TJacob

I was only told seizures. Yes, very complicated. I can usually critically think these things through but this one has me stuck!! Perhaps the casts are on for his feet/ankles and not contracture. But the answer would still be the same, what complications are associated with casts and children with CP and what meds would help? I emailed her a third time lol. Ill see if she throws me a bone or not :) I wanted to ask you about something you said... "skin breakdown is an issue for someone as you described. The only time my daughter ever ever had a pressure ulcer, was when she was in leg casts. Very important to move them with all that weight from the casts." So I want to add that skin breakdown is a complication but its not associated with altered sensation, is it just from having the cast in general, not specific to the disorder of CP? My instructor said its a med that controls pain and muscle spasms. I thought valium but both that and baclofen say not to take with eachother because they both increase CNS depression. Ill ask her. Ill let you know how this turns out :) youve been a great help!!

:) got ya... HE uses a wheel chair reflects that this is a person, wheelchair bound ignores the person. Ill let my instructor know too as it was her phrase. I have no idea what to say then. I need two complications of a child with cerebral palsy that has casts and a medication can help with one of these complications. I keep going back to her question of "what can the muscles not do when in a cast?" I think they would still be spastic. I know serial casting is used to prevent contracture and lengthen the muscle. I emailed my instructor again, she said its not botox, phenol or baclofen. It must be for pain. At this point, Im going to just accept getting this question wrong but I apprecaite all your help. And like I said, with all this research, Ive learned a LOT about the disorder and a many ways of treating different problems. More than I would have otherwise lol.

You are right, they are children first, I should have worded that better. He is wheel chair bound and Im not sure on the casting, I think youre right though. Ive read alot about botox injections, perhaps thats something that would help since it weakens muscles for 3-4 months which may also ease the pain. The baclofen I believe is oral, it only said that the mother listed the meds but didnt know the dosage. Oxygen.. He has very limited use of his upper extremities. All it says about his cognitive development is he likes his blue bunny tucked under his arm and only communicates by pointing, smiling for yes and looking down for no. He goes to a special education school. He is 10 but only weighs 25.2 kg and 104 cm so he is relatively small. I thought about the tent too but wasnt sure. That might be easier to defend but I wasnt sure if he was too big. Im having such a difficult time with this plan because nothing is very clear. Again, thank you so much for your insight!!!

Thank you tralalaRN, I thought about muscle relaxers and pain relievers since his current med list didnt include either. I thought if his muscles wanted to be spastic but he was confined to a cast it might hurt even more. Does that sound right? However, I thought the antispastic Baclofen would help with the muscles. What do you think about the best way to administer O2? Mask or NC? He does have a history of seizures. Thank you for your insight.. with all the research Im doing on this, Im starting to understand the complexity of the disorder!!!

I asked my instructor for further clarification, here is her reply. A child with CP will not always have altered sensation. The child in the design has spastic CP. What happens to the muscles of a child with spastic CP? Why are you casting? What can the muscles not do if they are in a cast? What about the reflexes in a child w/ CP? Ill research and think about this but nothing immediately comes to mind as far as one of the answers having a medication that will help. He is already on Dilantin, Diastat and Depakote for seizures and Baclofen which is an antispastic so his muscles are already being pharmacologicaly controlled. Furthermore.. I need to decide which methold of oxygen to admimister for pneumonia. I choose nasal canula. Would that be right? I wonder about the lines interfering if he were to have a seizure but what other method would work for a 10 year old? Thanks :) Im usually really good at figuring these out but this one really has me stummped!

He is wheelchair bound but the other information is not clear. This is a hypothetical patient. Here is the only information I have: 10-year-old has a history of cerebral palsy, spastic quadriplegia, neuromuscular scoliosis, seizures, and hydrocephalus with VP shunt. He is non-verbal and diapered. He is wheelchair bound. He was born at 27 weeks with complications from intraventricular hemorrhage and seizures. He has bilateral short leg casts. This is what I wrote so far... but its not right (see below) Increased risk for compartment syndrome due to altered sensation in their extremities. Skin breakdown caused by altered sensation and inability to communicate well. The next question asks: What medication can help with one of these complications? So now Im REALLY confused! Ive been researching this for two days reading everything I can on CP, casts, treatments etc.

I have a question I need to answer but after hours of researching I cant find the answer. Perhaps Im reading too much into the questions. What are complications of a child with cerebral palsy that has casts? The patient is a 10 year old boy with cerebral palsy, spastic quadriplegia, neuromuscular scoliosis, seizures, and hydrocephalus with VP shunt. He has bilateral short leg casts. I know the basic complications associated with casts but cant wrap my head around complications specific to CP. All my research discusses the benefits, not complications. Thanks for any help :)

Thank you very much everyone! I appreciate the rationale behind the reasoning :) Though I believe I have the answer, the details were that shes a pediatric pt with meduloblastoma. Wbc: 2,000/mm₃ Hgb: 7.2 g/dl Hct: 19.3 % Plt: 18,000 She has a single lumen infusa-port. Thank you!

Ive looked everywhere and cant find the answer. Does anyone know which blood product you would transfuse first, platelets or pRBC? Thank you :)