Question

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

What other questions should the nurse ask?

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

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

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

What should be included in the plan of care?

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

Answer 1

1.What time the child gets leg pain (afternoon or evening)

Which part of the leg aches (thigh, calf muscles or behind the knees)

Whether pain is present in one or both legs

Does the pain goes away in the morning.

All the above questions can enable to rule out whether the child is having growing pain or some musculoskeletal problems).

2..The main techniques to be incorporated in assessing this type of age group children are by actively involving parents in the assessment and understanding the child's behaviour.

3.The other assessments necessary for clinical presentation are

Biometric measurement (height, weight)

Nutritional assessment

Ear examination for recurrence of otitis media because the relapse rate is 20% _30%

Pain assessment (type,frequency,duration,intensity, radiation) to aide in treatment.

4.

Some of the major difference in the musculoskeletal assessment of a child are

Observation ratger than performing tests.A simple MSK assessment is performed (pGALS)which is paediatric Gait, Arms,Legs,Spine.

5.The most like cause of the pain is growing pain because this starts I'm nearly childhood from 3 years to 4 years.

6.Parents are more concerned about the leg pain of their child without any cause which wake them up during sleep.Here S.P has the same problem ,her vitals are normal and she is moving extremities with strength 5/5.Many children at their early childhood have pain in their legs without any cause and this condition is called Growing Pains .The care that can be given to S.P are;

Massage leg gently

-Warm bath before going to bed

-Hot application

Stretching exercises can be given

Pain relievers like acetaminophen ,ibuprofen can be given.