1. Carpal Tunnel Syndrome
Prepared By: Rommel L. Manalo BSN 3-A
College of Nursing and Health Sciences Department
2. is a painful disorder of the wrist and
hand, caused by pressure on the median
nerve in the carpal tunnel of the hand.
3. ASSESSMENT
Subjective:
“ Masakit ang aking kamay
hindi ko maigalaw ang aking
mga daliri,as verbalized by the client” PS 8/10
Objective:
Pain and/or numbness that is worse at night or
interrupts sleep.
grimace face
EMG- Hand weakness. Slow nerve conduction,
Difficulty gripping objects with the hands or dropping
objects.
Tinel’s Test.
4. NURSING DIAGNOSIS
Acute pain. r/t inflammation and
swelling secondary to pressure on
median nerve.
Self care deficit regarding ADL.
5. GOAL OF CARE
After 2 hours of nursing intervention the
patient verbalized pain is relieved/controlled.
After 3 hours of nursing intervention pain will
be reduced from 8/10 to 4/10.
After 2 hours of health teaching. the client, will
be able to verbalize willingness and
demonstrate participation in ADL.
After 7 hours of nursing intervention the client
will be able to maintain or increase strength and
function of affected and/or compensatory body
part.
6. NURSING INTERVENTION
Independent:
assess pain
duration, intensity, location, and frequency
Encourage verbalization of feelings about
the pain.
Use pain rating scale.
Instruct/encourage use of relaxation
technique, such as deep breathing exercise
to distract attention and reduce tension .
Encourage diversional activities such as:
watching TV. Listening music and
socialization with others.
7. provide client teaching and discharge
planning concerning.
simple exercises.
Extend and stretch both wrists and fingers
acutely as if they are in a hand-stand
position. Hold for a count of 5.
Straighten both wrists and relax fingers.
Make a tight first with both hands.
Then bend both wrists down while keeping
the fist. Hold for a count of 5.
comfort measures.
8. Straighten both wrists and relax fingers, for
a count of 5.
exercise should be repeated 10 times.
arms hang loosely at the side and shake
them for a few seconds.
DEPENDENT
Take meds as ordered by the physician .
Non- steroidal anti-inflammatory drugs
(NSAIDs)
Take medicines such as ibuprofen or
naproxen for the first 2 or 3 days after an
injury.
9. Here are some exercises intended to
help prevent carpal tunnel syndrome
10. Collaboration:
refer to rehabilitation medicine for
further mgt. and exercises regimen per
doctors order.
The significant others coordinate to
medical social worker for their bill
hospitalization and especially to the
physician for further fast recovery.
11. RATIONALE
To decrease pain
To locate pain and average the pain.
To note any changes in body’s behavior
towards pain.
To prevent furthered complications.
To advice the client for her own good.
advice to maintain her personal hygiene.
To provide adequate rest.
12. INTERVENTION 2
Assess age developmental issues affecting
ability of individual to participate in own
care
Assist the client to improve self care .
Establish remotivation or resocialization
programs when indicated.
provide for communication among those
who are involved in caring for assisting the
client.
Provided privacy and equipment within
easy reach during personal care activities.
Assist in necessary adaptation to
accomplish ADL.
13. Collaborative 2
Collaborate with rehabilitation
professionals to identify or obtain
assistive devices, mobility aids and
home modification as necessary.
DEPENDENT 2
assist medication regimen as
necessary, encouraging timely use of
medications.
14. Discharge Planning
o M- Instruction about the use of medications and
the possible side effects -Non steroidal anti-
inflammatory drugs (NSAIDs)
- ibuprofen, or naproxen for the first 2 or 3 days
after an injury.
o E-Advise client/SO to perform active/passive ROM
exercises & simple exercises only
o T- Advise the client to bring X-rays, MRI, result
prior to follow-up check up
o H-encourage to perform relaxation techniques
specially during attack.
o Advise client to maintain proper personal hygiene.
o O – Instruct client to bring laboratory result prior
to follow up check up after 1wk at OPD.
15. o D- Instruct client to eat nutritious food rich
in vit. Minerals & protein and to avoid
eating nuts.
o S - Instruct client to consult therapist for
problems regarding sexuality
-instruct client to consult spiritual adviser
for any concern’s regarding spirituality
