Scoliosis is an abnormal sideways curvature of the spine with a twisting that causes a “C” or “S” shape in the spine. Treatment depends on the severity of the case and may range from exercises and a brace to surgery. Scoliosis most commonly presents between 10 – 12 years of age or during the teens. Severe cases may be present at birth.
Congenital scoliosis is rare and is related to abnormal spine development during gestation and usually occurs with other congenital disorders such as cerebral palsy, Marfan syndrome, and muscular dystrophy. Functional scoliosis develops as a result of a problem elsewhere in the body, such as with unequal leg length or muscle spasms in the back. Injuries to the spine, bad posture, and connective tissue disorders can all cause scoliosis.
The patient will have optimal physical mobility; the patient will have minimal pain; the patient will have an adequate breathing pattern
Scoliosis Nursing Care Plan
- Back pain
- Hip pain
- Shortness of breath
- Uneven shoulders
- Curvature of spine
- Uneven waist
- One hip higher than the other
- One leg longer than the other
Nursing Interventions and Rationales
- Perform physical assessment noting abnormalities of the legs, shoulders, hips. Assess physical mobility
Determine a baseline for treatment and management of the condition. Determine severity by looking at the degree of curvature.
- Assess breathing patterns and auscultate breath sounds. Encourage deep breathing exercises and administer oxygen as necessary.
Patients with altered posture may have less than adequate lung expansion because of changes in the shape of the thoracic cavity. That can lead to respiratory infection and decreased lung function. Deep breathing exercises help improve lung inflation.
- Assess pain level with appropriate scale (FACES or number scale) and PQRST details
Help determine the best method for pain relief. The curvature of the spine can cause pressure on muscles, nerves, and spinal discs that result in pain.
- Manage pain appropriately
- Heat / cold
Non-pharmacological interventions are the first choice and often relieve pain well. When necessary, administer anti-inflammatory meds and analgesics as appropriate.
- Provide a range of motion exercises – AROM and PROM
Encourage strengthening of the muscles and flexibility. Promotes good posture. Prevent contractures and encourage mobility.
- Apply and educate patient parents in the use of braces
Properly used, a back brace can help relieve pain and provide stability for the spine. Ideally, the brace can help slow down the progression of the spinal curve, but it typically cannot correct it.
- Assess skin for breakdown with use of a brace
Monitor for signs of skin breakdown or improper fit of brace that may cause sores, blisters, and excoriation. Preventing skin breakdown can help prevent infection.
Promotes effective breathing and prevents skin breakdown.
- Assist patient and parents with the plan for school and activities
- The use of an appliance or brace may require certain changes to be made to activities.
- Promote independence and self-care.
- Develop a plan for school so that patients can move about and reposition frequently as needed to relieve pain and encourage mobility.
- Encourage regular monitoring
Patients with mild scoliosis may only require routine monitoring to make sure the condition is not getting worse.
- Provide pre- and post-op instructions and care
Patients with severe deformities may be eligible for surgery in which the spine is straightened with rods and screws. Prevent infection at the surgical site and promote early ambulation and range of motion exercises.
- Educate patient and parents regarding activities that should be avoided during treatment
Contact sports and high-risk activities should be avoided following surgery and while wearing a brace or appliance to prevent injury to the patient
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell