Deficient Knowledge related to Herniated Nucleus Pulposus

Deficient Knowledge related to Herniated Nucleus Pulposus

Nursing Diagnosis and Interventions   September 16, 2013

Nursing Care Plan for Herniated Nucleus Pulposus - Nursing Diagnosis : Deficient Knowledge

Definition
A herniated disc is a fragment of the disc nucleus which is pushed out of the outer disc margin, into the spinal canal through a tear or "rupture." In the herniated disc's new position, it presses on spinal nerves, producing pain down the accompanying leg. This produces a sharp, severe pain down the entire leg and into the foot. The spinal canal has limited space which is inadequate for the spinal nerve and the displaced herniated disc fragment.

The compression and subsequent inflammation is directly responsible for the pain one feels down the leg, termed "sciatica." The direct compression of the nerve may produce weakness in the leg or foot in a specific patter, depending upon which spinal nerve is compressed.

A herniated disc is a definite displaced fragment of nucleus pushed out through a tear in the outer layer of the disc (annulus). For a disc to become herniated, it typically is in an early stage of degeneration.


Deficient Knowledge

Absence or deficiency of cognitive information related to a specific topic

Defining Characteristics:

• Verbalization of the problem;
• inaccurate follow-through of instruction;
• inaccurate performance of test;
• inappropriate or exaggerated behaviors (e.g., hysterical, hostile, agitated, apathetic)

Nursing Diagnosis for Herniated Nucleus Pulposus : Deficient Knowledge : about the condition, prognosis and actions related to misinformation, misinterpretation, given the lack of information, not to know the sources of information.

Goal: The Client acknowledges, understands, about the condition, prognosis and actions to be taken.

Outcomes:

• Clients can express understanding of the condition, prognosis and action.
• Doing back lifestyle changes.
• Participate in the rule action.

Nursing Interventions:

1). Describe the process of disease and prognosis as well as restrictions on activities such as driving a vehicle in avoiding long periods of time.

2). Provide information about a variety of things as well as instruct patients to make changes "body dynamics" without the help and also do exercises including information about its own body mechanics to stand, lift and use of ancillary shoes.

3). Discuss the treatment and some side effects.

4). Suggest to use the board / mat hard. Small pillows were a little flat in the bottom of the neck, side sleeping position with knees flexed avoid prone.

5). Discuss dietary needs.

6). Avoid the use of heating preformance long time.

7). Refer back to the use of a soft neck collar.

8). Suggest to conduct regular medical evaluation.

9). Provide information about signs that need to be reported at the next evaluation as puncture pain, loss of sensation / ability to walk.

10). Assess the likelihood to alternative treatments such as chemonucleolysis, surgical intervention.

Impaired Physical Mobility related to Herniated Nucleus Pulposus

Impaired Physical Mobility related to Herniated Nucleus Pulposus

Nursing Diagnosis and Interventions   September 09, 2013

Nursing Care Plan for Herniated Nucleus Pulposus - Nursing Diagnosis : Impaired Physical Mobility

HNP, or a herniated nucleus pulposus, is the more medically oriented term for what most people refer to as a “herniated disc.” The nucleus pulposus is the gel-like inner material found within the thick, outer wall of each intervertebral disc, which are soft, sponge-like bodies responsible for providing support and flexibility along the entire length of the spine. Due to the gradual deterioration of these discs over time as part of the natural aging process, these discs develop a tear and the nucleus pulposus can push through the disc wall and extrude into the spinal canal – a condition known as a herniated nucleus pulposus.


Impaired Physical Mobility

A limitation in independent, purposeful physical movement of the body or of one or more extremities

Defining Characteristics:

• Postural instability during performance of routine activities of daily living (ADLs);
• limited ability to perform gross motor skills;
• limited ability to perform fine motor skills;
• uncoordinated or jerky movements;
• limited range of motion;
• difficulty turning;
• decreased reaction time;
• movement-induced shortness of breath;
• gait changes (e.g., decreased walking speed, difficulty initiating gait, small steps, shuffles feet, exaggerated lateral postural sway);
• engages in substitutions for movement (e.g., increased attention to other's activity, controlling behavior, focus on preillness/predisability);
• slowed movement;
• movement-induced tremor

Nursing Diagnosis for Herniated Nucleus Pulposus : Impaired Physical Mobility
related to pain and discomfort, muscle spasm restrictive therapy. For example: bed rest, neurovascular damage.
Goal: No impairment of physical mobility.

Outcomes:

• Clients expressed understanding of the situation / risk factors and individualized treatment rules.
• Demonstrate behavioral techniques.
• Maintain or improve the strength and function of body parts affected and or compensation.

Nursing Intervention:

1. Provide protective measures as indicated by the specific situation.
2. Note the emotional response / behavior on immobilization. Provide appropriate activities with patients.
3. Follow the activities / procedures with rest methods. Instruct the patient to participate in regular daily activities within individual limitations.
4. Help the patient to perform range of motion exercises active or passive.
5. Instruct the patient to train the lower leg / knee. Value of the edema, erytema the lower extremities.
6. Assist patients in performing activities of progressive ambulation.
7. Demonstrate the use of auxiliary equipment such as a walker, cane.
8. Provide good skin care, massage pressure points after each change of position. Check the state of the skin under the brace, with a specific time period.