify MD if pain, deformity or loss of fctn occurs, advise DDS for antibiotics b/4 dental work--- |
|
|
Term
| Hip precautions for how long |
|
Definition
| 6 weeks; must wait until capsule inside joint is healed |
|
|
Term
| Biggest complication of hip prosthesis post-op |
|
Definition
| Displacement of prosthesis |
|
|
Term
| S/S that prosthesis is dislocated |
|
Definition
| severe pain, limb becomes shorter, bump in buttocks, external rotation (looks like it did prior to surgery) |
|
|
Term
|
Definition
| lumbar strain, instability of lumbar region, osteoarthritis, , DJD and herniated disk. |
|
|
Term
|
Definition
| relief of pain, avoid constipation secondary to immobility and pain meds, learn correct posture, return to previous activity level |
|
|
Term
|
Definition
Acute-4 weeks or less
Chronic->3months |
|
|
Term
| Definition of Osteoporosis |
|
Definition
AKA-fragile bone disease
Bone resorption exceeds bone deposition |
|
|
Term
| Risk Factors for Osteoporosis |
|
Definition
| Female, age, family hx, white/asian, small stature, early menapause, sedentary lifestyle, low calcium intake, hx of anorexia |
|
|
Term
| Nursing Care/Osteoporosis |
|
Definition
| focus on nutrition, calcium supplementation, exercise, prevention of fxs, medications |
|
|
Term
|
Definition
| Bone loss w/o symptoms, weak bones leading to fxs with small trauma, collapsed vertebrae=height loss and spinal deformities |
|
|
Term
|
Definition
| inflammation of the joint |
|
|
Term
| Definition of Rheumatic disease |
|
Definition
| Involves bones, joints, and muscles |
|
|
Term
|
Definition
| most common form of joint disease, slowly progressive noninflammatory disease |
|
|
Term
|
Definition
| pain-worse when barometric pressure drops-gets cold, joint stiffness after rest, worse in morning; resolves after 30 minutes |
|
|
Term
| Joints affected by Osteoarthritis |
|
Definition
| lumbar, hips, knees, hands, and toes |
|
|
Term
| Care/management of Osteoarthritis |
|
Definition
| Manage pain/inflammation, prevent disability, maintain & improve joint function |
|
|
Term
| Facts about Rheumatoid Arthritis (RA) |
|
Definition
| Chronic, autoimune, inflammation of connective tissue, periods of remission and exacerbation, accompanied with extraarticular manifesttion |
|
|
Term
| 3 Types of genetic disorders |
|
Definition
Autosomal dominant
Autosomal recessive
X-linked recessive |
|
|
Term
|
Definition
| Stem cells can differentiate into other cells |
|
|
Term
|
Definition
|
|
Term
|
Definition
| involves B lymphocytes, produces antibodies, memory cells present, protection against virus (extracellular), bacteria, respiratory and gastro pathogens |
|
|
Term
| Examples of Humoral immunity |
|
Definition
| anaphylactic shock, atopic diseases, transfusion reaction, bacterial infections |
|
|
Term
|
Definition
| T-lymphocytes, macrophages, produces sensitized T-cells, memory cells present, protect agains fungus, intracellular viruses, chronic infectious agents, tumor cells |
|
|
Term
| Examples of cell mediated immunity |
|
Definition
| TB, fungal infections, contact dermatitis, graft rejection, destruction of cancer cells, rejection of transplant |
|
|
Term
| Organs of the Immune System |
|
Definition
| bone marrow, lymph nodes, spleen, thymus glands |
|
|
Term
| Immune responses serve 3 functions |
|
Definition
| Defense, homeostasis, surveillance |
|
|
Term
|
Definition
| Exposure to antigen results in production on antibodies |
|
|
Term
|
Definition
| Host is given the antibodies----ie. baby given antibodies through breastmilk |
|
|
Term
| Definition of Immunocompetence |
|
Definition
| When the bodies immune system is able to react to foreign bodies |
|
|
Term
|
Definition
| When the body over reacts - unable to turn reaction off; fails to recognize own protein and begins to fight itself |
|
|
Term
| 4 Types of Hypersensativity Reactions |
|
Definition
I.Immediate/Anapalactic
II. Cytotoxic/cytolytic Reaction
III.Immune complex reactions
IV.Cell mediated/delayed reactions |
|
|
Term
Type I: Immediate/anaphylactic
THE SHOCK |
|
Definition
IgE, reaction to foreign protein-pollen, food, drugs, wheal and flare-hives.
