N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide

©2017 Achieve Test Prep Page 128 of 204 Slipped Femoral Epiphysis This is a condition where the proximal femoral epiphysis becomes displaced in both a posterior and inferior direction. The evidence shows that the growth plates are wider on the lower femoral side of the epiphysis. When a child injures the area, the femoral part of the epiphysis slides up, but remains connected by a thin periosteum. Over time, the slipping gets worse and causes more slipping until a deformity occurs to the femoral head. The blood vessels to the epiphysis then become stretched. The cause is not known, but there are associated factors. Fast growth spurts, and tall, thin, and overweight children are more prone to this condition. It is most common to occur during growth spurts. Complications are necrosis of the cartilage and avascular necrosis. Signs and symptoms of slipped femoral epiphysis: • Continuous/intermittent hip pain • Limping on the affected side • Groin/thigh/knee pain • External rotation of the affected leg • Loss of abduction • Loss of internal rotation Nursing assessment for slipped femoral epiphysis: • Assess pain, location, severity, and duration • Measure height and weight • Assess range of motion and gait to determine severity • Review radiology reports: x-ray Nursing diagnosis for slipped femoral epiphysis: • Pain related to the movement of the growth plate structures • Immobility related to loss of abduction and rotation of leg • Knowledge deficit related to treatment routine and rehabilitation Nursing interventions for slipped femoral epiphysis: • Assess pain frequently and offer analgesics per MDorder • If MD orders corrective traction, monitor placement and provide skincare • Prepare patient for surgery if necessary; teach the family what to expect, rehabilitation, and recovery time • Post-operative: assess pain and offer analgesics, check peripheral circulation, and perform wound care at surgical site • Encourage rest and teach patient to pace activities as tolerated • Teach parents about rehabilitation: range of motion exercises, nutrition, and skin care