N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide • Teach patient to cough and deep breathe every twohours • Encourage patient to talk about feelings and body image • Encourage social activities with peers • Refer to a community support group Expected outcomes for scoliosis: • Demonstrates adequate coping skills regarding body image • Demonstrates compliance with brace wearing • Patient is free from respiratory complications • Verbalizes increased comfort • Patient remains free from skin breakdown • Patient and family verbalize understanding of brace use Legg-Calve-Perthes Disease This disease affects the femoral head in children aged four to ten years old. It is more common in boys than girls and is caused by a loss of blood supply to the epiphysis of the femur. After the vascular degeneration occurs, the bone begins to regenerate and recalcify. This can cause the acetabulum to misalign and cause complications. The femoral head begins to flatten and can eventually lead to premature arthritis or disability. There are four stages involved in Legg-Calve Perthes disease: • Stage one: This is when blood flow is interrupted to the femoral head and necrosis sets in. • Stage two: Blood flow finds a way back in and bone resorption occurs. New bone cells are deposited and my cause deformity due to pressure on an already weakened femoral head. • Stage three: The femoral head begins to reform itself from new bone. • Stage four: During this stage, the joint regenerates and heals itself. The cause for this disease is not known but it may be genetic or metabolic, or result from an infection or injury. Children may also show signs of hyperthyroidism, low insulin growth factor, and delayed development. Other factors are exposure to secondhand smoke, low birth weight, and older parents. Signs and symptoms of Legg-Calve-Perthes disease: • Limp that becomes worse over time • Groin pain • Thigh pain • Knee pain • Decreased and restricted hip abduction • Muscle spasm to hip

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