Question

A 3-year-old is immobilized in a hip spica cast. Which discharge instruction should be given to the parents? A. Keep the bed flat, with a small pillow beneath the cast B. Provide crayons and a coloring book for play activity C. Increase her intake of high-calorie foods for healing D. Tuck a disposable diaper beneath the cast at the perineal opening

Short answer

Answer: The most appropriate discharge instruction is to tuck a disposable diaper beneath the cast at the perineal opening, as it addresses hygiene concerns and helps maintain cleanliness while the child is wearing the cast.

Step-by-step solution

Understand hip spica cast

A hip spica cast is a type of orthopedic cast used to immobilize the hip and thigh area, usually after surgery or hip injury. Its purpose is to help the injured area heal by minimizing the movement of the child.

Analyze each option

A. Keeping the bed flat with a small pillow beneath the cast can help maintain the alignment of the cast and provide comfort to the child. This option seems reasonable. B. Providing crayons and a coloring book for play activity helps to keep the child mentally engaged and entertained, but this has nothing to do with the specific care of the hip spica cast. C. Increasing the intake of high-calorie foods for healing might be helpful in some cases, but it is not a specific discharge instruction related to the care of a hip spica cast. D. Tucking a disposable diaper beneath the cast at the perineal opening is a practical way to maintain hygiene and cleanliness for the child while wearing the cast, which is essential to avoid infections and complications.

Choose the most appropriate discharge instruction

Among the above options, D. Tuck a disposable diaper beneath the cast at the perineal opening seems to be the most relevant and helpful discharge instruction specific to the care of a hip spica cast. It addresses a major concern related to hygiene, which is important for the proper healing of the casted area.

Key concepts

Pediatric Nursing

Pediatric nursing is a specialized field of nursing dedicated to the care of infants, children, and adolescents. Nurses in this field provide holistic care tailored to the physical, emotional, and developmental needs of young patients. They play a key role in monitoring the growth and development of children, recognizing any deviations from normal patterns, and implementing supportive measures as needed.
Pediatric nurses also work closely with families, educating them on care techniques to ensure continuity from hospital to home. This includes guidance on appropriate activities, managing nutrition, and identifying signs of possible complications. Since children can't always communicate their needs or symptoms, pediatric nurses must have strong observational skills and be adept at translating medical jargon into clear, simple terms for families.

• Holistic care tailored to young patients
• Monitoring growth and development
• Family education and support

Understanding the psyche of a child is also crucial as it influences how nurses approach care and education. This involves using creative techniques, like play, to help children feel comfortable and cooperative during treatments and procedures.

Hip Spica Cast Care

Caring for a child with a hip spica cast involves several important steps to ensure proper healing and prevent complications. A hip spica cast typically immobilizes the hip and part of one or both legs, which can affect the child's daily activities and care routine.
One of the primary considerations in hip spica cast care is maintaining cleanliness around the perineal area. Since the cast can obstruct normal bathroom use, using a tucked disposable diaper under the cast at the perineal opening is highly recommended. This technique helps to prevent skin irritation, infections, and unpleasant odors, all of which can impede recovery.

• Keep the cast clean and dry
• Prevent skin irritation and infection
• Monitor for any changes or discomfort

Parents should also make sure that no foreign objects, such as crumbs or toys, get trapped in the cast. This can be achieved by encouraging activities that do not involve stuffing items into small spaces, like coloring.
It's also important to check for signs of pressure sores, swelling, or blueness of the extremities, which could indicate circulation issues. Adjusting the child’s position regularly and providing support with small pillows can enhance comfort and reduce pressure on sensitive areas.

Nursing Discharge Instructions

Discharge instructions are crucial for ensuring a seamless transition from hospital to home. Parents or guardians must be well-informed on how to continue care, recognizing that this knowledge is vital for the ongoing well-being of the child.
In the case of a hip spica cast, specific instructions may include tips on proper hygiene and the safe handling of the cast to prevent damage. For instance, parents should learn how to appropriately position their child to avoid unnecessary pressure on the cast, and how to keep it dry during bath time with waterproof covers.

• Home care instructions for specific conditions
• Recognizing warning signs
• Understanding follow-up appointments

Nurses need to ensure that caregivers understand the signs of potential complications, such as increased pain, fever, or changes in skin color around the cast. Providing an emergency contact number and a schedule for follow-up appointments is also an integral part of discharge planning.
Finally, addressing parental concerns and equipping them with coping strategies for stress or anxiety related to caring for a casted child encourages a more confident caregiving approach, leading to better outcomes for the young patient.