Chapter 45: Nursing Care of the Child With a Musculoskeletal Disorder

1. Dustin Timmons, 13 years old, was born with pectus excavatum. It is progressing and Dustin has been brought to the clinic for further evaluation. (Learning Objectives 1, 2, 3, 4, 6, and 7)

a. What information would the nurse know to include in the health history?

b. What diagnostic tests should the nurse expect to be ordered?

It is determined that Dustin will be admitted to the hospital for surgical steel bar placement.

c. What would be important to teach Dustin and his family preoperatively?

d. What should the nurse include when planning discharge teaching for Dustin and his family?

2. Francesca Christoff, 6 years old, is brought to the clinic by her grandmother because of redness, swelling, and tenderness of her right calf just below her knee. Francesca’s vital signs are T 38.5°C; respirations 21 breaths per minute; pulse 112 beats per minute; blood pressure 107/69. The grandmother reports that Francesca “stubbed” her right great toe and “limped for a day or two” but that she had not injured her knee in any way. (Learning Objective 1)

a. How could the nurse explain to the grandmother that Francesca got the infection in her bone after injuring her toe?

b. What teaching should the nurse do with Francesca and her grandmother on the diagnostic tests that would be ordered?

Francesca is diagnosed with osteomyelitis and admitted to the pediatric unit for intravenous therapy.

c. What nursing interventions would be important to include in Francesca’s care?

Francesca is being discharged home with a central line for administration of intravenous antibiotics at home.

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