Question

Part 2

S.P. 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:

a. What other questions should the nurse ask?

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

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

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

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

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

Answer 1

a. The other question which the nurse has to ask are

• Any recent falls
• Direct blow or injury to the leg
• Any past musculoskeletal problem
• The activities or play of the child

b.The techniques that are helpful to incorporate in assessing a patient in this age group are by

• Observation of the toddler
• Collecting thorough history from the parents
• Play techniques

c.The other assessment which the nurse has to make are

• Growth and developmental assessment
• Anthropometric assessment
• Behavioral assessment
• Gait assessment
• Psychosocial assessment
• Congenital or disability assessment
• Strength testing
• Functional assessment

d.The major difference in the musculoskeletal assessment of the children are

• Spinal cord assessment for symmetry and asymmetric
• Range of motion in the joints
• Foot deformity

e. The plan of care should include

• Health educate the parents regarding the growth and development
• Pain relieving measures

f.The likely cause of the leg pain is the part of growth and development because as the child is in growing stage the strain excerted on the leg causes pain .This is also called as growing pain.