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.
May be related to
- Lack of information about correction of functional or structural scoliosis
Possibly evidenced by
- request for information about treatments for scoliosis, application of brace and surgical procedure to correct scoliosis
- Clients verbalize understanding of scoliosis and the treatment plan.
|Assess knowledge of deformity, cause,|
|Provides information about teaching needs.|
|Teach parents and child about a functional or structural defect and methods of treatment modalities specific to the age of child severity of the deformity.||Promotes understanding of type of defect and treatment protocol to relieve anxiety; functional and scoliosis is corrected by treating the underlying problem, and|
structural scoliosis is treated with long-term bracing and exercising or surgical fixation to straighten and realign spine.
|Teach child to maintain proper posture, use shoe lifts, exercises, and other prescribed treatments for functional scoliosis.||Corrects functional scoliosis which is usually caused by poor posture or unequal length of legs.|
|Teach parents and child about application, care, and removal of brace or orthoplast jacket, and inform that appliance must be worn for 23 hours/day and may be removed for bathing and exercise.||Provides nonoperative bracing to prevent progressive curvatures; higher curves are treated with the Milwaukee brace and lower curves with the TLSO brace and both are worn until growth is complete.|
|Teach child exercises to be performed|
in and out of the brace or other
appliance and to perform them daily.
|Prevents atrophy of muscle of spine and abdomen.|
|Teach parents and child to use|
electrical stimulation, application of electrodes, skin protection, connection of leads, operation of machine to be used at night.
|Provides stimulation to the muscles to prevent progression of curvature.|
|Teach parents and child of operative|
procedure planned and preoperative
preparation required; reinforce
physician information and use pictures, models and drawings to aid in teaching.
|Provides information about option for internal surgical instrumentation of curves over 45 degrees or those which are rapidly progressing to 45 degrees.|
|Prepare parents and child for postoperative care, especially activity restrictions, log rolling, on progression to ambulation, use of pillows for proper support, maintaining flat position, and|
possible use of special bed such as
|Provides information about what to expect following surgery depending the type of procedure.|
|Teach parents and child of use of|
safety belt and walker when ambulating; instruct in safety precautions to take for child wearing brace [clear pathways,
handrails, performing ADL using
|Prevents trauma caused by fall from postoperative weakness, unassisted ambulation, or wearing of brace causing awkwardness in ambulation and ADL performance.|
|Reassure parents and child that physical and occupational therapy will be prescribed after surgery.||Provides information and support services. Promotes optimal physical activity.|
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
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