Insertion site with antibiotic ointment if ordered

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insertion site with antibiotic ointment (if ordered) Assess color, warmth, pulses, capillary refill, movement, and sensation Congenital Club Foot A congenital abnormality in which the foot is twisted out of its normal position, midfoot is directed downward (equinus), hindfoot turns inward (varus), and forefoot curls toward the heel, and occurs more often in boys than girls. True clubfoot cannot be moved due to fusion. Tx: serial casting ASAP after birth before ossification begins, cast changed every week Congenital Hip Dysplasia Displacement of the hipbone from its normal articulation with the joint: femoral head & acetabulum are improperly aligned with an unstable connection. Dx: positive Ortolani-Barlow maneuver (open hips & feel crack and when moved in circle feel grinding) Tx: casting (Pavlik harness <6 months, spica cast >6 months), Bryant’s traction Legg-Calve-Perthes Disease Self-limiting avascular necrosis (femur intact but avascular) of the femoral head between 2-12 years, blood supply interrupted to femoral epiphysis, dead bone is reabsorbed & new bone grows (revascularization), bone heals & remodels. May be caused by femoral head getting signal that chronological & bone age are mismatched so it automatically disintegrates & body tries to rebuild. S+S: mild pain in hip, limp then motion becomes limited as disease progresses Tx: Buck’s traction to inititally immobilize, once adduction is achieved cast, braces Spinal Curvatures Kyphosis- increased convex angulations of thoracic spin (hump back) Lordosis- accentuation of the cervical or lumbar curvature beyond normal limits (cheerleader pose or sway back) Scoliosis- lateral S or C curvature of the spine, is congenital, idiopathic, or associated with another disease, and has minimal pain unless severe. To assess look at shoulder height, if there are uneven hip bones, rib humps, or trunk asymmetry. Tx: exercise, turtle shell brace worn 23 hours/day, surgery if >30-40% curve
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Osteogenesis Imperfecta “Brittle bone disease” is a connective tissue disorder that primarily affects bones & makes them fragile. Biochemical defect in production of collagen, and is genetically transmitted. Safety is key in care planning, and diagnosis may come after CPS investigates child abuse case. S+S: blue sclera, thin soft skin, increased joint flexibility, weak muscles, hearing loss, brittle bones & short stature, frequent fractures Tx: supplements of vitamin D and calcium for bone healing Juvenile Rheumatoid Arthritis Chronic autoimmune inflammatory disease characterized by joint inflammation lasting >6weeks, diagnosed prior to 16 years old, and without any known cause. Results in decreased mobility, pain, & swelling. About 70% of children enter remission that may last for months or years S+S: fever, rash, swelling & pain in hands and feet, stiffness, loss of motion, favor one extremity, increased sedimentation rate, antinuclear antibody tests are positive Tx: aspirin therapy, corticosteroids, occupational & physical therapy Muscular dystrophy Inherited progressive diseases characterized by muscle fiber degeneration & muscle wasting. Necrosis
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  • Winter '19
  • Melissa DuVall

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