Question

Part 2

T.A. is a 3-year-old female toddler who presents to the pediatrician’s office for a yearly well visit. The child complains that her leg hurts.

Subjective Data
PMH of otitis media
Immunizations: Up to date
No medications
No allergies
Pain: 3/5 on pain scale
Attends preschool
Unable to recall injuring leg

Objective Data
Vital signs: T 98.3, P 92, R 18, BP 100/70
Lungs: clear in all fields
Heart rate and rhythm regular
Moving all extremities
+ Range of motion legs and arms
Strength 5/5 in all extremities

Questions

1. What other questions should the nurse ask?
2. What techniques are helpful to incorporate in assessing a patient in this age group?
3. What other assessments should the nurse make for this clinical presentation?
4. What are a few of the major differences in the musculoskeletal assessment of a child?
5. What should be included in the plan of care?
6. Based on the readings, what is the most likely cause of leg pain for this patient?

Answer 1

1.What other questions should the nurse ask?

-Duration of the complaint, is it acute or chronic

-history of fever

-which part of leg is hurting , ask to point out

-is it only leg or any other limbs(to rule out rheumatic fever)

2.What techniques are helpful to incorporate in assessing a patient in this age group?

-parents are to be with the patient

-toddler comfortably seated on the lap of parent

-the part to be examined is to be undressed

3. What other assessments should the nurse make for this clinical presentation?

-assess the patient in standing position

-assess for any posture abnormalities

-symmetry of both limbs

- any swelling

-assess the gait

- check for knee joint mobility and stability

4.What are a few of the major differences in the musculoskeletal assessment of a child?

-limb measurement are taken

-examine the spine of the toddler

-measure the muscle bulk

5.What should be included in the plan of care?

-FLACC scale

- keep her in a quiet room

-allow proper relaxation

- give the prescribed medication

6.Based on the readings, what is the most likely cause of leg pain for this patient?

-growth pain

-muscle pain

-ligament laxity