consists of definition, causes, clinical manifestations, signs, dx, rx and nursing mgt. for inquiries/ feedback email; gufuabdikadir96@gmail.com facebook; Gufu Abdikadir

1. Prolapsed Disc
Sultana

2. Definition…
Inner soft part of vertebral disc (nucleus pulposus) bulges
out (herniates) thro a weakness in the outer part of the disc
Also called herniated disc
The bulged disc press on nearby structures e.g. nerve
structures and inflammation develops

3. Causes
• Lots of siting esp. when driving
• Job involving lifting heavy weights
• Sports e.g weightlifting
• Smoking
• Obesity
• Elderly

4. Clinical manifestation
• Back pain>often acute… increases when lyiing down
flat and worsened by moving your back, sneezing and
coughing
• Numbness
• Nerve root pain(usually sciatic)> nerve coming from
spinal cord pressed on… pain is felt along the nerve esp.
leg calf or foot

5. Dx
• X ray- They don’t detect herniated discs but they may be
performed to rule out other causes of back pain such as an
infection,tumor,spinal alignment issues or broken bone
• MRI SCAN- Used to confirm the location of the herniated disk
and to see which nerves are affected
• CT SCAN- takes a series of xrays from many different
directions and then combines them to create cross-sectional
images of the spinal column and the structures around it
• Myelogram-A dye is injected into the spinal fluid and then x-
rays are taken.This test show pressure on the spinal cord or
nerves due to multiple herniated disk

6. Rx AND Mgt
• Exercising and keeping fit> resting is not advised because the
back pain can be chronic, instead one should do simple
exercises exercises
• Ice application- maybe helpful to ease initial inflammation and
muscle spasms associated with lumbar herniated spasms
• Pain medication-anti-inflammatory medication such as
naproxen to treat inflammation and pain
• Muscle relaxants- e.g baclofen may offer relief from the
painful spasms
• Epidural steroid injection- can offer pain relief by removing
inflammatory proteins from around structures that may cause
pain

7. Nursing Dx
• Impaired physical mobility related to muscle spasms as
evidence by inability to move
• Acute pain related to nerve compression as evidence by
phantom pain,headache
• Anxiety related to ineffective individual coping as
evidence by tension and fear
• Knowledge deficient related to the lack of information
about the condition, as evidence by questions; statement
of misconception; request for information

8. IMPLEMENTATION
• Maintain bed rest,semi-Fowler position to the spinal
bones,hips and knees in a state of flexion
• Provide good skin care,massage point pressure so as to
prevent pressure sores
• Review of secondary problems that may impede the
desire to heal and may hinder the healing process
• Explain the process of disease and prognosis and
restrictions on activities.Give information about the signs
that need attention such as loss of sensation