Today I had a patient who had surgery on a few of their cervical vertebral discs located in her neck. This wasn't her first surgery on that area which helped her know what to expect with her recovery. She came in to my unit during my shift and was able to relieve her pain with PO (oral) medications. That is not so common considering most patients Post-Anesthesia have to be given every thing through IV due to nausea. She was recovering fast!
One of the most important assessment tools that I had to use involved frequent Neuro Checks. These involved looking at pupil dilation and constriction, extremity strength, presence of numbness or tingling, and movement. So I began her assessment; I took my penlight and looked for equal reactivity of both pupils to determine brain function as pupil dilation involves cranial nerves. I then asked if she was having any numbness or tingling in her hands. She complained of numbness in her right hand which she said had prior to surgery. Then I had her squeeze both my hands to feel if their was equal strength in both her upper extremities. Both were fine. Now onto the lower extremities; I had her Dorsoflex her feet, which meant to lift up her toes, push down on my hands with her toes, and I had her wiggle all her digits so I could look for adequate movements. Along with the Neuro checks, I also checked for adequate circulation by checking pedal pulses, capillary refill in the nail beds, and feeling/observing for warmth, coloration, and movements.
It is important to assess these things especially for patients who have had any sort of spinal/vertebral surgery because of the risk for spinal cord injury. The spinal cord is a part of the central nervous system thereby contributing a major part in bodily functioning and voluntary movements.
My patient was discharged at the beginning of Post-Op day #2! Crazy good! :) It was an amazing recovery!
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