NUR 232 Week 5 Student View
Mobility
Concepts: Mobility and its importance in pediatric care.
Key Areas: Safety and glucose regulation.
Types of Injuries
Traumatic Injury: Can vary in severity and treatment needs.
Sports Injury: Often occurs in active children, requiring assessment and management.
Casting: Educate on traction and casting methods.
GED VADER: Context not specified, further clarification needed.
Fractures Overview
Resistance of Bone: Fractures depend on bone strength against stress.
Demographics: More common in children and older adults.
Multiple Fractures:
Consider conditions like osteogenesis imperfecta (OI).
Rule out non-accidental trauma.
Healing in Children: Rapid healing due to thick periosteum and blood supply.
Types of Fractures
Transverse: Crosswise at right angles to long axis.
Oblique: Slanting, straight between horizontal and perpendicular.
Spiral: Circular; twists around the bone shaft.
Simple/Closed: No skin break.
Compound/Open: Bone protrudes through skin.
Complicated: Fragments damage other organs/tissues.
Comminuted: Small fragments lie in surrounding tissue.
Cast Types
Casts: Used for immobilizing fractures.
Long leg cast (LLC).
Short leg cast (SLC).
Full spica cast.
Single spica arm cast (SAC).
Long arm cast (LAC).
Cast Materials
Plaster of Paris: Takes 10-72 hours to dry, smooth but heavy.
Synthetic Materials: Lighter, water-resistant, quicker drying (5-20 minutes).
Fiberglass and polyurethane resin.
Cast Care
Wet plaster casts need support to avoid indentations.
Dry casts sound hollow when tapped.
Monitor for swelling, discoloration, and signs of infection.
Traction Purposes
Primary Purposes:
Fatigue muscles to reduce spasms for realignment.
Align bone ends.
Immobilize fracture sites for healing.
Prevent/improve contracture.
Immobilize body areas.
Rarely reduce muscle spasms in children.
Clinical Manifestations of Fractures
Signs of Injury: Swelling, pain, deformity, reduced limb use.
Symptoms: Bruising, rigidity, crepitus, grating sensation.
Compartment Syndrome
Definition: Serious condition causing compressed nerves and blood vessels.
Risks: Can lead to tissue death; requires emergency fasciotomy.
Symptoms: Pain, pulselessness, pallor, paresthesia, paralysis, pressure.
Mobility Assessment
Components: History, examination, and diagnostic tests vital.
Mobility Management Strategies
Prevention: Regular physical activity, nutrition, ideal body weight, adequate rest.
Consequences of Immobility
Systems Affected:
Cardiovascular: Reduced capacity, venous stasis.
Respiratory: Poor lung expansion, risk of atelectasis.
Musculoskeletal: Atrophy, contractures, demineralization.
Integumentary: Skin breakdown.
Gastrointestinal: Reduced motility.
Urinary: Calculi and infection risks.
Safety Concerns
General Measures: Infection control and safety promotion critical in childcare.
Transporting Children: Guidelines depend on age, condition, and safety.
Best practice: Car seat safety, ensuring the right positioning.
Toys Safety Guidelines
Criteria: Age-appropriate, washable, unbreakable, size suitable to prevent choking.
Avoid items with removable parts for younger children.
Safety in Hospital Settings
Assess fall risks in children, especially with altered mental status or mobility.
Regular monitoring needed for children during transportation within the hospital.
Glucose Regulation: Overview
Categories:
Hypoglycemia: BG < 70 mg/dL.
Euglycemia: Normal BG 70-140 mg/dL.
Hyperglycemia: BG > 140 mg/dL post-prandial.
Signs and Symptoms of Glucose Abnormalities
Hypoglycemia: Weakness, irritability, seizures, hunger.
Hyperglycemia: Polyuria, dehydration, fruity breath, fatigue.
Diabetes Types Overview
Type 1: Common in non-Hispanic white children, autoimmune origins, abrupt onset.
Type 2: Gradual onset, linked to obesity and insulin resistance; significant family history.
Long-Term Diabetes Complications
Poor glycemic control leads to nephropathy, retinopathy, neuropathy.
Regular screening required to monitor these complications.
Developmental Considerations in Diabetes Management
Challenges vary by age group:
Infants: Hypoglycemic risks higher because of developing brain.
Toddlers: Food refusal, tantrum management.
School-aged: Need for supervision and support.
Adolescents: Balancing peer acceptance and self-management.
Insulin Requirements
Changes during growth; influenced by activity and health issues.
Adjustments required during illness to prevent hyperglycemia.
Nutrition and Exercise in Diabetes
Nutritional needs similar to non-diabetic children;
Regular meals according to insulin peaks.
Exercise encouraged; adjustments for unplanned activity are critical.