ANAPHYLACTIC-mediators released systemically. Life threatening w/i minutes, airway constriction, vascular collapse. No reaction first exposure. |
|
|
Term
Type II: Hypersensativity Reactions
Cytotoxic/Cytolytic Reactions |
|
Definition
| IgG or IgM; ABO and blood compatibility reactions...can result in kideney failure; make sure to monitor ptnt for 15 minutes after blood infusion started |
|
|
Term
Type III: Hypersensativity Reaction
Immune Complex Reaction-Autoimmune |
|
Definition
| IgM and IgG; antibodies deposit into blood vessels-leads to destruction/inflamtion of involved tissue. ie: systemic Lupus |
|
|
Term
Type IV: Hypersensativity Reaction
Delayed Hypersensitivity Reaction |
|
Definition
T-cell reaction; T-cells attack antigens and release cytokines.
ie: contact dermatitis and PPD |
|
|
Term
Allergic Disorders
TYPE I Hypersensativity-Nursing Assessment |
|
Definition
| Detailed HH, environment, meds, foods |
|
|
Term
|
Definition
| Redness, swelling, itching, hives,scratching, coughing, tongue feeling big |
|
|
Term
S/S Anaphylactic Shock-
Type I |
|
Definition
| Weak, rapid, pulse, crashing BP, U airway constriction, tachycardia, dilated pupils |
|
|
Term
|
Definition
Can be Type IV-delayed hypersensativity
Can be Type I-Immediate/anaphylatic shock |
|
|
Term
| Treating Anaphylactic Shock |
|
Definition
| RECOGNIZE IT, maintain airway, prevent spread (have a turnikit), administer drugs (epi), position supine and elevate legs (increases circulatory return) |
|
|
Term
|
Definition
| Identify allergen, support environmental changes, instruct on meds, treatment, therapies, allergy shots (always aspirate), |
|
|
Term
|
Definition
| PCN, Sulfa, iodine, latex, peanuts, eggs |
|
|
Term
Type III Hypersensativity: Autoimmuity
Response against itself; can not differentiate itself |
|
Definition
| SLE (Lupus), RA, and Glomerulonephritis |
|
|
Term
Factors relating to SLE
SLE is TYPE III Hypersensativty (autoimmune) |
|
Definition
| multi-system, affects skin, joints, renal, neuro, and hematologic, women more at risk, African Americans more at risk, chronic, unpredictable, exacerbations and remissions, genetic, birth control, stress, sun and infection |
|
|
Term
| Nursing DX for patient with SLE |
|
Definition
Always Risk for Infection
Why? Immune suppressed |
|
|
Term
S/S SLE
Type III Hypersensativity; Autoimmune |
|
Definition
| Butterfly rash on face, patchy hairloss, nasal ulcers, joint, treat pain, stiffness, arthritis, nephritis, swollen ankles=renal issues |
|
|
Term
RA
Type III: Hypersensativity-Autoimmune |
|
Definition
| Inflammation of connective tissue, external manifestations are lumps and bumps, occurs more in smokers, has exacerbations and remissions |
|
|
Term
|
Definition
| Treatment for RA, cant give to high risk patients with active infection; We are suppressing the immune system-so infections can be life threatening and patients can die |
|
|
Term
| Patients receiving Monoclonal Antibodies |
|
Definition
| Monitor VS prior and q30 min during infusion, 2 hours after, Type II Hypersensativity reaction |
|
|
Term
|
Definition
A procedure used to seperate out components of blood
Platelets, Leukocyts (WBC), plasma |
|
|
Term
|
Definition
| patient is at risk for infection, increased risk of malignancy-cant recognize disease, wear gloves when handling meds |
|
|
Term
| Primary immunodeficiency Disorders |
|
Definition
| Rare diseases, X-linked, hereditary |
|
|
Term
| Secondary Immunodeficiency disorders |
|
Definition
| secondary to meds like chemotherapy meds ad anti-rejection meds |
|
|
Term
| Nursing Care for the Immobolized Child |
|
Definition
| neuro check (6ps), color-pink, temp-warm, sensation-no n/t, motion, pain-use appropriate pain scale, pulse-strong or weak, cap refill <2sec, edema-elevate to reduce |
|
|
Term
| How to help child in pain |
|
Definition
| Use pillows for placement, proper pain management (pca, iv is best), alignment of traction |
|
|
