Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide • 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, which is an easier recovery for the patient. • Assure patient sits up straight and provide a sturdy chair at bedside • Assist with ADLs but allow the patient to do as much self-care aspossible • After surgery, gradually increase activity levels but allow for rest periods • Assist physical therapy with rehabilitation; encourage patient to do assigned exercises • Teach patient the use of TENS unit if necessary • Perform frequent neurological and peripheral circulationchecks • Encourage patient to wear anti-embolism stockings until discontinued by surgeonorders • Assist with range of motion if mobility is limited • Provide adequate nutrition and fluids for healing • Provide good skin care and monitor for signs and symptoms of infection to surgical site • Teaching for patient and family should focus on rehabilitation plan, use of assistive devices, and medications Expected outcomes for intervertebral disk problems: • Patient verbalizes relief from pain and increased comfort • Patient demonstrates increased mobility and activity tolerance • Patient is able to tolerate support devices • Remains free from skin breakdown, post-op complications, and infection • Verbalizes understanding of treatment and rehabilitation plan

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