Learning Guide


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Learning Guide

  1. 1. Learning Guide Module 8: Neurosensory Disorders:Herniated Disk (HNP)/Spinal Cord Tumors Marnie Quick, RN, MSN, CNRN Herniated Disk (HNP) 1. Identify risk factors, what teaching can be done to reduce risk for developing HNP? 2. Utilizing the Fig 41-8 on p. 1333, identify: a. Posterior sensory part of the spinal nerve/ nerve root. b. Anterior motor part of the spinal nerve/root c. State what symptoms the patient might have if affected by disk. 3. Identify the clinical manifestations for: a. L4-5 HNP (5th lumbar root) b. C5-6 HNP (6th cervical root) 4. What is sciatica? 5. How does increase in intrathoracic pressure cause increase in sciatica? Give some examples of how this pressure is increased. 6. Describe nursing care for the patient going for a myelogram. Where is the needle usually inserted to inject the dye? Why isn’t the spinal cord injured when they put the needle in? 7. Why should the head of the bed be keep elevated at least 30 degrees post myelogram with a water-based dye? 8. Why should bowel and bladder function be carefully assessed post myelogram and post-op lumbar discectomy? 9. Describe the conservative treatment for a HNP. 10. How do you teach log rolling? 11. What is the pain-spasm-pain cycle experienced by HNP clients? RNSG 2432  177
  2. 2. 12. What area of the body needs strengthening exercises for patients with back pain or HNP? 13. Should you apply the collar or brace on before the patient gets out of be? Why? 14. What is the difference between a laminectomy (posterior and anterior), spinal fusion, foraminotomy and discectomy? 15. What is the preoperative teaching and postoperative care after a posterior laminectomy? 16. What is important to assess for after an: a. Anterior cervical discectomy? b. Posterior laminectomy? 17. Why might postural hypotension occur post-op? 18. Why might a patient state that his pain is no different than pre-op? 19. Would you be concerned if your patient stated that the donor site hurt more than his fusion site? 20. Discuss the teaching needs as stated on p. 1341. Spinal Cord Tumors 21. How are spinal cord tumors classified? 22. Where do extramedullary-intradural spinal cord tumors arise from? 23. What would you expect to see in your assessment for the patient with thoracic spinal cord tumor? 24. How is the pain different in a spinal cord tumor than in a HNP? 178  RNSG 2432
  3. 3. 25. Why would Medrol dose pack be given when the patient goes home post-op spinal cord tumor surgery? 26. Compare the nursing assessment and care for the patient with a spinal cord tumor with that given to a patient with a spinal cord injury or HNP. RNSG 2432  179
  4. 4. 180  RNSG 2432