Scoliosis Screening Case Study
Sonja complains of pain at the insertion site. She rates her pain as 6/10. What is the nurse's first responsiblity?
Assess respiratory status.
Scoliometric findings for Sonja are: 8˚ thoracic curve and 4˚ lumbar curve. What is the correct nursing intervention the school nurse must complete?
Document the finding and recommend a rescreen at age 12 years
How should the nurse address the parents' concerns about blood transfusions?
Educate the parents about options such as autologous blood transfusions.
Sonja continues to have body image concerns. She visits the school nurse and asks the nurse if there are any exercises she could do to improve the curvature of her spine
Exercises can help maintain musculature of the trunk during bracing
Which question is most relevant for the school nurse to ask Sonja, when assessing the effect of growth on potential future curve progression?
Have you started your period?
The HCP prescribes preoperative laboratory orders. Which orders would the nurse consider a priority for this client?
Hemoglobin and hematocrit.
What is the most appropriate response for the nurse to tell Sonja?
I will show you ways to decorate the brace similar to current fashions
The school nurse rescreens 15-year-old Sonja. The findings include a noticeable rib hump, as well as waist and hip asymmetries, and a thoracic curve of 32˚. What is the most appropriate nursing interventoin?
Refer for x-rays and bracing.
Sonja is eager to resume her physical activities including participation in sports. She also wishes to know of risks the spinal instrumentation might cause for pregnancy in the future. How should the nurse counsel Sonja?
Resume regular activities of daily living, including school in 3 to 4 weeks
The nurse informs the student nurses to observe for which signs that would rule out disease processes that can cause scoliosis?
Sacral dimpling or hairy patches.
A mother informs the school nurse that she does not want her daughter to be screened at school. What is the appropriate response from the school nurse?
School screening is voluntary. She may have screening done at the pediatrician's office.
The nurse clarifies the purpose of pulmonary function tests. Which of the following statements is correct?
Scoliosis restricts movement of the ribs.
What topics must the nurse include in the teaching with Sonja and her parents? (Select all that apply.)
The use of incentive spirometry. The need for log rolling when turning postoperative. Presence of a Foley catheter and frequent neurovascular monitoring. Operation of a PCA pump.
Sonja is resting in the side-lying position after her first log roll. What nursing assessment is most critical when completing this procedure?
Assess nuerovasulcar status
Sonja begins ambulation on her third post-operative day. What factor must the nurse consider unique to ambulation post scoliosis surgery? (Select all that apply.)
A distorted sense of balance Potential orthostatic hypotension.
What critical observations to detect curvature are included in the screening process? (Select all that apply.)
Asymmetry of shoulder and hip height. Rib humps. Prominent scapula.
The nurse reviews the pathophysiology of scoliosis with the student nurses. What concepts should the school nurse include? (Select all that apply.)
Intraspinal abnormalities can cause scoliosis. Most causes of adolescent scoliosis are ideopathic. Scoliosis can be classified according to age of onset
Sonja's nurse provides instructions to the team members for the log rolling procedure. What instructions must the nurse provide to assure safe turning.
Place a pillow between the client's legs. Ask the first assistant to stand at the client's shoulder with the second assistant at the client's hips, reach over and pull the draw sheet in one smooth motion.
Six days after surgery, Sonja complains of abdominal pain and nausea. She initially vomits small amounts but progresses to vomiting copious amounts. Her pain is worse in the spine position. Which prescription should the nurse anticipate?
Placement of a nasogastric tube and begin parenteral feeding
Which of the following meals would best meet this goal?
Supplement meals with 8 ounces of Ensure(R) 3 times a day.
What is the school nurse's explanation as to the purpose of scoliosis screening in this population?
Target high prevalence age groups.
What is the correct method of assessment with the scoliometer?
The student bends over with arms dangling, and the scoliometer is placed on the thoracic curve, then on the lumbar curve
Did you learn about scoliosis from Sonja and her nurses through this case study?
True
The school nurse provides education to Sonja and her mother about the diagnostic procedures for scoliosis. Which response provides accurate information?
X-rays will be taken in several positions including a side view
