N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Nursing assessment for Legg-Calve-Perthes disease: • Assess for pain using the faces or non-verbal scale for youngerchildren • Inquire about the history of the disease: child who walks with a limp, family history of disease, or child with history of cerebral palsy, spinal bifida, or muscular dystrophy • Check range of motion and gait • Review radiology results: bone scan, x-ray, and MRI Nursing diagnosis for Legg-Calve-Perthes disease: • Impaired physical mobility related to muscle spasms, pain, and degeneration • Pain related to degeneration, muscle spasm, and immobility • Risk for impaired skin integrity related to surgical wounds or brace • Risk for non-compliance to treatment plan related to duration of treatment • Knowledge deficit related to disease process and treatment plan Nursing interventions for Legg-Calve-Perthes disease: • Assess pain levels frequently and offer analgesics per MDorder • If surgery is needed, prepare patient for surgery • Provide post–op care as needed; patient will be in a Spica cast to keep the femur abducted, which allows the acetabulum to contain the femoral head properly • Provide proper diet to help prevent weight gain to prevent excess weight on the femoral head • Monitor circulation below cast; have the patient wiggle toes, check skin color for cyanosis, check for edema, check for skin that is warm to the touch, and pinprick sensations • Provide cast and skin care • Teach the family about cast care, skin care, length of recovery, and further treatment plan Expected outcomes for Legg-Calve-Perthes disease: • Patient remains free from skin breakdown • Verbalizes increased comfort and reduction in symptoms • Demonstrates increased mobility • Patient remains free from complications • Family verbalizes understanding of disease and treatment plan

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