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 37 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.Some of the questions which the nurse could ask a rd

• 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.