In this question you will have two patient populations Patie

In this question you will have two patient populations.
Patient Population 1: Elementary School Students.
You are a school nurse in a local school. Today you will be screening the children for scoliosis.
Part 1: If a child were suffering from scoliosis, what signs may indicate scoliosis?

Patient Population 2: Google’s Private RN.

Part 2: Larry works as a technician. His chief complaint is “shoulder stiffness and upper back pain.” Larry is commonly seen hunched over his desk and as expected displays poor posture in your office. Based on this limited information, what is a possible diagnosis (current or future)?

Part 3: You patient Beatrix, is 6 months pregnant. Her chief complaint is lower back pain. She has a visible arch in the lumbar region of her spine with a well defined “C” shape. She also complains that since she has been pregnant, her “belly and buttocks have been sticking out more.”

Based on this limited information, what is a possible diagnosis (current or future)?

Would you expect her condition to be a life-long condition? Why or why not?

Solution

Part 1: If a child were suffering from scoliosis, what signs may indicate scoliosis?

Part 2: In most cases, scoliosis is not painful, but there are certain types of scoliosis than can cause back pain, rib pain, neck pain, muscle spasms, and abdominal pain. Doctor may examine Larry, check the spine and shoulder and prescribe a X ray examination. Usually doctors ask him to come back after few months to see if the deformity has increased. That is the best option to do if you feel the deformity is not severe. If the curve or Cobb angle stays below about 20-25 degrees (Cobb method or angle, is a measurement of the degree of curvature), no other treatment is needed. Additional X-rays may be repeated each year to obtain new measurements and check for progression of the curve. If the curve is between 25-40 degrees and the patient is still growing, a brace may be recommended. Bracing is not recommended for people who have finished growing. If the curve is greater than 40 degrees, then surgery may be recommended.

Part 2: Since the lady is pregnant, she cannot be given with braces or X ray. So she will be given with mild pain killers and some exercises. The primary objective of the above treatments is to relieve the spinal pain and discomfort. You may alsosuggest maternity belt and rest. Exercise makes you feel comfortable. It helps improve the strength in your back muscles and keep the spine in proper shape. Elastic resistance exercises are the most helpful, but they should be performed only with the help of a professional expert.