Intervertebral Disc Disease

Question 1 of 3 The nurse is reviewing the medical history of a patient with degenerative disc disease (DDD). Which reported history finding is a risk factor for DDD? Diabetes Underweight Femur fracture Tobacco smoking

Tobacco smoking Smoking can cause degenerative changes of the intervertebral discs, leading to DDD.

Question 2 of 3 A nursing student is making a clinical presentation regarding the anatomy of the spine, and the instructor asks the student about the annulus fibrosus. Which response by the student indicates an understanding of the topic? "It is the spongy portion of the bone." "It is the soft, jellylike center of the disc." "It is the tough outside capsule of the disc." "It is a protruding portion of the center of the disc."

"It is the tough outside capsule of the disc." The tough outer coating that protects the soft inner portion of the disc is the annulus fibrosus.

Question 6 of 9 A patient being prepared for a laminectomy tells the nurse, "I only took six days off from work to recover. Will that be enough time?" Which response by the nurse is appropriate? "You should have at least 10 days off from work to recover." "You should speak to the surgeon about how much recovery time is needed." "As long as you will only be sitting down and not moving around much, you should be fine." "It may take a few weeks to fully recover from the surgery. Six days may not be enough time."

"It may take a few weeks to fully recover from the surgery. Six days may not be enough time." Depending on the amount of lifting, walking, and sitting the patient's job involves, the patient may be able to return to work within a few weeks.

Question 2 of 9 The nurse is providing orientation to a new graduate who is caring for a patient with a herniated disc. The graduate asks, "What is a disc herniation?" Which is the appropriate response by the nurse? "The annulus fibrosus is deteriorating." "The annulus fibrosus has penetrated the nucleus pulposus." "The nucleus pulposus has bulged out through an opening in the annulus fibrosus." "The nucleus pulposus is inflamed and causing irritation to the surrounding nerves."

"The nucleus pulposus has bulged out through an opening in the annulus fibrosus." When the jellylike center of the vertebra bulges out through the tough outer layer of the vertebra, the disc is herniated.

Question 9 of 9 The medical-surgical charge nurse receives a patient in the postanesthetic care unit after successful completion of spinal fusion. The patient is still sedated and is assigned to a staff nurse. The unit charge nurse intervenes when the staff nurse prepares to give which prescription to the patient? Morphine, 2 mg, intravenously (IV) Diazepam, 2.5 mg, by mouth Morphine via patient-controlled analgesia pump Hydromorphone, 1 mg, intravenously

Diazepam, 2.5 mg, by mouth The sedated patient should not be given an oral medication. The presence of a gag reflex and the ability to tolerate oral fluids must be assessed first.

Question 5 of 9 The nurse is providing health education to a patient who is scheduled for disc replacement. Which information should the nurse include in the teaching plan about the procedure? Disc replacement will permanently resolve pain. Disc replacement will reduce, but not eliminate, pain. Pain from the procedure should be resolved within five days. Disc replacement will allow the patient to regain hyperextension ability.

Disc replacement will reduce, but not eliminate, pain. Disc replacement will likely make the pain more manageable, but it is not a permanent or long-term solution.

Question 1 of 3 A patient is experiencing signs of painful constipation related to an ileus after spinal surgery. Which medication should the nurse anticipate administering to this patient?DocusateFamotidineCyclobenzaprineAcetaminophen with codeine

Docusate Docusate is a stool softener that will assist in resolving the constipation caused by the paralytic ileus. Opioid use often results in constipation.

Question 3 of 3 The nurse is caring for a patient with a herniated disc at L4-5 and symptoms of radiculopathy. The nurse would expect the patient to experience pain in which location? Shoulders Sole of foot Inner thigh Dorsum of foot

Dorsum of foot Pain with a herniation at L4-5 is experienced in the area from the back to the buttocks to the top (dorsum) of the foot and the big toe.

Question 7 of 9 The nurse is caring for a patient who has undergone cervical spine surgery. Which findings should prompt the nurse to implement immediate life-saving measures? Select all that apply. Cough Dyspnea Nasal flaring Vesicular breath sounds Diminished breath sounds

Dyspnea Dyspnea is a sign of respiratory distress and can be life threatening to the patient. Correct Nasal flaring Nasal flaring is a sign of respiratory distress and can be life threatening to the patient.

