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.
Here are four (4) nursing care plans (NCP) and nursing diagnosis (NDx) for scoliosis:
Disturbed Body Image
Nursing Diagnosis
May be related to
- Biophysical and psychosocial factors of spinal deformity
Possibly evidenced by
- Verbal response to actual change in structure of spine
- Negative feelings about body
- Dependence on long-term use of brace
- feeling of rejection by peers, inability to participate in some activities.)
Desired Outcomes
- Child will experience improved body image.
Nursing Interventions | Rationale |
---|---|
Assess child’s feelings on wearing brace, long-term treatments, restricted movements, and inability to keep up with peers and participate in activities. | Provides information about the status of self-concept and changes in appearance. |
Encourage verbalization of feelings and concerns and support child’s communications with significant others and peers. | Provides an opportunity to verbalize and limit negative feelings on changes in appearance and prolong wearing of an appliance. |
Assist child to adjust to self-perception of short leg, use of appliance and effect on appearance. | Promotes realistic perception of appearance and positive self-image. |
Assist with the plan for independence in performing ADL, application and removal of appliance, choice of shoes and clothing to wear. | Promotes independence and adjustment to the appliance. |
Maintain positive environment and encourage activities appropriate to the child. | Enhances body image and confidence, and promotes trust and respect of the child. |
Reassure parents and child that most activities are permitted with use of appliance. | Promotes positive feelings about the treatment and restrictions created by the deformity. |
Assist the child find ways to inform others about wearing appliance. | Assist child in dealing with questions and curiosity of others about differences caused by deformity. |
Assist child to the type of clothing to cover appliance that is stylish and has peer acceptance. | Improves appearance and body image. |
Educate child about activity restrictions that include progression from quiet activities to involvement in those to avoid: contact sports, bike riding, driving, skating, or those that may result in a fall if surgery has been done. | Prevents injury following surgical correction of the deformity. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- 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, 2021-2023Â (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.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
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