NR 328
(EDAPT WEEK 7)
Care of the Child with Alterations in Mobility
Pediatric Nursing
,Care of the Child with Alterations in
Mobility
This lesson provides an overview of nursing care for pediatric clients with
alterations in mobility.
Immobilization may be due to a disability, illness, or injury. Bone fractures
are a common musculoskeletal injury in children and this module
presents fractures, casting, and traction.
Immobility Impact
The nurse is caring for a pediatric client who is immobile. Which systems
should the nurse monitor for complications? Select all that apply.
Cardiovascular
Musculoskeletal
Gastrointestinal
Integumentary
Respiratory
Immobility affects the respiratory, gastrointestinal, cardiovascular,
musculoskeletal, and integumentary systems.
Neurovascular Assessment
The nurse is assessing the neurovascular status of a 5-year-old with a
broken femur. Match the neurovascular check with the correlating nursing
action.
To assess for pain, the nurse should ask the child to rate pain using the
FACES pain scale. Using the 1 to 10 pain scale would be inappropriate for
a 5-year-old.
,To assess for pallor, the nurse should check the capillary refill of the
extremity.
To assess for pulselessness, the nurse should check for a pulse distal to
the injury, not proximal to the injury.
To assess for paresthesia, the nurse should ask if the child can feel you
tickle their toes.
To assess for paralysis, the nurse should ask the child to wiggle their toes.
Complications of Fractures
When caring for a client with a fracture, the nurse should monitor for
which complications? Select all that apply.
Compartment syndrome
Physeal damage
Osteomyelitis
Nerve compression
Circulatory impairment
Circulatory impairment, nerve compression, compartment syndrome,
physeal (growth plate) damage, and osteomyelitis are all complications of
fractures.
The nurse should assess circulation of the extremity for any circulatory
impairment, assess sensation and motor strength for nerve compression,
monitor the 5 Ps (pain, pallor, pulselessness, paresthesia, and paralysis)
for compartment syndrome, and monitor growth after the injury, which
may indicate physeal damage.
Nursing Care Management of the
Immobilized Child
, Immobilization from illness or injury directly and indirectly impacts many
body systems. Assessment of a child who is immobilized includes focus on
the injury and other systems which may be affected. The amount of the
body that is immobilized and the length of immobilization are related to
the risks of complications. The nurse needs to be aware of the effects on
the body from immobilization and implement nursing interventions to
prevent complications.
System Effects Nursing Interventions
Muscular decreased muscle strength, plan activities to use uninvolved
tone, and endurance extremities
loss of joint mobility place in upright position when
development of contractures possible
perform active and passive range-of-
motion exercises
maintain body alignment
Skeletal bone demineralization carefully handle extremities when
hypercalcemia positioning
monitor serum calcium levels
Metabolism decreased metabolic rate mobilize as soon as possible
provide high-protein diet
Cardiovascular venous stasis use antiembolism stockings or
altered distribution of blood intermittent compression devices
volume assist with frequent position changes
dependent edema elevate extremities
increased risk for thrombus monitor for signs of pulmonary
formation embolism
monitor skin color, temperature, and
integrity
Signs of a deep vein thrombosis include sudden chest pain, shortness of breath, air hunger, or
pain and swelling in the lower extremities.
(EDAPT WEEK 7)
Care of the Child with Alterations in Mobility
Pediatric Nursing
,Care of the Child with Alterations in
Mobility
This lesson provides an overview of nursing care for pediatric clients with
alterations in mobility.
Immobilization may be due to a disability, illness, or injury. Bone fractures
are a common musculoskeletal injury in children and this module
presents fractures, casting, and traction.
Immobility Impact
The nurse is caring for a pediatric client who is immobile. Which systems
should the nurse monitor for complications? Select all that apply.
Cardiovascular
Musculoskeletal
Gastrointestinal
Integumentary
Respiratory
Immobility affects the respiratory, gastrointestinal, cardiovascular,
musculoskeletal, and integumentary systems.
Neurovascular Assessment
The nurse is assessing the neurovascular status of a 5-year-old with a
broken femur. Match the neurovascular check with the correlating nursing
action.
To assess for pain, the nurse should ask the child to rate pain using the
FACES pain scale. Using the 1 to 10 pain scale would be inappropriate for
a 5-year-old.
,To assess for pallor, the nurse should check the capillary refill of the
extremity.
To assess for pulselessness, the nurse should check for a pulse distal to
the injury, not proximal to the injury.
To assess for paresthesia, the nurse should ask if the child can feel you
tickle their toes.
To assess for paralysis, the nurse should ask the child to wiggle their toes.
Complications of Fractures
When caring for a client with a fracture, the nurse should monitor for
which complications? Select all that apply.
Compartment syndrome
Physeal damage
Osteomyelitis
Nerve compression
Circulatory impairment
Circulatory impairment, nerve compression, compartment syndrome,
physeal (growth plate) damage, and osteomyelitis are all complications of
fractures.
The nurse should assess circulation of the extremity for any circulatory
impairment, assess sensation and motor strength for nerve compression,
monitor the 5 Ps (pain, pallor, pulselessness, paresthesia, and paralysis)
for compartment syndrome, and monitor growth after the injury, which
may indicate physeal damage.
Nursing Care Management of the
Immobilized Child
, Immobilization from illness or injury directly and indirectly impacts many
body systems. Assessment of a child who is immobilized includes focus on
the injury and other systems which may be affected. The amount of the
body that is immobilized and the length of immobilization are related to
the risks of complications. The nurse needs to be aware of the effects on
the body from immobilization and implement nursing interventions to
prevent complications.
System Effects Nursing Interventions
Muscular decreased muscle strength, plan activities to use uninvolved
tone, and endurance extremities
loss of joint mobility place in upright position when
development of contractures possible
perform active and passive range-of-
motion exercises
maintain body alignment
Skeletal bone demineralization carefully handle extremities when
hypercalcemia positioning
monitor serum calcium levels
Metabolism decreased metabolic rate mobilize as soon as possible
provide high-protein diet
Cardiovascular venous stasis use antiembolism stockings or
altered distribution of blood intermittent compression devices
volume assist with frequent position changes
dependent edema elevate extremities
increased risk for thrombus monitor for signs of pulmonary
formation embolism
monitor skin color, temperature, and
integrity
Signs of a deep vein thrombosis include sudden chest pain, shortness of breath, air hunger, or
pain and swelling in the lower extremities.
