Scoliosis is a lateral curving of the spine with the thoracic area being the most commonly affected. It can be classified as functional or structural. Functional scoliosis is the result of another deformity and is corrected by treating the underlying problem. Structural scoliosis is most often idiopathic although it may be congenital or secondary to another disorder. There is a growing body of evidence that idiopathic scoliosis is probably genetic but the etiology is not completely understood. Structural scoliosis is more progressive and causes changes in supporting structures, such as the ribs. Management includes observation, bracing, and surgical fusion. Patients with idiopathic curves of less than 25 degrees are observed for progress until they have reached skeletal maturity. Bracing is recommended for adolescents with curves between 30 and 45 degrees, while curves greater than 45 degrees usually require surgery. The deformity may occur at any age, from infancy through adolescence, but the best prognosis belongs to those who are almost fully grown and whose curvature is of a mild degree. Idiopathic scoliosis most commonly occurs in adolescent girls.
Nursing Care Plans
Nursing care planning goals for a pediatric client with scoliosis may include restoration of normal breathing pattern, relief of pain, improved physical mobility, enhanced learning, stop the progression of the curve and prevent deformity.
Ineffective Breathing Pattern
May be related to
- Musculoskeletal impairment
- Decreased lung expansion
- Hypoventilation syndrome
Possibly evidenced by
- Changes in respiratory rate and depth
- Increased work of breathing, use of accessory muscles
- Shortness of breath
- Client will maintain an effective breathing pattern, as evidenced by relaxed breathing at normal rate and depth and absence of shortness of breath.
|Assess respiratory status every 4 hours.||Scoliosis 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.|
|Auscultate breath sounds at least every 4 hours.||This is to detect decreased or adventitious breath sounds.|
|Monitor intake and output.||Adequate hydration mobilizes secretions and prevents infection.|
|Assess oxygen saturation and pulse rate by using pulse oximetry.||Pulse oximetry is a helpful tool to detect alterations in oxygenation.|
|Assist the child in doing deep breathing exercises.||Deep breathing exercises are initiated to improve lung function.|
|Place the client in a semi-Fowler position.||Facilitates expansion of the lungs.|
|Frequently reposition the child every 2 hours.||Promotes lung field inflation.|
|Assist the child in using an incentive spirometry.||Improves lung expansion and aeration of the alveoli.|
|Administer oxygen as needed.||Oxygen increases peripheral oxygen saturation by 95%–100%|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for musculoskeletal disorders and conditions:
- Amputation | 4 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Fracture | 11 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Laminectomy (Disc Surgery) | 8 Care Plans
- Osteoarthritis | 4 Care Plans
- Osteoporosis | 4 Care Plans
- Rheumatoid Arthritis | 6 Care Plans
- Scoliosis | 4 Care Plans
- Spinal Cord Injury | 12 Care Plans
- Total Joint (Knee, Hip) Replacement | 5 Care Plans