1. NAME______________________ Musculoskeletal Case Study due in class on entry.
Musculoskeletal Case Study in Preparation for class is required an worth two points.
Think why on these select all questions and give rationales.
You may be called on in class
Two points is for completion on time, class presence and class participation.

2. Presents with pain in lower back down leg
All the following are true of idiopathic scoliosis: (Select all) Give rationales.
Presents with pain in lower back down leg
A curve needs to be at least than 5 degrees for diagnosis.
Scoliosis is characterized by a lateral curvature and spinal rotation
Bracing is a curative treatment if the brace is left on 23 hours a day
There is a genetic tendency towards scoliosis
The Cobb Technique is used to determine skeletal maturity.
7. The Risser scale determines the skeletal maturity

3. Presents with what physical signs and symptoms?
Scoliosis:
Presents with what physical signs and symptoms?

4. The curve to diagnose scoliosis is ? degrees
What degree of curvature requires a brace?
What degree of curvature requires surgery?
Besides wearing the brace 23 hours a day what else should the family be taught about the brace worn for scoliosis?
Teach about Skin Care?
Application of the brace and what to wear under?
Chances of cure with a brace?

5. What is the Cobb Technique? the Risser scale?
Describe how a child is screened for scoliosis with the cobb technique?
Describe the Risser scale.

6. What degree of curvature requires surgery?
What is a spinal fusion?
The following are true about spinal fusion surgery. (Select all)
Used for curvature greater than 45 degrees.
Is usually performed on young children
The nurse needs to assess skin for pressure areas.
The nurse needs to log roll the patient.
The patient may not ambulate to the bathroom.
Explain procedures in simple terms.

7. Other care post op spinal fusion includes:

8. List 5 things true about club feet. Include family teaching.
Breathing Difficulties
2. Low self esteem
3. Constipation
4. Infection

9. 2. IV antibiotics will be needed for weeks
The following are true about osteomyelitis: Select all: (Give Rationales)
1. The patient will not move the extremity.
2. IV antibiotics will be needed for weeks
3. Pain medicine will be needed.
4. Infection is often in the long bones.
5. A Joint or bone biopsy may be needed
6. Irritability, pain, tenderness, fever, tachycardia
7. May be endogenous or exogenous.

10. The following are true about cast application are: Select all: (Give rationales)
1. Plaster casts are very warm, heavy and not water resistant and dry in 10 to72 hours.
2. The cast may be elevated above the heart to prevent swelling in the first twenty four hours.
3. A hair dryer may be used to dry the cast.
4. Avoid turning the patient until the cast dries.
5. Turn the patient every two hours with palms of hands.
6. Teach that a q tip may be used for itching.

11. The following are true about Legg-Calve-Perthes Disease: Select all and give rationale
1. This is a dislocation of the femoral head
2. This is diagnosed by x-rays of hip and pelvis
3. Symptoms may be intermittent painless limp, thigh pain, shortening of the affected leg, muscle wasting
4. This disease usually affects adolescents, with risk factors of trauma and coagulation defects.
6. Casts, abduction braces or traction may be used for treatment
7. The surgical intervention is hip joint replacement or resurfacing.

12. Remove the boots once a day for a bath.
A nurse is caring for a child with Russell Traction. Which of the following are appropriate actions for the nurse to take? Select all: (Give rationales)
Remove the boots once a day for a bath.
Assess the child’s position frequently
3. Assess pin sites every 4 hours.
4. Ensure the weights are hanging freely
5. Ensure the buttocks is raised off the bed.