Concept map-Scoliosis PDF

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concept map for nursing, scoliosis ...

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Risk Factors/Medical History: Genetic tendency, gender: more common in girls, age: highest incidence between 8 to 15 years of age (ATI, 2016). Accounts for 10% to 15 % of all idiopathic cases, tends to be right-sided, but those who develop a left-sided curve fare better because right-sided becomes more severe, follows a common progression (Rudd & Kocisko, 2019).

Potential Medications for this problem & Pt home meds:

Diagnostic Tests (Purpose/Preparation):

Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or medications that treat inflammation from arthritis (e.g. Celebrex) can help reduce pain. Acetaminophen (e.g. Tylenol) is another common option. Avoidance of narcotic pain medication is generally recommended except in rare circumstances when all else has failed to alleviate the symptoms. Injections: Epidural steroid injections can reduce inflammation, or a facet block injection can block pain signals from reaching the brain. These types of injections deliver the anti-inflammatory medication directly to the affected area in the back via needle and X-ray guidance (Duncan, 2017)

Screen during preadolescence for boys & girls-observing the child only wear under wear posteriorly; have the child bend over at the waist with arms hanging down & observe for asymmetry of ribs & flank, measure truncal rotation with a scoliometer; perform radiography-use Cobb technique to determine degree of curvature, use the Risser scale to determine the skeletal maturity (ATI, 2016). In some cases, X-rays, & MRI’s may be utilized to evaluate curvature; also a complete neurological examination to rule out other conditions/deformities (Rudd & Kocisko, 2019)

Pathophysiology (Admitting DX) Scoliosis: is a term to describe a lateral curvature of the spine that deviates from normal spinal alignment (Rudd & Kocisko, 2019). Cobb’s angle is the measurement used to evaluate the amount of curvature in the spine. There are 3 main categories of scoliosis: neuromuscular, congenital, & idiopathic (Hoffman & Sullivan, 2017). Idiopathic (occurs for no known reason) or structural scoliosis is most common and can ve seen in isolation or associated with other conditions. Scoliosis is a complex deformity of the spine that also affects the ribs. (ATI, 2016)

Signs/Symptoms: Asymmetry in scapula, ribs, flanks, shoulders, & hips; improperly fitting clothing (one leg shorter than the other) (ATI, 2016). Sideways curve in spine, uneven shoulders, uneven waist, one hip higher than the other, signs of cardiopulmonary compromise with severe scoliosis such as tachypnea, tachycardia, SOB, and decreased O2 saturation (Hoffman & Sullivan, 2017).

Potential Complications: Breathing difficulties (with severe curvatures), spine or nerve damage, lowered self-esteem, infection following surgery (ATI, 2016)

List 3 Potential Nursing Problems: Ineffective breathing pattern, pain management, disturbed body image

Created by Noraky/Armstrong

Nursing Interventions & Collaborate Care Breathing pattern: 1) assess RR every 4 hoursScoliosis hinders the movement of the ribs, therefore weakens the respiratory muscles causing an increase in the work of breathing during, rest, activity or at sleep. (2) Assess O2 saturation & PR regularlyTachypnea, tachycardia, SOB, & decreased O2 saturation may indicate cardiopulmonary compromise. (3) Place child in a semi-fowlers position-promotes lung expansion (Martin, 2019). Pain management: 1) Assess pain using ageappropriate scale- this well assist us in documenting a baseline leading to the Tx of scoliosis associated pain (2) Administer pain medication as orderedadequate pain management helps the PT to achieve maximal functional mobility. (3) Apply thermal therapy as ordered- Hot & cold therapy can help to reduce pain & increase functionality (Hoffman & Sullivan, 2017). Body Image: 1) Assess child’s feelings on wearing brace, long-term treatments, restricted movements, and inability to keep up with peers and participate in activities-provides info about the status of self-image. (2) Encourage verbalization of feelings-provides an opportunity to talk about negative feelings and not hold them in to fester. (3) Maintain a positive environment-enhances body image, confidence, & independence (Martin, 2019).

References Duncan, J. (n.d.). Treatment for Degenerative Scoliosis. Retrieved March 25, 2020, from https://www.spine-health.com/conditions/scoliosis/treatment-degenerative-scoliosis

Hoffman, J. H., & Sullivan, N.J., (2017). Medical-surgical nursing: Making connections to practice. Philadelphia, PA: F.A. Davis Company

Martin, P. (2019, April 10). 4 Scoliosis Nursing Care Plans - Nurseslabs - Page 3. Retrieved March 25, 2020, from https://nurseslabs.com/scoliosis-nursing-care-plans/3/...