Pediatric Musculoskeletal System - NUR2002 Study Notes

Objective 1: Examine the anatomy, physiology, pathophysiology, and screening of pediatric clients experiencing alterations in musculoskeletal function.
Objective 2: Examine the anatomy, physiology, pathophysiology, and screening of pediatric clients experiencing alterations in neuromuscular function.
Objective 3: Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and treatment of alterations in neuromuscular function in pediatric clients.
Objective 4: Describe the effect of alterations in neuromuscular function on pediatric clients’ overall health.
Objective 5: Explore the role of the nurse when caring for pediatric clients experiencing alterations in neuromuscular function.
Objective 6: Apply the nursing process using clinical judgment functions while providing care to pediatric clients experiencing alterations in neuromuscular function.

The musculoskeletal system includes:
- Skeletal system: Comprising bones, which provide structure, protection, and aid movement.
- Muscular system: Comprising muscles that contract and facilitate movement.
- Associated Structures: Tendons, ligaments, cartilage, and joints.
- Function: Essential role in movement and mobility, allowing for physical activity and physical development in children.

Definition: A dislocated elbow involves an injury where two bones come apart at the joint, often accompanied by a tear in a ligament.
Pathophysiology:
- More common in older children and adolescents, primarily due to sports and physical activities.
Risk Factors:
- Ehlers-Danlos syndrome: A disorder impacting connective tissues, increasing susceptibility to dislocations.
Treatments and Therapies:
- Ice and elevation for initial management.
- Immobilization and possible splinting.
- Manual manipulation to realign bones.
- Surgical correction may be required in severe cases.

Pathophysiology: Damaging of ligaments occurs due to excessive movements, typically seen in ankle and wrist injuries from sports activities.
Etiology:
- Tearing of a ligament from twisting motions or overstretching usually during sports.
Clinical Presentation:
- Discoloration or ecchymosis at the site of injury.
- Decreased movement, pain, swelling, and a tendency to limp or hold the injured area.
Lab Testing and Diagnostic Studies:
- X-ray, MRI, CT Scan, and neurovascular assessment to evaluate extent of injury.
Treatments and Therapies:
- PRICE (Protection, Rest, Ice, Compression, Elevation) or POLICE (Protection, Optimal Loading, Ice, Compression, Elevation) methods are standard approaches.
- Pain management strategies are crucial.
- Considerations of growth and development in pediatric clients must include education for parents/caregivers regarding overuse injuries.

Types of Fractures:
- Complicated, Buckle (Torus), Greenstick, Simple (Closed), and Compound (Open).
Pathophysiology:
- The physis: Critical area allowing for bone expansion, it is the weakest part of the bone, and damage may lead to further complications.
Etiology:
- Results from stress on bone over time, diseases that weaken bones, or trauma.
Treatments and Therapies:
- Treatment varies based on fracture type and severity, including:
- Reduction and immobilization (casts, splints, boots).
- Surgical interventions like external fixation or traction when necessary.
Complications:
- Potential issues include impaired circulation, nerve compression, compartment syndrome, physeal involvement, nonunion and malunion of fractures, infection, and pulmonary emboli.
Pain Assessment Tools: Applying age-appropriate pain assessment tools:
- FLACC scale for infants and young children.
- Wong-Baker FACES Pain Rating Scale for those who can use visual cues.
- Regular reassessment of pain to adjust pain management strategies as necessary.