The nurse is providing care to a client who is experiencing back pain. Which of the following in the client's history is a known risk factor for disc herniation?
Short stature
Anorexia
39 years of age
Female gender
The Correct Answer is C
A) Short stature: While body height can play a role in overall musculoskeletal health, short stature is not specifically identified as a risk factor for disc herniation. Other physical characteristics have a more direct impact on spinal issues.
B) Anorexia: Although nutritional status is important for general health, anorexia is not a recognized risk factor for disc herniation. The condition is more related to physical stressors and age rather than dietary habits alone.
C) 39 years of age: Age is a significant risk factor for disc herniation. Most cases occur in adults aged 30 to 50, as degenerative changes in the spine increase vulnerability to herniation. At 39, the client falls within this high-risk age range.
D) Female gender: While certain musculoskeletal conditions may vary by gender, disc herniation does not have a strong gender predisposition. Both men and women are equally affected, making this option less relevant as a specific risk factor.
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Correct Answer is C
Explanation
A) Chronic pain: Chronic pain is defined as pain that lasts for an extended period, often longer than three months, and is usually associated with conditions that are ongoing or recurring. The client’s symptoms, including sudden-onset severe pain and accompanying acute symptoms like nausea and vomiting, do not align with the characteristics of chronic pain.
B) Intractable pain: Intractable pain refers to pain that is resistant to treatment and does not respond well to analgesics or other interventions. While the client's pain is severe, the sudden onset and associated symptoms suggest a specific acute process rather than a pain condition that is inherently resistant to treatment.
C) Acute pain: Acute pain is characterized by its sudden onset and typically corresponds to a specific injury or condition, often with accompanying physiological responses such as nausea and restlessness. The client’s severe pain rating of 10, along with nausea and vomiting, strongly indicates that they are experiencing acute pain, likely related to an underlying acute abdominal condition.
D) End-of-life pain: End-of-life pain usually occurs in patients with terminal illnesses and is often managed with palliative care strategies. The client’s sudden onset of severe pain and accompanying symptoms indicate a different situation, likely not related to a terminal condition.
Correct Answer is D
Explanation
A) Splint and immobilize the extremity: While immobilizing the injured extremity is important to prevent further injury, it should follow an initial assessment of blood flow and nerve function to ensure there are no vascular or neurological compromises.
B) Apply an ice pack to the ankle: Applying ice can help reduce swelling and alleviate pain. However, it is essential first to assess the circulation to the limb to ensure that applying ice will not worsen any underlying issues.
C) Encourage weight bearing and ambulation: Encouraging weight bearing on a potentially injured ankle can lead to further damage and is not appropriate. The priority is to assess the injury and understand its severity.
D) Assess pulse, color, temperature, and capillary refill: This step is crucial as it evaluates the vascular status of the limb. Assessing these factors helps identify any potential complications, such as compartment syndrome or inadequate blood flow, and guides further management of the injury.