Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide

Intervertebral Disk Problems This disease begins with an abnormality in the structure of the spine. The vertebrae begin to narrow and put pressure on the disks that normally act to absorb shock. The annulus fibrosis (fibrous tissue) begins to tear and degrade. Any stress to the spine causes the disk to degenerate even more and eventually the gelatin like filling pushes through and herniates, or pushes out, the side in between the vertebrae. 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 is irritated • 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

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