notes_ms - Notes Musculoskeletal System Disorders

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Notes Musculoskeletal System Disorders I.  Pediatric differences in the musculoskeletal system compared  with the adult: a. The musculoskeletal system has remarkable resiliency in childhood. b. Due to the growth process, the pediatric musculoskeletal system is  prey to complications.   I. Talipes Equinovarus (Clubfoot): Definition: Clubfoot is a congenital malformation of the lower extremity that affects the lower leg, ankle,  and foot.  Etiology and Pathophysiology: The cause of Talipes Equinovarus is unknown there is some indication that the anomaly is  related to genetic disposition or multiple factors.  Adduction and supination of forefoot with an inversion (varus) of the heel and fixed plantar  flexion.   The risk of occurrence increases with certain neuromuscular disorders particularly  myelomeningocele.  Occurs most often in males (2:1 ratio) Assessment: Clubfoot is readily apparent on clinical examination of the newborn. The deformity is
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fixed and can’t be manipulated. Diagnostic tests: X-ray  Ultrasound, CT and MRI Therapeutic Interventions and Nursing Care: The immediate need of the neonate identified with clubfoot is realignment of the extremity to  reduce long-term complications and deformity. Clubfoot requires long-term treatment to prevent  recurrence.  Medical Intervention-  o Serial manipulation  o Corrective casting  - cast changes every 3-14 days o Dennis-Broune splints may be used.  Horizontal bar attached to  foot plates Surgical Intervention- Surgical manipulation with corrective casting Nursing Interventions:  Nursing interventions for the pediatric patient with clubfoot focus on early identification and  correction of the displacement through careful assessment and referral from initial newborn  assessment throughout the developmental years of the young child.  Care of casts Regular check-ups important Prognosis good.  Full explanation to parents ROM once cast removed Evaluation: Discuss methods of evaluating effectiveness of nursing interventions. Create a plan for adapting  nursing interventions to meet the individual needs of pediatric patients and their families as they 
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undergo treatment for congenital clubfoots.   Newborn Toddler Older child II.  Congenital Dislocation of the Hip: Definition:  Congenital dislocation of the hip, also know as, developmental dysplasia of the hip, is a  condition where the head of the femur is improperly seated in the acetabulum of the pelvis.  Etiology and Pathophysiology: Congenital dislocation, or malrotation of the hip at birth occurs in about 3/1000 births. The  etiology is unknown however, genetic factors and pre-and postnatal positioning may influence 
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notes_ms - Notes Musculoskeletal System Disorders

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