Term
| Altered Skin integrity of a child |
|
Definition
| Chnge positions q2hrs, use eggcrate mattress or sheepskin on bed |
|
|
Term
| What are the risks for infection |
|
Definition
| cast care, pin care, wound care |
|
|
Term
| What type of nutrition for a child who has a fracture? |
|
Definition
| Protein---foods good for bone healing |
|
|
Term
| How to promote "normal" elimination |
|
Definition
| high fiber foods, increase fluids, use stool softners, privacy during use of bedpan |
|
|
Term
|
Definition
Intentional or accidental
Need to differentiate which type it is |
|
|
Term
| Abuse.....look like what type of injury |
|
Definition
Backside injury to child
Make sure stories are the same-child, parent, etc. |
|
|
Term
| Cl. Man of fractures in kids |
|
Definition
|
|
Term
| Confirm fx by using what...? |
|
Definition
|
|
Term
| Therapeutic mgmt of fracture in child |
|
Definition
| pain, immobolization (casting/splinting), and swelling (edema) |
|
|
Term
| Goals in the Management of Fracutures |
|
Definition
| Regain alignment and length, restore function, prevent further injury |
|
|
Term
| How to determine treatment for fx |
|
Definition
| age of patient, severity of fx, edema, condition of skin and soft tissue, sensation/circulation below injury |
|
|
Term
|
Definition
| Assess 6Ps, move as little as possible, cover with clean dressing, elevate if possible, apply ice (no longer than 20min), get to ER or call 911 |
|
|
Term
|
Definition
| circumferential devices going around affected limb, check for rough edges, keep dry, don't stick anything down them |
|
|
Term
| Nursing Concerns re: casts |
|
Definition
| Hot spots of the cast indicate infection, during first few hours monitor for edema, circulation and do neuro checks |
|
|
Term
| Hip Dysplasia (DDH) Etiology |
|
Definition
Cause is unknown, there are factors
Female, first born, family hx, feet first (breech birth) |
|
|
Term
|
Definition
| unequal folds of the buttocks and thighs, limited ROM, unequal knee heighth. Older kids-pelvis tilted forward on normal side rather than upward |
|
|
Term
| Diagnosis of DDH (Hip Dysplasia) |
|
Definition
3m or less-ultrasound
3m or older-xray (because of the bone ossification) |
|
|
Term
| Tx of DDH (hip dysplasia) |
|
Definition
Pavlik Harness3-5 months
Frog like position of the legs; keeps knees out, shoulder straps and leg braces; wears 24/7, checking straps often, teach parents how to apply-return demonstration, don't apply directly to skin |
|
|
Term
| Osteomyelitis-what is it and cause |
|
Definition
Infection of the bone
Most commonly caused from Staph infection |
|
|
Term
|
Definition
| infection introduced into bone, parents don't identify, usually lower extremeties-puncture wound, staph is introduced into blood stream, then to bone causing pain and the child discontinues using the limb. |
|
|
Term
|
Definition
| Fever, lack of use, heat, swelling over area of infection, tenderness of affected area, decreased ROM to joints of affected area |
|
|
Term
|
Definition
| Aggressive antibiotic tx-at least 4 weeks; clindimiacin or cephlosporin |
|
|
Term
|
Definition
|
|
Term
| Why do we treat Scoliosis? |
|
Definition
| Preserve pulmonary function |
|
|
Term
| At what age do we typically dx scoliosis |
|
Definition
| Around age 10---usually not evident before |
|
|
Term
|
Definition
Usually braced
If curvature <40%-brace is effective
If curvature >40% brace no so effective |
|
|
Term
|
Definition
| Must be worn most of the day, over clothes, type depends on nature of curve, age of child and underlying conditions |
|
|
Term
| Surgical Technique of Scoliosis |
|
Definition
| realign, straighten with internal fixation and instrumentation combined with bony fusion of the realigned spine |
|
|
Term
| Goals of surgery for Scoliosis |
|
Definition
| corrrect curve, provide solid, painfree fusion and well balanced torso, maximum mobility |
|
|
Term
|
Definition
Teaching is CRITICAL!!!
