[NSG 502 exam 4 musculoskeletal, GI]
developmental dysplasia of the hip - subluxation or dislocation of the head of the hemur from the
(DDH/hip dysplasia) acetabulum
- females affected more than males
developmental dysplasia of the hip generally unknown, but multiple possibilities:
etiologies - maternal hormone secretion
- positioning (breech or tight infant swaddling)
- genetics
developmental dysplasia of the hip - pavlik harness worn 24 hr/day
treatments/considerations - only the provider may adjust the harness
- may use regular car seat
- check for skin breakdown where harness touches skin
- sitting upright is a major milestone (<6 months), need to
promote normal activities/play
4/16/2026, 4:58:38 PM 4/16/2026, 4:58:36 PM 4/16/2026, 4:58:34 PM
, [NSG 502 exam 4 musculoskeletal, GI]
talipes equinovarus (clubfoot) - congenital malformation of the lower extremity
- foot and ankle "turns inward"
- occurs in 1/1000 live births
- males affected more than femals
- etiology unknown - possibly related to restricted mobility in
utero
- deformity is apparent at birth
talipes equinovarus (clubfoot) therapeutic - treatment is started as soon as possible after birth
management - goal is to gently stretch the tightened ligaments and tendons
- serial stretching, manipulation, and casting are performed at
least weekly
- caregiver may soak off cast (plaster) in AM before
appointments
- if not corrected within 3-6 months, surgery is usually
indicated
4/16/2026, 4:58:38 PM 4/16/2026, 4:58:36 PM 4/16/2026, 4:58:34 PM
, [NSG 502 exam 4 musculoskeletal, GI]
talipes equinovarus (clubfoot) nursing - maintain skin integrity
considerations - assess circulation distal to the cast
- pain management
- parental support
- facilitate normal growth and development
- rare long term affects are calf muscle atrophy and small foot
osgood shlatter disease (OSD) - most frequent cause of knee pain in children
- most often occurs between 9-16 years, can be earlier
- males and females affected equally
- associated with overuse
- caused by irritation of the patellar ligament at its attachment
point at the tibial tuberosity
what is RICE - rest
- ice
- compression
- elevation
very common in MSK issues
4/16/2026, 4:58:38 PM 4/16/2026, 4:58:36 PM 4/16/2026, 4:58:34 PM
, [NSG 502 exam 4 musculoskeletal, GI]
Osgood-Shlatter Disease nursing - RICE
interventions - taping, bands, braces
- time off sports
- education r/t better shoes, etc, and you will return to normal
with proper rest
- educate that a bony prominence my occur in the area
scoliosis - abnormal lateral curvature of the spine
- adolescent idiopathic
- occurs during growth spurt
- females affected more than males
scoliosis clinical manifestations - uneven fit of clothing
- uneven hem length
- shoulder asymmetry
- prominent scapula and hip
- spinous process misaligned
scoliosis complications - respiratory issues: lungs cannot fully expand
- GI/GU issues
- mobility limitations
4/16/2026, 4:58:38 PM 4/16/2026, 4:58:36 PM 4/16/2026, 4:58:34 PM
developmental dysplasia of the hip - subluxation or dislocation of the head of the hemur from the
(DDH/hip dysplasia) acetabulum
- females affected more than males
developmental dysplasia of the hip generally unknown, but multiple possibilities:
etiologies - maternal hormone secretion
- positioning (breech or tight infant swaddling)
- genetics
developmental dysplasia of the hip - pavlik harness worn 24 hr/day
treatments/considerations - only the provider may adjust the harness
- may use regular car seat
- check for skin breakdown where harness touches skin
- sitting upright is a major milestone (<6 months), need to
promote normal activities/play
4/16/2026, 4:58:38 PM 4/16/2026, 4:58:36 PM 4/16/2026, 4:58:34 PM
, [NSG 502 exam 4 musculoskeletal, GI]
talipes equinovarus (clubfoot) - congenital malformation of the lower extremity
- foot and ankle "turns inward"
- occurs in 1/1000 live births
- males affected more than femals
- etiology unknown - possibly related to restricted mobility in
utero
- deformity is apparent at birth
talipes equinovarus (clubfoot) therapeutic - treatment is started as soon as possible after birth
management - goal is to gently stretch the tightened ligaments and tendons
- serial stretching, manipulation, and casting are performed at
least weekly
- caregiver may soak off cast (plaster) in AM before
appointments
- if not corrected within 3-6 months, surgery is usually
indicated
4/16/2026, 4:58:38 PM 4/16/2026, 4:58:36 PM 4/16/2026, 4:58:34 PM
, [NSG 502 exam 4 musculoskeletal, GI]
talipes equinovarus (clubfoot) nursing - maintain skin integrity
considerations - assess circulation distal to the cast
- pain management
- parental support
- facilitate normal growth and development
- rare long term affects are calf muscle atrophy and small foot
osgood shlatter disease (OSD) - most frequent cause of knee pain in children
- most often occurs between 9-16 years, can be earlier
- males and females affected equally
- associated with overuse
- caused by irritation of the patellar ligament at its attachment
point at the tibial tuberosity
what is RICE - rest
- ice
- compression
- elevation
very common in MSK issues
4/16/2026, 4:58:38 PM 4/16/2026, 4:58:36 PM 4/16/2026, 4:58:34 PM
, [NSG 502 exam 4 musculoskeletal, GI]
Osgood-Shlatter Disease nursing - RICE
interventions - taping, bands, braces
- time off sports
- education r/t better shoes, etc, and you will return to normal
with proper rest
- educate that a bony prominence my occur in the area
scoliosis - abnormal lateral curvature of the spine
- adolescent idiopathic
- occurs during growth spurt
- females affected more than males
scoliosis clinical manifestations - uneven fit of clothing
- uneven hem length
- shoulder asymmetry
- prominent scapula and hip
- spinous process misaligned
scoliosis complications - respiratory issues: lungs cannot fully expand
- GI/GU issues
- mobility limitations
4/16/2026, 4:58:38 PM 4/16/2026, 4:58:36 PM 4/16/2026, 4:58:34 PM
