Class Talk Fall 2016

What do you assess: focused hx & physical exam; neurologic testing, discomfort/pain (OLDCART), previous successful pain control methods, work/recreational activities, environmental variables, posture, position changes, gait, spinal curve, leg length, pelvic crest & shoulder symmetry, paraspinal muscles, nerves (DTR’s, sensations, muscle strength).

Limitations in mobility: not to remain on bed rest (result in deconditioning), avoid prone positioning, avoid twisting, lifting above waste level, lumbar strain and forward flexion position. As comfort is achieved, an exercise program is gradually initiated.

D/C teaching: good body mechanics & posture; teach how to sit, stand, lie, lift properly; provide list of suggestions to make long term changes; role-related responsibility modifications; weight reduction if obese; *chart 42-2

What do you assess: focused hx & physical exam; neurologic testing, discomfort/pain (OLDCART), previous successful pain control methods, work/recreational activities, environmental variables, posture, position changes, gait, spinal curve, leg length, pelvic crest & shoulder symmetry, paraspinal muscles, nerves (DTR’s, sensations, muscle strength).

Limitations in mobility: not to remain on bed rest (result in deconditioning), avoid prone positioning, avoid twisting, lifting above waste level, lumbar strain and forward flexion position. As comfort is achieved, an exercise program is gradually initiated.

D/C teaching: good body mechanics & posture; teach how to sit, stand, lie, lift properly; provide list of suggestions to make long term changes; role-related responsibility modifications; weight reduction if obese; *chart 42-2

What do you assess: focused hx & physical exam; neurologic testing, discomfort/pain (OLDCART), previous successful pain control methods, work/recreational activities, environmental variables, posture, position changes, gait, spinal curve, leg length, pelvic crest & shoulder symmetry, paraspinal muscles, nerves (DTR’s, sensations, muscle strength).

Limitations in mobility: not to remain on bed rest (result in deconditioning), avoid prone positioning, avoid twisting, lifting above waste level, lumbar strain and forward flexion position. As comfort is achieved, an exercise program is gradually initiated.

D/C teaching: good body mechanics & posture; teach how to sit, stand, lie, lift properly; provide list of suggestions to make long term changes; role-related responsibility modifications; weight reduction if obese; *chart 42-2

BONE TUMORS

By: Alysha Payne

2. Assess:

            Pain

            S/S of weight loss, malaise, fever

            Spinal cord compression

            Neuro deficits

 

3. Limitations to mobility include gait abnormality, position changes can result in fractures; effected extremities must be supported, splints may be used, weight bearing restrictions must be followed

 

4. D/C teaching includes understanding the disease process, including potential complication of delayed wound healing and inadequate nutrition and hypercalcemia; importance of PT and OT; demonstration of using assistive devices

BONE TUMORS

By: Alysha Payne

2. Assess:

            Pain

            S/S of weight loss, malaise, fever

            Spinal cord compression

            Neuro deficits

 

3. Limitations to mobility include gait abnormality, position changes can result in fractures; effected extremities must be supported, splints may be used, weight bearing restrictions must be followed

 

4. D/C teaching includes understanding the disease process, including potential complication of delayed wound healing and inadequate nutrition and hypercalcemia; importance of PT and OT; demonstration of using assistive devices

Assessment

• The nurse would assess the circulatory and neurovascular and functional status of the limb.
  You would assess for phantom limb pain, which is a possible complication of amputations
• The nurse also needs to assess the function and condition of the residual limb
• The nurse would identify an concurrent health problems
• The nurse would also evaluate the patient’s nutritional status.
• The nurse would assess the patient’s psychological status and their emotional status and how they are coping with this life changing surgery.

Limitations

• Yes, there are limitations to mobility
• A residual limb sock is applied immediate after surgery
• A prosthetic and artificial foot maybe needed (for lower extremity amputations)
• The patient will need rehabilitation to learn how to use their prosthetic and become mobile once again.

Patient Education

• Before discharge the patient and family are encouraged to become active participants in care (of the skin, residual limb and prosthesis-if one is present)
• The patient is educated about long-term rehabilitation and modification of lifestyle
• The patient can be educated about support groups in the area that can help with rehabilitation
• The patient is educated about signs and symptoms of complications that must be reported to the physician
• The nurse would also educate the patient about eating a healthy diet that is high in protein and vitamins to promote wound healing

By: Amani Baidwan, Khaya McKeever Odom, Genesys Paraja

Assessment

• The nurse would assess the circulatory and neurovascular and functional status of the limb.
  You would assess for phantom limb pain, which is a possible complication of amputations
• The nurse also needs to assess the function and condition of the residual limb
• The nurse would identify an concurrent health problems
• The nurse would also evaluate the patient’s nutritional status.
• The nurse would assess the patient’s psychological status and their emotional status and how they are coping with this life changing surgery.

Limitations

• Yes, there are limitations to mobility
• A residual limb sock is applied immediate after surgery
• A prosthetic and artificial foot maybe needed (for lower extremity amputations)
• The patient will need rehabilitation to learn how to use their prosthetic and become mobile once again.

Patient Education

• Before discharge the patient and family are encouraged to become active participants in care (of the skin, residual limb and prosthesis-if one is present)
• The patient is educated about long-term rehabilitation and modification of lifestyle
• The patient can be educated about support groups in the area that can help with rehabilitation
• The patient is educated about signs and symptoms of complications that must be reported to the physician
• The nurse would also educate the patient about eating a healthy diet that is high in protein and vitamins to promote wound healing

By: Amani Baidwan, Khaya McKeever Odom, Genesys Paraja

The priority assessments post-operative are ABC’s, tissue perfusion, DVT’s, pain, pressure ulcers, and signs and symptoms of hypovolemic shock.

There are limitations related to mobility. The physical therapist determines limitations on an individual basis and the nurse will instruct, supervise, and participate in safe ambulation. Often weight bearing is limited and assistive devices are used.

Discharge teaching would include the patient’s positioning limitations including: no crossing legs, bending hips more than 90 degrees, and not turning the affected leg inward. The patient is also taught about their medications (if applicable), potential problems, nutrition (to promote healing), wound care, safe use of ambulatory aids, and a safe home environment.

I believe that the items mentioned in the video are very important factors for the patient to know. It ultimately helps keep them safe as well as promotes optimal health. These details would be something I would educate my patient on, especially because they might not even be aware of these factors.

So far clinical is going well. Even though we had a rough start at the beginning by not having a code, I think we have come a long way. I just finished my first med pass this past week and it went well. My goals for this clinical is to become more comfortable with medications. This is something that still intimidates me, even if it is only on one patient. I want to be able to be confident in passing meds to more than one patient, and feel organized and ready.