Question 3 of 3 A patient who had a lumbar spinal fusion six weeks ago is experiencing pain when he sleeps. Which action is appropriate for the nurse to take? Advise patient to use the neck collar during sleep Encourage the patient to sleep on a firm mattress Instruct the patient to take pain medication at night Encourage the patient to use nonpharmacologic pain measures

Encourage the patient to sleep on a firm mattress A firm mattress can support spinal healing and promote comfort for the patient during sleep. A soft mattress, on the other hand, can cause pain in patients recovering from spinal fusion.

Question 3 of 9 The nurse would most likely expect to see vertebral discs break down in which region of the spine? Lumbar Sacral Thoracic Cervical

Lumbar The lumbar area is the most common area for vertebral disc breakdown because it is the most used area of the spine.

Question 2 of 3 The nurse is caring for a patient after cervical spine surgery. Which actions should the nurse take while managing the care of this patient? Select all that apply. Keep head of the bed flat for 48 hours. Monitor the patient for signs of respiratory distress. Perform neurovascular checks on the lower extremities. Keep the patient's neck immobilized with a cervical collar. Place pillows under the patient's thighs when he or she is supine.

Monitor the patient for signs of respiratory distress. Keep the patient's neck immobilized with a cervical collar.

Question 8 of 9 The nurse is assessing the dressing of patient after completion of lumbar spine surgery and notes yellow-tinged drainage. After further examination, the nurse documents that the patient has a headache with a rating of seven on a pain scale of one to 10. Which action is most appropriate action for the nurse to take next? Administer morphine intravenously Test the drainage for the presence of glucose Notify the health care provider immediately Remove the dressing and apply a pressure bandage

Notify the health care provider immediately The health care provider should be alerted immediately because these are signs of cerebrospinal fluid leakage, which can be life threatening.

Question 1 of 9 A nurse is caring for an older adult patient and suspects the patient may have a herniated disc. Which signs/symptoms are indicative of a herniated disc? Select all that apply. Pain Numbness Leg weakness Cold sensation Swelling of the arm

Pain Radiculopathy is a symptom of a herniated disc; this includes pain caused by the distressed disc. Correct Numbness Radiculopathy is a symptom of a herniated disc and includes numbness. Correct Leg weakness Radiculopathy is a symptom of a herniated disc and includes leg weakness secondary to nerve impingement.

Question 1 of 3 A nurse is caring for a patient with complaints of lower back pain and decreased range of motion, unrelieved by nonoperative measures. The nurse suspects that the patient may have intervertebral disc disease. Which health care provider's order would the nurse anticipate? Prepare the patient for an x-ray. Consult with a physical therapist. Request a bedside diagnostic sonogram. Administer morphine, 2 mg, intravenously.

Prepare the patient for an x-ray. An x-ray provides an image of the spinal column, which can confirm or rule out the presence of suspected disc disease.

Question 4 of 9 When preparing to care for a patient with intervertebral disc disease, what should the nurse plan to tell the patient to do in order to maintain proper body mechanics? Use a backless chair Stand with feet close together Sit upright while seated at a desk Use a soft, airy mattress for sleep

Sit upright while seated at a desk Sitting upright will promote and maintain proper alignment of the spine.

Question 3 of 3 A patient tells the nurse that she has tried several conservative approaches for intervertebral disc disease and even had "one quick surgery." After learning that the patient's spine is unstable, which procedure does the nurse most likely anticipate for the patient? Spinal fusion Discectomy Disc replacement Interspinous process decompression (IPD)

Spinal fusion If the patient's spine is unstable, a spinal fusion is likely to be performed. In a spinal fusion, adjacent vertebrae are fused together using a bone graft. Metal rods may also be put in place to provide more stability and decrease vertebral motion.

Question 2 of 3 A patient diagnosed with intervertebral disc disease has elected to receive nonoperative therapy. The patient reports to the nurse that after four months of activity restriction and physical therapy, the symptoms are resolved. Which action should the nurse implement next? Encourage the patient to use analgesics for mild to moderate pain. Remind the patient of the need to continue activity restrictions. Advise the patient of the need to continue physical therapy for two additional months. Teach the patient about proper body mechanics and how to perform back-strengthening

Teach the patient about proper body mechanics and how to perform back-strengthening exercises. When pain subsides, the patient should begin back-strengthening exercises twice a day and continue doing them for life. The nurse should also explain the importance of good body mechanics.