How to manae his/her own PCA, logroll, use and functions of other equipment used, bring favorite toy, laptop, cd player and meeting with a child who has gone through similar procedure |
|
|
Term
|
Definition
| Ambulate by 2nd-3rd day, access wound, VS, and circulation, neurologic assessment, pain (do meds IV), skin integrity, UO, fluids, respiratory, ilius (abdominal distention, decreased BS) NG tube for what? Decompression |
|
|
Term
| Most common post-op problems Spinal surgery |
|
Definition
| neurologic injury or spinal cord injury, HTN from acute blood loss, wound infection |
|
|
Term
|
Definition
| Lack of O2 during fetal development or shortly after birth |
|
|
Term
| Most common classification of CP |
|
Definition
| Spastic-may be bilateral or unilateral, poor control of posture, balance and coordination, not ongoing. Lots of times just muscular motor skills affected-no cognitive delay. Some can have both motor and cognitive delay |
|
|
Term
|
Definition
| Spasticity or uncontrolled movements, poor muscle tone, delayed developmental issues, gait disturbance, abnormal posturing, flat bones on the side of the head |
|
|
Term
| Associated problems with CP |
|
Definition
| Impaired gas x-change, orthopedic complications, visual, hearing loss, constipation, dental problems-caries, malocclusion or gingivitis |
|
|
Term
|
Definition
| Poor head control after 3m, stiff arms/legs, pushing away-arching back, clenched hands after 3m, seizures, sensory impairment, uses only one side of body |
|
|
Term
| Duchene Muscular Dystrophy (DMD) |
|
Definition
| Most common, x-linked inheritance-mom carries, boys get, ascending (progresses from bottom up) |
|
|
Term
|
Definition
| early onset b/t 3-5 yrs old, progressive muscle weakness and wasting, large calf muscles, loss of ambulation b/t 9-12 yrs of age, slow progressive weakness, progression until death from respiratory or cardiac failure |
|
|
Term
|
Definition
| Difficulties running, riding a bike, climbing stairs |
|
|
Term
|
Definition
| abnormal gain on level surface |
|
|
Term
|
Definition
| pelvic weakness, occassional mental deficiency, increased respiratory distress (affecting the diaphram and respiratory muscles) stands up by kneeling, walking hands up by the legs (gowers sign) |
|
|
Term
|
Definition
| Encourage exercise to prolong use of the wheelchair |
|
|
Term
|
Definition
most common childhood cancer
more boys than girls
Peak onset 2-6y/o
malignant disease of lymphatic system and bone marrow |
|
|
Term
|
Definition
| Different drugs for different stages of cell reproduction/growth |
|
|
Term
|
Definition
| Onset can be acute or incidious/very few symptoms |
|
|
Term
|
Definition
| minor infection that does not completely go away, pale, irritable, febrile, anorexic, weight loss, petechiae, bruising, bone and joint pain. |
|
|
Term
|
Definition
chemotherapeutic agents in four stages
Induction-a complete remission or clinical disapearance of leukemic cells
2. intensification or consolidation therapy-further decreases the total number of tumor burden
3. CNS prophylactic therapy-prevents leukemic cells from invading CNS
4.Maintainance of remission phase |
|
|
Term
|
Definition
| <5% blast cells in bone marrow |
|
|
Term
| ***ANC Absolute Neutrophil Count*** |
|
Definition
| Tells us exactly how many WBC the patient has to fight off the infection. You will figure this out on all of your patients. |
|
|
Term
| How to figure ANC***KNOW THIS |
|
Definition
WBC X % of neutrophils (bands)
If there are several %%%% (neutrophils and nonsegmented neutrophils)- add them together and then multiply. |
|
|
Term
|
Definition
| Patient is at risk for infection, dehydration, seizures, secondary infections |
|
|
Term
| A low platelet count can lead to..... |
|
Definition
|
|
Term
| Low uric acid in leukemia is .... |
|
Definition
| cell break down. normal uric acid = 2.5-5.5 |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Infection, hemorrhage, anemia, n/v, nutrition, ucosal ulcers, neurological problems, hair loss (alopecia), pain |
|
|
Term
Wilms Tumor
Nephroblastoma-Tumor on the kidney |
|
Definition
malignant neoplasm of the kidney
genetic, peaks around age 3 1/2, |
|
|
Term
|
Definition
