Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide • • 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 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 Provide cast and skin care

©2018

Achieve

Page 127

of 203