Nursing care of Herniated Nucleus Pulposuswith Lumbar Stenosis Patient under going Laminectomy with Pedicular Screw : Case study 2 case

Abstract

         Objective : To study disease progress, treatment, functional health pattern, nursing diagnosis, nursing and nursing out come.

         Methods :This study was comparisons of two cases of patients with Herniated Nucleus Pulposus with Stenosis patient with Laminectomy and Comorbidities were admitted in male orthopedics ward Mahasarakham Hospital in December 2020. The instrument employed in the study consisted of data from Functional Health Pattern, medical records and collected data from observation of patients as well as  relative’s history,  the use of  nursing process and determining nursingdiagnoses The data analysis were compared functional health pattern, clinical, sign and symptom, Herniated Nucleus Pulposus with Stenosis and Laminectomy Treatment, problem and nursing diagnosis,nursing care of patients with pre-operative, critical post- operative , continuing rehabilitee phase, and discharge planning.

         Result : The case study of 2 cases showed that they who low back pain refer to leg, paresis and weakness, underlying disease Diabetes Mellitus type II and Hypertension were treated with Laminectomy DCL with PDS with PLF L4-5. The nursing is divided into four phases, namely1) pre-operating phase focusing onpatient ready for surgery; 2)crisis post-operating phase focusing onkeeping the patient’s safe from complication; 3)continuing rehabilitee phase focusing on promoting health status, increase ADLand control underlying disease; 4)Thedischarge phase focusing on patient ready for self care at home.

         Conclusion : Herniated Nucleus Pulposus with Stenosis with Laminectomy patient was high risk of complication. The nurse must have knowledge, skill, expert, able to assess and gave effective nursing care to keep patients safe after discharge back to normal life.