The 5-year-old child is brought to the emergency department (ED) after a fall at school that has resulted in a broken wrist. The nurse notes the child is thin, with curved femurs and kyphosis. Metaphyseal fraying and cupping is noted on x-ray of the wrist. There is evidence of old fractures that healed poorly, as if they hadn’t been set properly. Upon review of the patient’s medical history, it does not appear that the patient has received ongoing well-child care. After laboratory evaluation, the child is diagnosed with rickets. The nurse prepares information on which medication for the family?

Question

The 5-year-old child is brought to the emergency department (ED) after a fall at school that has resulted in a broken wrist. The nurse notes the child is thin, with curved femurs and kyphosis. Metaphyseal fraying and cupping is noted on x-ray of the wrist. There is evidence of old fractures that healed poorly, as if they hadn&rsquo;t been set properly. Upon review of the patient&rsquo;s medical history, it does not appear that the patient has received ongoing well-child care. After laboratory evaluation, the child is diagnosed with rickets. The nurse prepares information on which medication for the family?

Accepted Answer

Vitamin D 600,000U intramuscularly once. The patient with rickets requires vitamin D supplementation. Based on the evidence of lack of regular healthcare for this child, a one-time dose that provides the necessary vitamin D to treat the rickets is the most appropriate option for the child. Rickets treatment can be provided in the form of a daily dose of 10,000U of vitamin D for 3 months, but this is a less appropriate option for this child. Vitamin D rescue is not provided in weekly IM injections for 6 weeks. Maintenance vitamin D intake is 600U orally each day, not 100U.

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