AT NCP ASSESSMEN T S> The patient verbalized, Indi ko kaya mag-rotate yung right ankle ko.

O> Px unable to rotate right ankle; sometimes cannot distinguish between sharp/dull sensation on right leg; muscle strength: grade of 2 on right leg; absence of R. Patellar reflex. VS BP: 110/80 mmHg RR: 83 bpm DIAGNOSIS Impaired physical mobility r/t neuromuscular impairment secondary to compression fracture of L1 as evidenced by limited range of motion of right leg, slowed movements, and reluctance to attempt movement. SCIENTIFIC RATIONALE Compression fractures of the spine usually occur at the bottom part of the thoracic spine (T11 and T12) and the first vertebra of the lumbar spine (L1). Compression fractures of the spine generally occur from too much pressure on the vertebral body. This usually results from a combination of bending forward and downward pressure on the spine. If the fracture is caused by a sudden, forceful injury, severe pain will probably be felt on the back, legs, and arms. As well as weakness or numbness in these areas if the fracture injures the nerves of the spine. If the bone collapse is gradual such as a fracture from bone thinning, the pain will usually be milder. There might not be any pain at all until the bone actually breaks. PLANNING G> After 3 days of nursing intervention, the patient will be able to: 1. Increased strength and function of affected body part Move within range of motion INTERVENTION Independent 1. Continually assess motor function (as spinal shock or edema resolves) by requesting patient to perform certain actions. 2. Assist with normal range of motion exercises and function of lower extremity and joints using slow, smooth movements. RATIONALE EVALUATIO N After 3 days of nursing intervention, goal is met through the regaining of the patients previous range of motion in the leg and demonstrate s proper exercises for the lower extremities.

1. Evaluates status of individual sensation for a specific level of injury, affecting type and choice of intervention.

2.

2.

O> After 8 hours of nursing intervention, the patient will be able to: 1. Demonstrat e and verbalize proper exercises of the lower extremities

Necessary to regain normal mobility of leg to speed recovery and enhances circulation, restores/maintains muscle tone and joint mobility, and prevent disuse contractures and muscle atrophy. Increase patients use of affected leg and prevents fatigue, allowing opportunity for maximal efforts or participations by patient.

3. 3. Encouraged progressive activities according to level of fatigue.

PR: 22 bpm T: 36.2

The nerves can be affected as well. The narrowing of the spinal canal due to a compression fracture can either lead to immediate injury to the nerves or of the spine, or irritation of the nerves later. If the irritation on the spinal nerves comes later (even after the fracture has healed), it can cause pain and problems with the nerves not working right. The lack of space can also cause the supply of blood and oxygen to the spinal cord to be reduced. When the spine needs more blood flow during increased activity, the blood vessels may not be able to swell to get more blood to the spine. This can lead to numbness and pain in the nerves that are affected. The nerves also lose some of their mobility when the space available to them is reduced. This leads to irritation and inflammation of the nerves. This condition is called spinal stenosis.

4. 4. Encourage and facilitate early ambulation and other ADLs when possible. Assist with each initial change: dangling, sitting in chair, ambulation. Provide patient with ample time to perform mobility related task. Use side rails of bed. 7.

The longer the patient remains immobile the greater the level of debilitation that will occur.

5.

5.

To promote optimum level of function.

6.

6.

To prevent patient from possible fall or accident that might happen. To help ease the pain and numbness of said part.

7.

Encourage patient to move the affected part from time to time. Inspect the skin daily.

8.

8.

Altered circulation, loss of sensation, and paralysis potentiate pressure sore formation. May be useful in

1.

Dependent 1. Administer prescribed medication (muscle relaxants/antispas ticity). Collaborative 1. Consult with physician or occupational therapist. 1.

limiting or reducing pain associate with spasticity.

Helpful in planning and implementing individualized exercise program and identifying or developing assistive devices to maintain function, enhance mobility, and independence.