Question 1 of 6
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Which patient statement indicates understanding of discharge instructions after a laminectomy for a herniated lumbar disk? Select all that apply. One, some, or all responses may be correct.
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- “I should try to maintain a normal weight.”The patient should try to maintain a normal weight to support healing.
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- “I should walk as much as tolerated.”The patient should try to walk as much as tolerated to support faster healing.
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- “I need to be sure not to twist or bend at the waist when lifting things.”The patient should try to avoid twisting or bending at the waist when lifting to prevent further injury and promote healing.
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- “I can take a 4-hour car ride, as long as I stay perfectly still.”The nurse would discourage standing and sitting for long periods for several weeks after a laminectomy and would encourage the patient to stop and walk around at least every 2 hours.
Question 2 of 6
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Which diagnostic imaging would be useful to determine the degree of nerve irritation with a disk-related injury?
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- Computed tomography (CT)A CT is useful to diagnose muscle and bone disorders, such as bone tumors and fractures.
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- Magnetic resonance imaging (MRI)An MRI is used to detect tumors, traumatic brain injuries, developmental anomalies, strokes, dementia, infection, and multiple sclerosis, as it gives a detailed image of the organs and tissues of the body.
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- Electromyogram (EMG)An EMG measures muscle response to electrical activity in response to a nerve’s stimulation of the muscle and is useful to determine the degree of nerve irritation.
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- X-rayAn x-ray is a quick diagnostic tool mostly used to examine bones and joints.
Question 3 of 6
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Which test might the nurse use to confirm a potential disk injury when caring for a patient with sciatic pain and muscle spasms in the lower back?
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- Romberg testThe Romberg test is useful to test balance.
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- Straight leg testThe straight leg test is useful to confirm a disk problem.
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- Grip testThe grip test is used to measure strength in the hands.
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- Electrocardiogram (ECG)An ECG is a test used to monitor the heart’s rhythm and electrical activity.
Question 4 of 6
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Which intervention would be used when caring for a patient complaining of back pain with sciatica for 5 days? Select all that apply. One, some, or all responses may be correct.
- Correct
- No lifting greater than 5 lbThe patient should be cautioned not to lift anything greater than 2 to 5 lb and not to twist when reaching for objects.
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- Chiropractic adjustmentAdjustments are recommended for pain relief if the pain has not been present for more than 16 days.
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- Lying down for short periods of timeLying down for short periods of time can help to relieve the pain.
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- Sitting in a comfortable chairStanding or lying is recommended instead of sitting, as it puts pressure on the disks.
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- Wearing flat shoesWearing flat shoes as opposed to high heels is recommended as it takes pressure off the spine.
Question 5 of 6
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Which complication might the nurse suspect when assessment post-laminectomy reveals a patient who is afebrile, has abdominal distention and absent bowel signs, and is nauseous?
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- Paralytic ileusA paralytic ileus may occur postlaminectomy and present with constipation, nausea, abdominal distention, and absent bowel sounds.
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- PeritonitisPeritonitis generally presents with abdominal pain, bloating, fever, loss of appetite, diarrhea, and low urine output.
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- Irritable bowel syndrome (IBS)IBS might present with abdominal pain, bloating, diarrhea, and constipation. It would not be a primary concern after surgery.
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- Intraabdominal infectionAn abdominal infection might present with a fever, abdominal pain, lack of appetite, and a change in bowel habits.
Question 6 of 6
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Which statement by a patient after a spinal fusion indicates a need for further education?
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- “I will try not to sit for prolonged periods of time.”This will prevent putting too much pressure on the spine.
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- “I will carry items closer to my body.”This will help prevent the patient from putting more pressure on the spine.
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- “I will bend to lift items less than 10 pounds.”The patient should not lean over without bending the knees and should lift no more than 8 lb.
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- “I will walk 10 minutes at a time to start.”This is appropriate to start and slowly progress to 20 to 30 minutes.
