Question

A nurse is caring for a child in a hip spica cast. List three actions the nurse should include in the child’s care. List at least two education points the nurse should include for the child and patients.

Answer 1

Hip spica is defined as the plaster which is applied to the child from the hip to the feet. This is done to immobilise the hip and the thighs or legs. This is done for any fracture cases or congenital deformiy correction where the hip or legs should be immobilise.

The main three action the nurse should include are

• Neurovascular assessment is very important as to know whether the legs are getting the good blood flow and also the movement of the toes to know whether the spica applied is not too tight.
• Position is important as children with hip spica cannot move themselves and so the position should be changed every 2 hours to prevent from any pressure ulcers. Also note that the legs or toesdo not press on the cast.
• Skin care to be done regularly to prevent any breakdown or pressure ulcers
• Toileting is important. Nappies to be changed every 2 hours in the day and 3 to 4 hours in the night for small children. For bigger children bedpans or urinals should be provided provided the cast should not be soiled or wet.

The education points needed to be informed to the child and parents are

• Parents should be given proper education as taking care of patients with hip spica is stressful and needs family support
• Education on toileting needs of the children to be given
• Educate the parents on taking care of daily activities of the child and positioning is important.
• Educate the parents on the importance of involving the children in activities.