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42 Cards in this Set
- Front
- Back
Bulging disc (also called protruding, herniated, or ruptured disc
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Intervertebral discs are under constant pressure. As discs degenerate and weaken, cartilage can bulge or be pushed into the space containing the spinal cord or a nerve root= pain. most occur in lower, lumbar.
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Sciatica
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is a condition in which a herniated or ruptured disc presses on the sciatic nerve
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Spinal degeneration
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from disc wear and tear can lead to a narrowing of the spinal canal. A person with spinal
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Spinal stenosis
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related to congenital narrowing of the bony canal predisposes some people to pain related to disc disease.
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Osteoporosis
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Metabolic bone disease marked by progressive decrease in bone density and strength. Fracture of brittle, porous bones in the spine and hips results when the body fails to produce new bone and/or absorbs too much existing bone
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Skeletal irregularities
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Produce strain on the vertebrae and supporting muscles, tendons, ligaments, and tissues supported by spinal column.
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Fibromyalgia
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Chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple “tender points,” particularly in the neck, spine, shoulders, and hips.
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Spondylitis
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Chronic back pain and stiffness caused by a severe infection to or inflammation of the spinal joints.
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scoliosis
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a curving of the spine to the side
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kyphosis
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in which the normal curve of the upper back is severely rounded
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lordosis
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an abnormally accentuated arch in the lower back
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back extension
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a bending backward of the spine
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back flexion
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the spine bends forward
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pain that persists for more than __ _______ is considered chronic
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3 months
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Most important risk for injuries to the cervical or neck vertebrae
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Airway
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Most important risk for injuries to the thoracic or upper back vertebrae
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Respiration and Cardio Vascular
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Most important risk for injuries to the five lumbar vertebrae, the lower back
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GI/GU function- obstructions, constipation, urination problems
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Bulging disc, Sciatica, Spinal degeneration, Spinal stenosis, Osteoporosis, Skeletal irregularities, Fibromyalgia, and Spondylitis are all conditions associated with what?
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Low Back Pain
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What precautions for pts getting MRI?
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no metal implants, jewelry, patches with aluminum backing
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What precautions for pts getting X-ray?
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no pregnancy, BUN/creatinine levels and allergies if with contrast
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What assessments for pts getting myelogram
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allergies, BUN/creatinine (contrast), contrast is injected into lumbar space. Check fluid leakage. If Glucose is present, fluid is spinal. Contact MD stat. Raise head of bed 30 to keep contrast from traveling to brain-- seizures
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Nonsurgical Management of Lumbosacral pain
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Positioning
Drug therapy Heat therapy Physical therapy Weight control CAM |
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Hw to care for pt after LumbarLaminectomy
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Strict bed rest 24-48 hrs. Bed needs to be flat.
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Hw to care for pt after Spinal Fusion
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If cut from front monitor GI, CMA at extremities, pt will have brace- assess skin (pt should wear a shirt under brace), watch for FE, use logroll when repositioning.
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Which type of lower back surgery uses titanium capsules to insert bone from pelvis into vertebrae?
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Spinal Fusion
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How often should a neuro check be performed post op for back surgery/.
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q 4 hrs
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How long are patients generally on bed rest after back surgery?
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24-48 hrs
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How long are patients in rehab (generally)?
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1-3 weeks
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What are the 4 main purposes of rehab
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The regain function of body part
Gain back functions for daily living Mobility function Learn to live with new condition |
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What is the difference between impairment and a disability?
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Impairment: long term
Disability: can be temporary |
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6 members of the rehab team that we do not have in acute care?
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Recreational therapist
rehab assistant restorative aids rehab nurse physiatrist (rehab dr.) vocational counselor |
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What is the RNs role in rehab?
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Interdisciplinary conferences
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What act is important for vocational counselors to explain to patients in rehab?
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American with Disabilities Act
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What is an important teaching for patients newly wheelchair bound, but still have use of arms?
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Not to gain weight
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What is a good way to plan activities in order to best conserve a patient’s energy without compromising the patient’s physical or mental health?
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Which activity plan would best conserve a patient’s energy without compromising the patient’s physical or mental health?
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What is a HUGE risk for diagnoses in the rehab setting?
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Risk for Impaired Skin Integrity
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The best intervention to prevent skin impairment is frequent _______ changes in combination with adequate ______ care and sufficient _______ intake.
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position
skin nutritional |
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All patients in rehab should be turned how often?
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q 2 hrs
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What are the 3 GI/GU concerns in rehab?
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Bladder training
Constipation Bowel training |
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What is the priority nursing diagnosis for a patient in a rehabilitation program after a stroke that has caused extensive right-sided weakness?
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Risk for Impaired Skin Integrity
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The nurse is assessing the patient’s ability to transfer from the bed to the wheelchair. What might impair the patient ’s ability to perform this task?
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Recent weight gain
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Which assessment finding would prevent a patient from being a candidate for self-catheterization?
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Confusion
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