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The Pattern That Should Change Priority
A preschool child who uses the hands to push up from the floor, falls repeatedly, and has enlarged calves may be showing the first visible pattern of Duchenne muscular dystrophy...
NCLEX-RN
NCLEX-RN
A preschool child who uses the hands to push up from the floor, falls repeatedly, and has enlarged calves may be showing the first visible pattern of Duchenne muscular dystrophy (DMD). The weakness is proximal, so rising, climbing, running, and jumping become difficult before hand function is obviously affected. The nursing question is not simply whether the child can still walk. Dystrophin-related muscle injury also progressively reduces cough strength, swallowing reserve, and cardiac muscle function. A change in mobility therefore prompts assessment of breathing, sleep, nutrition, and cardiac follow-up—not just a falls plan.
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