N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Back pain from this condition happens when pressure is put on the spinal nerves. The causes are injury to the back, age, or a congenital condition that causes a small spinal canal. This condition happens in the lumbar and lumbosacral area over 90% of the time. It can also happen in the thoracic and cervical areas, but not as often. Signs and symptoms of intervertebral disk problems: • Sciatic nerve pain down legs • Paresthesia to legs, feet, and arms • Weakness in extremities • Decreased mobility • Decreased reflexes • Muscle spasms Nursing assessment for intervertebral disk problems: • Assess pain, location, severity, character, andduration • Inquire about recent injuries, history of back pain, and congenital abnormalities • Assess peripheral circulation to legs and feet • Have patient lift leg straight up, if it causes back pain then spinal nerve isirritated • Review radiology reports: MRI, x-ray, CT scan, andmyelogram Nursing diagnosis for intervertebral disk problems: • Pain related to muscle spasms and nerve compression • Impaired physical mobility related to muscle spasms and pain • Activity intolerance related to pain and weakness • Ineffective coping related to loss of function and pain • Risk for injury related to loss of sensation and decreased mobility Nursing interventions for intervertebral disk problems: • Assess pain frequently and medicate for pain per MD orders; use of narcotics, anti- inflammatories, and muscle relaxers • Encourage bed rest until treatment decisions have been made: therapy, medication, or surgery • Apply ice/heat alternating per MD order • Apply devices per MD order: traction or back brace and teach patient how toapply • Give good skin care if devices are used • Prepare patient for surgery if necessary: o Laminectomy: The damaged part of the lamina and nucleus pulposus is removed and fused to relieve compression on the spinal nerve roots. o Diskectomy: Removes extruded or herniated intervertebral disk fragments. The surgeon may do a bone graft for stabilization. This may be performed with a laser, ©2017 Achieve Test Prep Page 136 of 204