N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide ©2017 Achieve Test Prep Page 129 of 204 Patient demonstrates increased comfort and relief from pain • Patient is compliant with limitations on mobility and activity • Patient remains free from injury and complications from surgery • Parents verbalizes an understanding of the treatment plan and rehabilitation process Contractures Contractures develop due to muscle inactivity. When a muscle is not used for a long period of time it begins to shorten along with the tendon. The joints are then unable to move and it is very painful to the patient if a joint is forced to move. This condition often becomes permanent if the joints are not moved with passive range of motion exercises or splinting. Those most at risk factors include patients with a neurological dysfunction or coma, those with illnesses that cause immobility, and burn patients. The less a patient moves, the more the joints and muscles contract. When the patient attempts to move a contracted joint, they tend to expend more energy. This spirals into permanent contractures quickly if measures are not taken to improve mobility. Complications of contractures are skin breakdown, ulcers, and inability to perform ADLs. Signs and symptoms of contractures: • Painful muscle spasms • Rigid muscles • Shortened muscles/decreased range of motion • Stiffness • Joint deformity/curled up appearance • Skin breakdown Nursing assessment for contractures: • Check pain levels and medicate prior to full assessment • If patient is comfortable, assess range of motion, strength, and ambulatory ability; check ability to transfer and use assistive devices; evaluate ability to perform ADLs; look for shortened muscles over the joint areas • Inquire about history behind immobility: paralysis, coma, arthritic condition, or any other condition that causes immobility • Inquire if patient has had any physical therapy, splinting, and care in the home for mobility • Review radiology reports: x-ray Nursing diagnosis for contractures: Expected outcomes for slipped femoral epiphysis: •