الاثنين، 25 يونيو 2018

76-Laminectomy

About
Surgery to access the disks by removing part of the laminae and facet joints.
Assess
Incision, bleeding, bruising, presence of clear drainage on surgical dressing, circulation; Vital signs, pulse oximetry, pain level.
Complications
Infection; post-operative complications ( CSF leak, failed therapy, pneumonia, DVT, constipation, paralytic ileus, pain, PE)
Diagnosis
  • Acute pain related to surgical procedure
  • Risk for infection related to surgical procedure
  • Deficient knowledge related to post surgical treatment regimen
Goals
  • The client will understand pre-, intra-, and post-operative instructions.
  • The client will remain free from post-operative complications.
Interventions
  • Teach client what to expect pre-, intra-, and post-operatively.
  • Maintain NPO prior to surgery and start with clear liquids after surgery.
  • Monitor vital signs every 15 minutes X 2, 30 minutes X2, one hour X2, than every 4 hours ( may have different guidelines for each clinical agency).
  • Monitor incision for redness, edema, drainage, bruising. Monitor dressing for clear drainage which may indicate CSF leak.
  • Administer pain medications prn as ordered.
  • Encourage coughing and deep breathing and position changes to facilitate movement of respiratory secretions.
  • Apply elastic compression stockings and/or sequential compression device as ordered.
  • Monitor for signs/ symptoms of complications.

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