Ch. 28: Scoliosis Flashcards Preview

ATI Pediatrics-MJ > Ch. 28: Scoliosis > Flashcards

Flashcards in Ch. 28: Scoliosis Deck (21):
1

Scoliosis is a complex deformity of the spine that also affects the ___

Ribs

2

How is scoliosis characterized by?

A lateral curvature of the spine and spinal rotation that causes rib assymetry

3

A curve needs to be at least ___ for diagnosis and mild curves (less than ___) are monitored.

10 degree for diagnosis
Mild curves: less than 25 degrees are monitored

4

What is the most common form of scoliosis?

Idiopathic or structural scoliosis

5

What are the sub/obj data for scoliosis?

-Assymmetry in scapula, ribs, flanks, shoulders, and hips
-Improperly fitting clothing (one leg shorter than the others)

6

When is screening for scoliosis and how does it happen?

Preadolescence for B and G

-Child only wear underwear and observe child from back-
-Have child bend over at waist with arms hanging down and observe for symmetry of ribs and flank

7

How is truncal rotation measured?

Scoliometer

8

How do we determine the degree of curvature?
How do we determine the skeletal maturity?

Degree of curvature: Cobb technique
Skeletal maturity: Risser scale

9

Pre-op for surgical interventions we obtain routine lab studies, including a type and cross match for blood as prescribed. Why do we need to have blood labs studies done?

The adolescent may have self-donated blood available for transfusion---clients who have spinal instrumentation for scoliosis have a lengthy surgery with blood loss and require blood replacements

10

What slows the progression of the curve?

Bracing

11

What is the surgical intervention for scoliosis?

Spinal fusion with rod deplacement--used for curvatures greater than 45

12

Pre-op: Inform the adolescent to obtain ______ blood donations and assist them

Obtain autologous (self-donated)

13

Post-op: Do they get PCA pump?

Yes

14

Post op: How is pt turned?

Frequently by log rolling to prevent damage to the spinal fusion

15

Post-op: Why do we assess and monitor the bowel sounds?

Observing for paralytic ileus

16

Post-op: What do we monitor for decreases in?

Hgb and Hct--observe for indications of bleeding

17

Post-op: What do we preform frequently?

Neurovascular checks

18

What are indicators of changes when assessing neuromuscular status?

-Numbness
-Tingling
-Decreased mobility
-Sensation
-Cap. refill

19

What are some complications from scoliosis?

1. Breathing difficulties (with severe curvatures)
2. Lower self-esteem
3. Infection following surgery (may be caused by bacteria like staph)
4. Spine or nerve damage (uncorrected scoliosis)

20

If the child has an infection following surgery, what do we need to monitor, do about position, and nutrition?

Monitor: VS (changes in temp can be associated with complications and infection); changes in neuromuscular status

Position: reposition child frequently

Nutrition: High-fiber diet and adequate hydration

21

A nurse is completing prep teaching with an adolescent client who is going to receive spinal instrumentation for scoliosis. Which of the following information should the nurse include in the teaching?

A. You will go home same day of surgery
B. You will have minimal pain
C. You will need to receive blood
D. You will not be able to eat until the day after surgery

C