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Module 4 > Back Pain And Intervertebral Disc Disease > Flashcards

Back Pain And Intervertebral Disc Disease Flashcards

1
Q

Radicular pain

A

Irritation of nerve root

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2
Q

Referred pain

A

Source of pain is another location

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3
Q

Lumbar region

A

Low back pain
Bears most weight
Most flexible
Contains nerve roots
Has poor biochemical structure

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4
Q

Risk factors

A

Lack of muscle tone
Excess body weight
Poor posture
Cigarette smoking
Prior compression fractures
Congenital al problems
Family history o back pain

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5
Q

Occupational risk factors

A

Repetitive lifting
Vibration
Extended periods of sitting
Health care personnel engaged in pt care

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6
Q

Chronic low back pain

A

Last longer than 3 months

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7
Q

Spinal stenosis

A

Narrowing spinal canal
Acquired conditions

Osteoarthritis RA tumors and trauma
Inherited: congenital spinal stenosis

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8
Q

Spinal stenosis manifestations

A

Pain in low back radiates to buttocks and leg
INCREASES with walking
When you bend forward it decreases pain

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9
Q

Spondylolysis

A

Structural defect , forward displacement , heredity

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10
Q

Spondylolisthesis

A

Vertebrae slides forward
(Grades not for us )

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11
Q

Low back pain goals

A

Satisfactory pain relief
Return to previous level of activity
Correct performances of excercise
Adequate coping
Adequate self help management

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12
Q

Health promotion for low back pain

A

Proper body. Mechanics
“Back school program”
Appropriate body weight
Proper sleep positioning
Firm mattress (change 8-10 years and rotate mattress)
Stop smoking
Weight reduction
Sufficient rest periods
Local hear and cold app
PT
Excercise and activity through out the day complementary and alternative therapies

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13
Q

Back school program

A

A specific therapy for back pain

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14
Q

What medications can help with back pain

A

NSAIDS , muscle relaxants

Severe- corticosteroids , opioids

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15
Q

What can we tell truck drivers if that’s how they make a living

A

Frequent excercise (back school)
Drive shorter time
Get in town Job

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16
Q

Other forms of care

A

Massage
Back manipulation
Acupuncture
Cold and hot compresses

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17
Q

Drug therapy

A

Mild analgesics-nsaids
Antidepressants
Gabapentin (neuropathy)
Baclafin for spasm
Deladid

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18
Q

Nursing diagnosis

A

Acute pain
Impaired physical mobility
Ineffective coping
Ineffective health management

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19
Q

Intervertebral ray disc disease

A

Intervertebral disc seperate vertebrae and help absorb shock
Deterioration herniation or other dysfunction
Involves all levels(cervical thoracic or lumbar)

20
Q

Patho of intervertebral disc disease

A

Loss of elasticity , flexibility and shock absorbing capabilities
Disc becomes thinner

21
Q

Radiculopathy from intervertebral disc disease

A

Radiating pain
Numbness
Tingling
Strength
Decrease strength and or ROM

22
Q

Clinical manifestations of disc disease

A

Low back pain
Radicular pain
Straight leg raise
Decrease or absent reflexes
Parenthesis
Muscle weakness

23
Q

Thinning disc

A

Causes bone on bone

24
Q

Disc degeneration with osteophyte formation

A

From osteoarthritis or RA

25
Q

Multiple nerve root( (cauda equina). Compression ——clinical manifestation of disc disease)

A

Severe low back pain
Progressive weakness
Increased pain
Bowel and bladder incontinence
Medical emergency

26
Q

More clinical manifestations

A

Pain radiated to arms and hands
Decreases reflexes and hand grip
May include shoulder pain and. Dysfunction

27
Q

Diagnostic studies for disc disease

A

X-ray
Myelogram, MRI or CT scan
Epidural venogram or disco gram
EMG

28
Q

Conservative therapy for disc disease

A

Limitation of movement
Local heat or ice
Ultrasounds and massage
Skin traction
Transcutaneous electrical nerve stimulation

29
Q

Back strengthening excercises for disc disease

A

2x a day
Encourage for a lifetime
Teach good body mechanics
Avoid extremes of FLEXION and torsion
Most pt heal in 6 months

30
Q

Drug therapy for disc disease

A

NsaIDs
Short term corticcosteriods
Opioids
Muscle relaxants
Antisiezure drugs anti depressant (Gabapentin )
Epidural corticosteroid injections

31
Q

Surgical therapy disc disease

A

Indicated only when conservative treatment fails
Radiculopathy worsens
Loss of bowel or bladder control
Constant pain
Persistent neuro deficit

32
Q

IDET
Intradiscal electrothermoplasty

A

Surgical treatment
Minimal invasive treatment
Denervates nerve fibers

33
Q

X stop /interspinous process decompression system surgical

A

To treat lumbar stenosis
Titanium fits into mount placed on vertebrae
Lifts vertebrae off pinched nerve

34
Q

Laminectomy

A

Most common seen
Surgically remove disc through excision of part of vertebra

35
Q

Discectomy

A

Most common
Surgically decompress nerve root
Microsurgical or. Percutaneous technique

36
Q

How do you move pt after surgery

A

Log roll technique
Person at head of the bed to count and call out turn

37
Q

Artificially disc replacement

A

Charite or prodisc-l disc for lumbar ddd
Allows for movement at level of implant

38
Q

Spinal fusion surgical technique

A

Metal fixation can add stability
BMP to stimulate bone growth to graft

39
Q

Nursing management

A

Vital signs - ICU only nurse
Wound inspection
Motor strength
Urinary retention
Positioning
Logroll
Home care

40
Q

From baseline if it gets worse

A

Inform physician

41
Q

Post op management spinal surgery)

A

Opioids for 24-48 hours
PCA
Switch oral drugs when able
Muscle relaxants
Assess and document pain intensity and pain management effectiveness

42
Q

What should you never do

A

Administer meds thru PCA

43
Q

What to assess post op spinal surgery

A

Potential for CSF leakage
Monitor for and report severe headache or leakage of CSF
(Clear or slightly yellow drainage on dressing and for glucose
Frequently assess for peripheral neuro signs

44
Q

Monitor GI and bowel function post op spinal surgery

A

Administer stool softeners

45
Q

Monitor and assist with bladder emptying post op spine surgery

A

Loss of tone may indicate nerve damage
Notify surgeon immediately if bowel or bladder incontinence

46
Q

Nursing managment post op

A

Teaching regarding activity
Proper body mechanics
Avoid prolonged sitting/standing
Encourage walking,lying down, shifting weight
No lifting and twisting
Use thighsn and knees to absorb shock
Firm mattress or bed board

47
Q

Baclofen

A

Also for MS and severe back problems (spasms)

Module 4 (47 decks)

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