Peds exam 5 Scoliosis

scoliosis

lateral curvature of the spine that can lead to secondary changes in the vertabrae, ribs, and pelvis progresses with growth severity ranges from mild to severe may become S shaped as the body devlops a compensatory curve

xrays taken every 4- 6months

management of scoliosis: observation

25-45 may slow progression to allow skeletal growth and maturity but does not correct the curve: MUST BE WORN 23 HOURS A DAY

usually curves ___-__ degrees are braced

clothing under the brace!!!!! monitor skin for redness

bracing is not curative but may slow progression of the curvature...

prone to shock from blood loss

cardiovascular assessment:

Neuro injury hypotension wiund infection SIADH atelectasis pnuemothorax ileus

post-op comps

scoliosis

usually diagnosed in adolescents

3

A 12 year old diagnosed with scoliosis is to wear a brace for 23 hours a day. What is the most likely reason the child will not wear it for that long? 1. pain from the brace 2. difficulty in putting the brace on 3. self conciousness about appearance 4. not understanding what the brace is for peds success pg 223 number 27

4

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting, on firther assesment the nurse notes abdominal distention. On the basis of these findings the nurse should take which action? 1. administer antiemetic 2. increase the iv fluids 3. place the child in a sims position 4. notify the HCP Saunders pg 517 number 447

20

A spinal curve of less than _____ degrees that is non-progressive does not require treatment for scoliosis. peds success pg 223 number 28

log rolled to prevent damage to the fusion.( immediately after surgery) neuro assessment, report any deficits promptly. delayed paralysis may develop/surgery required....

Neurological assessment:

Pain management

PCA pump due to severe pain

curvature more than 45 degrees

Surgery is indicated for scolisis with a curvature more than:::

3

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. which statement by the parents indicates a need for further instruction. 1. I will encourage my child to perform prescribed exercises 2. I will have my child wear soft fabric clothing under the brace 3. I should apply lotion under the brace to prevent skin breakdown 4. I should avoid the use of powder because it will cake under the brace saunders pg 517 number 448

3

Which intervention would be essential for the nurse to implement to promote a stable respiratory status in an adolescent who recently had a spinal fusion for scoliosis? 1. logrolling and re positioning every 4 hours 2. coughing and deep breathing every 2 hours while awake 3. Assessing paint status and ensuring adequate pain relief 4. encourage use of incentive spirometer every 4 hours while awake Hogan page 1157 number 24

1,2,4,5

a 13 year old just returned from surgery for scoliosis. which nursing interventions is/are appropriate in the first 24 hours. select all that apply 1. asses for pain 2. log roll to change positions 3. get the teen to the bathroom 12-24 hours after surgery 4. check neurological status 5. monitor bp peds success pg 223 number 29

scoliosis

a lateral curvature and spinal rotation causing rib asymmetry is also known as wong workbook page 241 number 28

unlevel hips prominent scapula flank asymmetry/rib hump shoulder asymmetry visible curve

clinical manifestations are:

superior mesenteric artery syndrome( post op complication

duodenal compression by the aorta and superior mesenteric artery and leads to partial or complete duodenal obstruction. epigastric pain nauseas copious vomitting eructation( burping)

degree of curvature

management of scoliosis depends on

10

must have a ___ degree of curve for a dx of scoliosis

respiratory: reluctant to breathe, encourage it GI management: monitor bowel sounds, prone to ileus Urinary Management: monitor I&O. some prone to urinary retention Ambulation; walk as soon as possible, usually the second or thrid day post-op they are up and out of bed... discharge within a week

nursing care:

scolioscore

saliva test called ______ can test for idiopathic scoliosis

occurs in girls more often should be screened around 10-12 years of age and boys screened around 13-14 years of age

scoiliosis profile:

congenital- occurs in fetal development infantile- occurs at birth to 3 years of age juvenile- occur in children ages 3-10 years old adolescent- occurs at 10 years of age or older

scoliosis is classified by age 4 different groups