What are Neural Tube Defects? π§
Birth defects that affect the brain and spinal cord
What are the risk factors for Neural Tube Defects? π§
β’ Anti-seizure meds exposure
β’ Folate deficiency
β’ Maternal Diabetes
What is the minimum amount of folate a pregnant/expecting person should take? π«
400mcg
Explain an Encephalocele ππ«
Skull does not fuse in gestation
- protruding brain and membranes
Tx: Surgery πͺ
Explain Anencephaly πΆβπ«οΈ
Small/missing brain hemispheres
- upper end of neural tube fails to close in gestation
- incompatible with life π΄
Potential causes: Diabetes, Obesity, Opioid use, lack of folic acid βΌοΈ
Explain Spina Bifida
(broad definition)
Defect within the spinal column, causing disorders with the spinal cord
What are the 3 types of Spina Bifida?
- Occulta
- Meningocele
- Myelomeningocele
Explain Spina Bifida Occulta π
Sacral vertebrae don’t fully close
- spinal cord exposed under skin, causing a small patch of hair to grow over top
No s/s and typically does not cause any problems for pts β οΈ
Explain Spina Bifida Meningocele π₯
Meninges and spinal fluid herniate through vertebral defect
- occur anywhere on spine
- no neurological symptoms
Tx: Surgery πͺ
Explain Spina Bifida Myelomeningocele π
Spinal cord, meninges, and CSF herniate though open vertebral column β οΈ SEVERE β οΈ
S/s: paralysis, incontinence, hydrocephalus
Tx: Surgery (shunt) πͺ
What are Nursing Care and Considerations for pts with severe Spina Bifida? π
β’ Sensitivity to latex from frequent catheterizations
β’ Risks for skin breakdown r/t paralysis and incontinence
β’ Protect exposed sac from injury and infection
- cover with sterile saline dressing
Explain Duchenne Muscular Dystrophy π₯ π¦Ό
Progressive muscle deterioration due to lack to dystrophin (protein that strengthens muscles)
- affects males 3Y - 5Y
- cardiac and respiratory muscle failure leads to death π΄
S/s: progressive muscle weakness, Gower’s Sign π§ββοΈπ§ββοΈ
What are the medical managements for Duchenne Muscular Dystrophy? π₯ π¦Ό
Glucocorticoids - slow progression
Ca+ and Vitamin D supplements π¦΄
Cardiac Meds/Respiratory Therapy
NO CURE βΌοΈ
Explain Cerebral Palsy π¨βπ¦―
Injury of brain around time of birth
- impairs muscle control, coordination, and posture
S/s: motor impairment, scissoring gait, contractures, poor head control
How do Pediatric patient’s Musculoskeletal system differ from adults?
β’ Infant bone is bendy γ°οΈ
β’ Bones heal quicker
β’ Growth plates (Epiphysis) π§½
β’ Toddlers are bow-legged and walk on their toes π£
Explain the Epiphyses
(growth plates) π§½
β’ cartilage-y bone that grows and elongates with age π¦΄
β’ Vulnerable area
- injury can lead to deformity
List the types of Fractures: π₯π¦΄
- Transverse β
- Linear | ‘ |
- Oblique βοΈ
- Spiral π
- Greenstick π±
- Comminuted π
What is the Nursing Management and Care for Fractures? π₯π¦΄
Reduction and Immobilization π«
Prevent infection π¦
Cast Care:
- elevate first 48hrs
- wipe soiled cast w/ damp cloth
- blow dry with hairdryer on cool
β οΈCOMPARTMENT SYNDROME β οΈ
What are signs a cast is too tight or infected? π€
β’ cool extremities
β’ unable to move fingers/toes
β’ numbness + tingling
β’ foul smell π€’
β’ fever 101.5+
β’ skin edges are red/swollen
Explain Compartment Syndrome π’
Pressure buildup in muscle compartments obstructs circulation to extremity πͺ
- causes tissue necrosis
What are the 5 P’s to Compartment Syndrome? π’πͺ
- Pain βΌοΈ
- Pulselessness π
- Pallor π»
- Paresthesia π€
- Paralysis πΆ
Explain Osteomyelitis π¦ π¦΄
Infection of bone tissue
- wound infection enters bloodstream and invades bone
S/s: π WBC, CRP, and ESR
painful and swollen extremity, fever, decreased mobility
Tx: 4w - 6w ABX, central line
Explain Scoliosis π
Lateral curvature of the spine
- postural or structural cause
- noticed around 10Y, school exam
Tx: bracing, surgery, PT
Spinal fusion w/ pins
- log roll, prevent constipation
Explain Developmental Dysplasia of the Hip πΈ
Ball joint does not fit into the hip socket properly
S/s: shortened leg, asymmetrical gluteal folds
Causes: Breech, infant positioning
Tx: Pavlik harness then Spica cast
