CPEN Orthopedic and Musculoskeletal Emergencies Flashcards
6 cards from real CPEN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CPEN Orthopedic and Musculoskeletal Emergencies flashcards as text
A child with a long bone fracture develops increasing pain, paresthesias, and a tense extremity 6 hours post-casting. What is the priority nursing action?
Answer: Bivalve or remove the cast immediately and notify the physician
Progressive pain, paresthesias, and extremity tightness under a cast are signs of compartment syndrome; the cast must be bivalved or removed immediately to relieve pressure.
What is the hallmark presentation of a toddler's fracture?
Answer: Non-displaced spiral fracture of the tibia in a child beginning to walk, after minor twisting injury
A toddler's fracture is a non-displaced spiral tibial fracture occurring in children 9 months to 3 years from trivial twisting forces as they learn to walk.
Which clinical sign differentiates a greenstick fracture from a buckle (torus) fracture in a child?
Answer: A greenstick fracture involves cortical disruption on one side; a buckle fracture shows cortical compression without disruption
In a greenstick fracture the cortex breaks on the tension side while intact on the compression side; in a buckle fracture the cortex buckles inward without complete disruption.
A child with sickle cell disease presents with severe pain, swelling, and warmth of the hand and feet. What condition should the nurse recognize?
Answer: Dactylitis (hand-foot syndrome)
Dactylitis is the earliest manifestation of sickle cell disease in infants, caused by vaso-occlusion in the small bones of the hands and feet producing symmetric painful swelling.
Which finding on physical exam suggests a pelvic fracture in a pediatric trauma patient?
Answer: Instability on pelvic compression/distraction, perineal ecchymosis, or blood at the urethral meatus
Pelvic ring instability, perineal or scrotal ecchymosis, and blood at the urethral meatus indicate significant pelvic fracture with potential urological and vascular injury.
When applying a traction splint to a pediatric femur fracture in the ED, what is the primary goal?
Answer: To reduce muscle spasm, decrease pain, and control hemorrhage by restoring femur length
Traction splints counter muscle spasm in femur fractures, restore bone length, reduce pain, and decrease potential blood loss into the thigh compartment.