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    NURS 227 Pediatric Nursing Proctored Exam

    Patient 1 Client 1: 6-year-old boy with gradual limp and mild hip/knee pain for 2 months. Afebrile Patient 2 Client 2: 12-year-old overweight adolescent with sudden hip pain and externally rotated leg. Patient 3 Client 3: 5-year-old with recent viral illness and acute hip pain: low-grade fever, able to bear some weight. For each diagnosis indicate the anticipated plan of management

    Explanation & Rationale

    • NSAIDs and rest: In Legg-Calvé-Perthes, NSAIDs help reduce pain and inflammation, while rest and limited activity prevent further femoral head damage. For transient synovitis, NSAIDs alleviate pain and inflammation, and rest allows self-limiting inflammation to resolve, usually within 1–2 weeks. • Long-term activity restriction: Children with Legg-Calvé-Perthes may require extended periods of activity limitation, including avoidance of high-impact activities, to allow the femoral head to heal and maintain hip function. This helps prevent deformity and improves long-term mobility. • Immediate non-weight-bearing: SCFE requires strict non-weight-bearing to prevent further slippage of the femoral head. Crutches or a wheelchair are used immediately, as weight bearing can worsen displacement and increase risk of complications such as avascular necrosis. • Surgical pinning: Surgical stabilization with in-situ pinning is the definitive treatment for SCFE. Pinning prevents further slippage, stabilizes the femoral head, and reduces the risk of long-term hip deformity and functional impairment. Early surgery is essential to preserve hip anatomy.

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