Ward Class

An Online Resource Site For Student Nurses

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Ward Class is an online resource for student nurses. Created with the aim of helping student nurses cope with the demands of nursing school and clinicals, it offers free downloads, notes, sample NCPs, sample drug studies, study aids, news and updates, and practical tips to its users.

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The December 2012 PRC Nursing Board Exam Result is already available here at Ward Class and at Pinoy R.N.




Musculoskeletal Disorders: Osteogenesis Imperfecta

deformities and femoral fractures in an infant with OI

  • Osteogenesis Imperfecta (OI) is an inherited disorder affecting collagen formation and characterized by the formation of pathologic fractures
  • occurs in two main forms: osteogenesis imperfecta congenita (autosomal recessive, with poor prognosis) and osteogenesis imperfecta tarda (autosomal dominant less severe, occurs later in life)
  • severity of symptoms decreases during puberty due to hormone production and ability to prevent injury
  • classic picture includes fragile bones, blue sclera, and early hearing loss due to otosclerosis


Assessment Findings


1. osteogenesis imperfecta congenita
> multiple fractures at birth
> intrauterine fracture may lead to skeletal deformity
> soft bones of the skull
> intracranial hemorrhage

2. osteogenesis imperfecta tarda
> limb and spinal column deformities
> multiple fractures especially in the lower limbs
> hypermobility of joints
> development of dental caries

Medical Management
  1. magnesium oxide supplements
  2. growth hormone and calcitonin--> stimulates growth and promotes bone healing, respectively
  3. reduction and immobilization of fractures--> alignment and casting
  4. application of lightweight leg braces and intermedullary rods--> strengthens bones

Nursing Management
  1. ensure child safety -->raise side rails, keep floors dry, remove objects that could cause falls
  2. administer medications as ordered
  3. position child with care--> use blankets when moving child, lift child gently
  4. instruct patients in bathing, dressing, and diapering--> focusing on how to support limbs to prevent further injury
  5. provide for emotional support to parents--> parents may have been wrongly suspected of child abuse due to symptoms associated with the disease


Prognosis

Osteogenesis Imperfecta in very severe form may lead to death in the first year of life. Some patients may be wheelchair-bound and have shortened life spans.

Prevention


Osteogenesis Imperfecta is not preventable.


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