| swelling or mass on the abdomen-firm, non-tender, confined on one side, anemia, HTN (because of the release of renin from kidney), metastisize to lungs---SOB, cough, pain in chest |
|
|
Term
|
Definition
| abdominal xray, MRI, CAT scan, bone marrow aspirate, hematological studies, urinalysis |
|
|
Term
| Tumor Classification/staging |
|
Definition
| Used to individualize a plan of care for the patient |
|
|
Term
Osteosarcoma
Osteogenic Sarcoma |
|
Definition
| Most common type of malignant bone tumor |
|
|
Term
|
Definition
|
|
Term
| Two sources of organ donation |
|
Definition
| Deceased (cadaveric); living donor |
|
|
Term
| Patient matched to donor based on..... |
|
Definition
| ABO blood and leukocyte antigen, medical urgeny, time on the waiting list, geographic location |
|
|
Term
|
Definition
| Cant be IV drug user, long standing DM, malignancy, HIV, Hep BorC, syphilis, TB |
|
|
Term
|
Definition
|
|
Term
| Definition of Direct donor |
|
Definition
| biologically related, unrelated-but some type of social relationship |
|
|
Term
| A Non-direct donor is..... |
|
Definition
| One who donates to anonymous candidate on the waiting list...ie. baby cord blood |
|
|
Term
| Types of stem cell transplants |
|
Definition
| marrow, peripheral blood stem cells and cord blood stem cells |
|
|
Term
|
Definition
| can be stored in tissue banks to be used at a later time...corneas, middle ear, skin, heart valves, bone, veins, cartilage, tendons & ligaments |
|
|
Term
| Test used to type for the antigens at all five loci (in transplantation) |
|
Definition
| PCR (polymerase chain reaction)a way to make many copies of DNA or RNA in just a few hours; artificial replication |
|
|
Term
| Compatibility of organs and tissue |
|
Definition
|
|
Term
|
Definition
| Human Leukocyte Antigen System; major method of determining compatibility of tissue/organs. Matches of 5 or 6 have better outomes than 4 or less |
|
|
Term
|
Definition
|
|
Term
Hyper-Acute rejection
**MASSIVE** sudden rejection |
|
Definition
| Antibody mediated rejection w/i minutes of transplant, rare, no tx; remove organ. |
|
|
Term
|
Definition
| Days to months after transplant, body recognizes organ and attacks, T-lymphocyte response, tx w/immunosuppressants (corticosteroids). VERY common |
|
|
Term
|
Definition
| Occurs months to years, not reversable, T & B cells, 2nd transplant may be required; commonly due to bronchiolitis obliterans |
|
|
Term
| Immunosuppressant Therapies |
|
Definition
| B careful with them, always monitor I&O, Bun/Crea; wear gloves when handling; risk for infection |
|
|
Term
| Success Rate- transplantation |
|
Definition
| Survival rates are better for those receiving from living donors than those from cadavers |
|
|
Term
| Indications for Kidney transplant-Most successful |
|
Definition
| HTN, kidney failure, diabetes |
|
|
Term
| Indications for heart transplant-2nd most common |
|
Definition
| cardiomyopathy, CHF (failed medical tx, myocarditis, congenital heart disease-birth defect |
|
|
Term
| Indications for lung transplant |
|
Definition
| cystic fibrosis, pulmonary HTN, pulmonary fibrosis, emphysema, pulmonary edema, sedetary lifestyle |
|
|
Term
| Liver transplant..indications for |
|
Definition
| birth defect of liver or bile duct, chronic liver infections-HEP, damage from alcohol or drugs, clots in liver. |
|
|
Term
|
Definition
| Jaundiced...gain weight and general weakness |
|
|
Term
| Nursing care of transplant patients |
|
Definition
| infection, monitor VS & report FEVER, give prophylacic antifungals & antivarals as ordered, instruct patient on infection prevention, avoid crowds, don't immunize w/live vaccines, take temp at same time everyday |
|
|
Term
|
Definition
| Increased WOB, SOB, increased O2 need, dyspnia on exertion, crackles, increased secretions |
|
|
Term
|
Definition
| decreased I&O, increased Bun/Crea. #s., swelling |
|
|
Term
|
Definition
| Jaundice, change in LOC, petechaie, bruising, fatigue, ascites, chandge in LFT |
|
|
Term
| Bone marrow transplants & blood stem cell |
|
Definition
| most commonly used to treat fluid tumors like lymphoma and leukemia |
|
|
Term
|
Definition
| Bone marrow harvested and frozen (from oneself) |
|
|
Term
|
Definition
| Receiving from a 3rd party--relative |
|
|
Term
|
Definition
|
|
Term
|
Definition
| no relationship to the recipient |
|
|
