care pans of Anterior cervical discectomy and fusion (ACDF)

nursej22, MSN, RN · Jul 17, 2015

Your care plan should be based on your assessment of the patient. If they were in pain, then your first priority is correct. Were vital signs stable, hydration adequate, labs WNL, skin intact, mobility, knowledge, blood sugars good, family support, anxiety?

Do you see where I'm going here? Nursing Dx is not based solely on the medical diagnosis, but on the patient needs.

Horseshoe, BSN, RN · Jul 17, 2015

I see you have a fair amount of views but no answers. I rarely answer these kinds of posts because you should really do your own homework rather than getting others to give you the answers.

However, I have had this exact surgery, and I can tell you that incision pain was the least of my troubles. I don't remember having incisional pain, but I had a lot of pain inside my neck from where the work was done, and extreme esophageal discomfort and spasms due to the fact that they have to move your esophagus to the side while they work. The spasms were scary until the nurse explained why this was happening and I calmed down about it. It took several weeks for this to actually settle down, though I don't think everyone experiences this.

I received narcotic pain killers for this neck pain. I was helped to my feet frequently during those two days I was in the hospital and taken for walks around the unit. I wore TEDs and SCDs as well the first day, until I began walking frequently on my own volition. Respiratory came in at intervals to watch me use the inspiration spirometer. I was counseled about being proactive with stool softeners. I was instructed in use of the hard neck brace I woke up wearing.

Have I given you any ideas?

allnurses Guide · Jul 17, 2015

Like nurse22 said your care plan would be based on your assessment of the patient. Remember you care plans are based on Nursing Dx - The acute pain would be: Alteration in comfort related to.....Bla bla bla.

Another might be Alteration in skin integrity R/T incision etc..... When I was in my ADN program I bought a book called the complete guide to Nursing Diagnoses, care plans and rationales, I believe the author was Deogenes. It's a great little paper back that fits in your pocket. You can get it new and used on amazon.

Hppy

Trauma Columnist · Jul 17, 2015

Moved to Nursing Student Assistance