4 Scoliosis Nursing Care Plans

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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:

  1. Ineffective Breathing Pattern
  2. Impaired Physical Mobility
  3. Disturbed Body Image
  4. Deficient Knowledge
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Deficient Knowledge

Nursing Diagnosis

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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

Desired Outcomes

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  • Clients verbalize understanding of scoliosis and the treatment plan.
Nursing InterventionsRationale
Assess knowledge of deformity, cause,
and treatments.
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
Stryker frame.
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
aids].
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.

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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for musculoskeletal disorders and conditions:

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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