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Scoliosis - 5 Nursing Diagnosis and Interventions

Scoliosis is a curvature, or lateral curvature of the spine due to the rotation and vertebral deformity.

Three forms of structural scoliosis are:
  1. Idiopathic scoliosis is the most common form and classified into 3 groups: infantile, which arise from birth to age 3 years; children, who emerged from the age of 3 years to 10 years; and adolescents, which appears after the age of 10 years (the age of the most common).
  2. Congenital scoliosis is scoliosis that causes malformation of one or more vertebral bodies.
  3. Neuromuscular scoliosis, children who suffer from neuromuscular diseases (such as brain paralysis, spina bifida, or muscular dystrophy) which directly causes the deformity.
(Nettina, Sandra M.)

Clinical Symptoms
  1. Spine curves abnormally to the side.
  2. Shoulder or hip and the left and right are not the same height.
  3. Back pain.
  4. Fatigue in the spine after sitting or standing for long.
  5. Severe scoliosis (curvature greater than 60) can cause respiratory problems.

Nursing Diagnosis and Interventions for Scoliosis

1. Ineffective Breathing Pattern related to emphasis the lung.
Goal: effective breathing pattern.
Intervention:
  • Assess respiratory status every 4 hours.
  • Help and teach the patient to do deep breaths every 1 hour.
  • Set the semi-Fowler position bed to improve lung expansion.
  • Auscultation of the chest to listen for breath sounds every 2 hours.
  • Monitor vital signs every 4 hours.

2. Acute pain: back related to body position tilted laterally.
Goal: pain is reduced / lost.
Intervention:
  • Assess the type, intensity, and location of pain.
  • Adjust the position of which can increase the sense of comfort.
  • Maintain a quiet environment to improve comfort.
  • Teach relaxation and distraction techniques to divert attention, thus reducing pain.
  • Encourage regular postural exercises to improve posture.
  • Teach and encourage use of the brace to reduce pain during activity.
  • Collaboration in providing analgesic to relieve pain.

3. Impaired physical mobility related to an unbalanced posture.
Objective: To improve physical mobility.
Intervention:
  • Assess the level of physical mobility.
  • Increase activity if pain is reduced.
  • Teaching aids and active joint range of motion exercises.
  • Involve the family in performing self-care.
  • Increase return to normal activity.

4. Disturbed Body Image or Self-concept disturbance related to kelateral tilted posture.
Objective: To enhance the image of the body.
Intervention:
  • Instruct to express feelings and problems.
  • Give supportive environment.
  • Help the patient to identify positive coping styles.
  • Give realistic expectations and goals for the short term to facilitate the achievement.
  • Give rewards for tasks performed.
  • Encourage communication with people nearby and need socialization with family and friends.
  • Give encouragement to care for themselves as tolerated.

5. Knowledge Deficit related to lack of information about the disease.
Goal: understanding of the treatment program.
Intervention:
  • Explain about the state of the disease.
  • Emphasize the importance and benefits of maintaining the recommended exercise program.
  • Tell us about the treatment of: name, schedule, purpose, dosage, and side effects.
  • Demonstrate the installation and maintenance brace or corset.

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