4 Scoliosis Nursing Care Plans

Ineffective Breathing Pattern

In a child with scoliosis, musculoskeletal impairment caused by the abnormal curvature of the spine can restrict the movement of the ribs and chest, leading to decreased lung expansion and ventilation. This can result in an ineffective breathing pattern and hypoventilation syndrome, which can lead to decreased oxygen levels in the blood and a range of health complications.

Nursing Diagnosis

• Ineffective Breathing Pattern

May be related to

• Musculoskeletal impairment
• Decreased lung expansion
• Hypoventilation syndrome

Possibly evidenced by

• Changes in respiratory rate and depth
• Fatigue
• Increased work of breathing, use of accessory muscles
• Shortness of breath

Desired Outcomes

• The child will maintain an effective breathing pattern, as evidenced by relaxed breathing at a normal rate and depth and the absence of shortness of breath.

Nursing Assessment and Rationales

1. Assess respiratory status every 4 hours.
Patients with scoliosis may experience respiratory issues due to weakened respiratory muscles caused by limited rib movement. This can lead to an increased work of breathing, making it challenging to breathe during rest, activity, and sleep. These assessments can help identify changes in respiratory status and guide interventions to improve breathing function. It is essential to monitor respiratory status closely, especially during periods of activity or exertion, to prevent complications and ensure patient safety.

2. Auscultate breath sounds at least every 4 hours.
This is to detect decreased or adventitious breath sounds.

3. Monitor intake and output.
Adequate hydration mobilizes secretions and prevents infection.

4. Assess oxygen saturation and pulse rate by using pulse oximetry.
Pulse oximetry is a helpful tool to detect alterations in oxygenation.

Nursing Interventions and Rationales

1. Assist the child in doing deep breathing exercises.
Deep breathing exercises are initiated to improve lung function.

2. Elevate the head of the bed or use pillows to support the chest and facilitate breathing.
Facilitates expansion of the lungs.

3. Assist the child in using incentive spirometry.
Improves lung expansion and aeration of the alveoli.

4. Administer bronchodilators if indicated.
Bronchodilators may be used in scoliosis to relieve symptoms related to respiratory problems caused by the abnormal curvature of the spine. These medications work by relaxing the muscles in the airways, allowing them to widen and facilitating easier breathing.

5. Administer oxygen as needed.
Oxygen increases peripheral oxygen saturation by 95%–100%

6. Educating the child and their family on proper breathing techniques, the importance of maintaining good posture, and the need to seek medical attention promptly if any respiratory symptoms occur.
Poor posture can further limit the movement of the chest and lungs, making breathing more difficult. In addition, it is important to notify the physician promptly if any respiratory symptoms occur, such as shortness of breath, wheezing, or coughing, as these could indicate a worsening of the condition or the development of complications that require immediate treatment.