University:
Northwest College
Course:
VN420 | Child Health
Academic year:

2024
Views:

286

Pages:

2
Author:

Yesenia M.

SCOLIOSIS- PEDS Lateral curvature of the spine that > 10 degrees. Can be congenital , associated w another d/o, idiopathic Idiopathic is the MOST COMMON TYPE – etiology of this type is unknown but genetic factors, growth abnormalities, and bone, muscle, disc, or CNS d/o can contribute to development. Pathophysiology: when adolescent grows the involved vertebrae rotate around a vertical axis resulting in a lateral curve and asymmetry of the shoulder and waistline is evident Vertebrae rotate to the convex side of the curve w the spinous processes rotating toward the concave side , resulting in displacement of the ribs and rib asymmetry. As curve progresses, the shape of the thoracic cage continues to change and RR and cardiovascular compromise occur Therapeutic management Prevent progression and decrease impact on pulmonary and cardiac function For curves of 25-45 degrees – bracing can be enough Curves > 45 degrees- surgery is often needed- rod placement and bone grafting ** HARRINGTON ROD** Assessment No pain is usually reported- maybe just mild discomfort to back Asymmetry of shoulder and hips Poor posture Prominence of scapula Uneven curve at waistline Rib hump on one side Risk factors: family hx, growth spurt, physical changes r/t puberty Lab and DX test: full spine radiographs determine degree of curvature Nursing management Encourage compliance w bracing- prevents progression but does not CORRECT the d/o Brace must be worn 18hrs/day to prevent progression Inspect skin for rubbing by brace that can impair skin integrity Promote positive body image TYPES OF BRACES Underarm- for low thoracic and thoracolumbar curves; w no visible neck piece Milwaukee- for thoracic or major double curves; traditional , standard w visible neckpiece and chin rest Nighttime bending (Charleston)- creates a curve so severe that walking is no possible so it can ONLY BE WORN AT NIGHT.