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NURS 301 - Exam 4 > Intervertebral / Herniated Disks > Flashcards

Intervertebral / Herniated Disks Flashcards

1
Q

What is the primary cause of a herniated disk?

A

Trauma - incorrect lifting

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2
Q

Describe the pathophysiology of a herniated disk (2)

A
  • Protrusion of nucleus pulposus
  • Pressure on spinal cord
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3
Q

What is an intervertebral disk?

A

Cartilaginous plate - serves as a cushion between each vertebrae

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4
Q

What are the most common sites of a herniated disk? (4)

A
  • L4 - L5
  • L5 - S1
  • C5 - C6
  • C6 - C7
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5
Q

Herniated disks rarely occur in the ______ region

A

Thoracic

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6
Q

What are the general manifestations of a herniated disk? (4)

A
  • Pain
  • Paresthesia
  • Fasciculation
  • Decreased ROM
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7
Q

What is the primary diagnostic test used for the diagnosis of a herniated disk?

A

MRI

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8
Q

Describe the function of an MRI in the diagnosis of a herniated disk

A

Localization of small disk herniations

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9
Q

What alternative diagnostic tests are used for the diagnosis of a herniated disk if an MRI is not consistent with patient symptoms? (3)

A
  • CT
  • EMG
  • Myelography
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10
Q

Describe the function of a myelography in the diagnosis of a herniated disk

A

Uses contrast dye to visualize abnormalities in the spinal cord / nerve roots

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11
Q

Describe the general nursing interventions associated with herniated disk treatment (2)

A
  • 1 - 2 days of bedrest
  • William’s position
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12
Q

Describe William’s position

A

Semi-fowlers with knees flexed

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13
Q

Describe medications associated with herniated disk treatment (4)

A
  • NSAIDs
  • Analgesics
  • Corticosteroids
  • Muscle relaxants - Flexeril
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14
Q

Surgical treatment for a herniated disk is used when there is ______

A

Progressive neurological dysfunction

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15
Q

What is the goal of surgical management for a herniated disk?

A

Relieve pressure on nerve roots

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16
Q

What are the causes of cervical disk herniation? (3)

A
  • Aging
  • Spondylosis
  • Occupational stressors
17
Q

Cervical disk herniation may lead to …

A

Lesions damaging the spinal cord

18
Q

Describe the location of pain associated with cervical disk herniation (3)

A
  • Neck
  • Upper extremities
  • Shoulders / scapulae
19
Q

Pain associated with cervical disk herniation is sometimes mistaken for ______

A

Chest pain

20
Q

Describe the medical management associated with cervical disk herniation (2)

A
  • Cervical collar
  • Ice followed by hot moist compress
21
Q

Describe the frequency of hot moist compress use for treatment of a herniated disk

A

10 - 20 minutes - several times / day

22
Q

What are the manifestations of lumbar disk herniation? (4)

A
  • Sciatica
  • Lower back pain
  • Postural deformity
  • Pain during straight leg test
23
Q

Lumbar disk herniation pain is aggravated with actions that …

A

Increase intra-spinal fluid pressure

24
Q

Describe some examples of actions that increase intra-spinal fluid pressure (4)

A
  • Sneezing / coughing
  • Straining
  • Bending
  • Lifting
25
Q

Describe the straight leg test

A

Raising a leg into the straight position while laying in the supine position

26
Q

Describe the medical management associated with lumbar disk herniation (2)

A
  • Physical therapy
  • Ice followed by hot moist compress
27
Q

Describe the surgical management associated with lumbar disk herniation (2)

A
  • Microdiskectomy
  • Lumbar disk excision
28
Q

What are the complications associated with surgical treatment of lumbar disk herniation? (3)

A
  • Arachnoiditis
  • Urinary retention
  • Scarring around spinal nerves
29
Q

______ may continue despite surgical management

A

Sciatica

30
Q

What nursing method is used in pre-operative care for a patient with a herniated disk?

A
  • The 3 Bs:
  • Blood
  • Bone
  • Brace
31
Q

Describe “blood” regarding pre-operative herniated disk care

A

Donation of a patient’s own blood

32
Q

Describe “bone” regarding pre-operative herniated disk care

A

Donation of a patient’s own bone OR a bone graft from a donor

33
Q

Describe “brace” regarding pre-operative herniated disk care (4)

A
  • TLSO braces
  • Provide support
  • Prevent twisting
  • Fitted to the individual patient
34
Q

Autograft donor site pain may be present for ______

A

2 - 3 years

35
Q

Describe post-operative nursing interventions associated with a herniated disk (3)

A
  • Logroll every 2 hours
  • Neurological assessment
  • Measure JP / Hemovac drainage
36
Q

Describe correct positioning post-op herniated disk when out of bed (2)

A
  • Back straight
  • Feet on the floor

NURS 301 - Exam 4 (4 decks)

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