Prolapsed disc

consists of definition, causes, clinical manifestations, signs, dx, rx and nursing mgt.
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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