Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide 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 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 • Stage one:

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