Nursing Care Plan for Scoliosis

Pathophysiology

Scoliosis is an abnormal sideways curvature of the spine with a twisting that causes a “C” or “S” shape in the spine.  Treatment depends on the severity of the case and may range from exercises and a brace to surgery. Scoliosis most commonly presents between 10 – 12 years of age or during the teens. Severe cases may be present at birth.

Etiology

Congenital scoliosis is rare and is related to abnormal spine development during gestation and usually occurs with other congenital disorders such as cerebral palsy, Marfan syndrome and muscular dystrophy. Functional scoliosis develops as a result of a problem elsewhere in the body, such as  with unequal leg length or muscle spasms in the back. Injuries to the spine, bad posture and connective tissue disorders can all cause scoliosis.

Desired Outcome

Patient will have optimal physical mobility; patient will have minimal pain; patient will have adequate breathing pattern

Scoliosis Nursing Care Plan

Subjective Data:

  • Back pain
  • Hip pain
  • Shortness of breath

Objective Data:

  • Uneven shoulders
  • Curvature of spine
  • Uneven waist
  • One hip higher than the other
  • One leg longer than the other

Nursing Interventions and Rationales

  1. Perform physical assessment noting abnormalities of the legs, shoulders, hips. Assess physical mobility

  2. Determine baseline for treatment and management of condition. Determine severity by looking at the degree of curvature.

  3. Assess breathing pattern and auscultate breath sounds. Encourage deep breathing exercises and administer oxygen as necessary.

  4. Patients with altered posture may have less than adequate lung expansion because of changes in the shape of the thoracic cavity. That can lead to respiratory infection and decreased lung function. Deep breathing exercises help improve lung inflation.

  5. Assess pain level with appropriate scale (FACES or number scale) and PQRST details

  6. Help determine the best method for pain relief.  The curvature of the spine can cause pressure on muscles, nerves and spinal discs that result in pain.

  7. Manage pain appropriately

    • Massage
    • Heat / cold
    • Positioning
    • Medication
  8. Non-pharmacological interventions are the first choice and often relieve pain well.

    When necessary, administer anti-inflammatory meds and analgesics as appropriate.

  9. Provide range of motion exercises – AROM and PROM

  10. Encourage strengthening of the muscles and flexibility.  Promotes good posture. Prevent contractures and encourage mobility.

  11. Apply and educate patient parents in use of braces

  12. Properly used, a back brace can help relieve pain and provide stability for the spine. Ideally, the brace can help slow down the progression of the spinal curve, but it typically cannot correct it.

  13. Assess skin for breakdown with use of brace

  14. Monitor for signs of skin breakdown or improper fit of brace that may cause sores, blisters and excoriation. Preventing skin breakdown can help prevent infection.

  15. Reposition every 2 hours

  16. Promotes effective breathing and prevents skin breakdown.

  17. Assist patient and parents with plan for school and activities

    • Use of appliance or brace may require certain changes to be made to activities.
    • Promote independence and self-care.
    • Develop a plan for school so that patient can move about and reposition frequently as needed to relieve pain and encourage mobility.

  18. Encourage regular monitoring

  19. Patients with mild scoliosis may only require routine monitoring to make sure the condition is not getting worse.

  20. Provide pre- and post- op instructions and care

  21. Patients with severe deformities may be eligible for surgery in which the spine is straightened with rods and screws.  Prevent infection at surgical site and promote early ambulation and range of motion exercises.

  22. Educate patient and parents regarding activities that should be avoided during treatment

  23. Contact sports and high risk activities should be avoided following surgery and while wearing brace or appliance to prevent injury to patient


References

Instantly Unlock over 1000+ Nursing Lessons

Create Your Free Account

Get Started

Module 0 – Nursing Care Plans Course Introduction

Module Obstetrics (OB) & Pediatrics (Peds) Care Plans

Study Plans are available to NRSNG Users
Sign Up Now