Chronic Pain and Body Image Disturbance - NCP Tuberculous Spondylitis


Pott disease, also known as tuberculous spondylitis is a rare infectious disease of the spine which is typically caused by an extraspinal infection. Pott's disease is often experienced as a local phenomenon that begins in the thoracic section of the spinal column. Pott’s Disease is a combination of osteomyelitis and arthritis which involves multiple vertebrae.

Back pain is the earliest and most common symptom. Patients with Pott’s disease usually experience back pain for weeks before seeking treatment and the pain caused by spinal TB can present as spinal or radicular. Although both the thoracic and lumbar spinal segments are nearly equally affected, the thoracic spine is frequently reported as the most common site of involvement. Together, thoracic and lumbar involvement comprise of 80-90% of spinal TB sites.

Neurologic abnormalities occur in 50% of cases and can include spinal cord compression with the following: paraplegia, paresis, impaired sensation, nerve root pain, cauda equina syndrome.

Fortunately, there are several ways to determine if tuberculosis spondylitis is the root cause of the symptoms. Blood tests can help determine if there is an elevation in the rate of erythrocyte sedimentation. A bone scan will determine if there is some indication of problems, which may lead to the scheduling of a bone biopsy. Conducting a CT scan as well as a radiograph of the spine is also likely to provide valuable information about the presence and current status of the disease.

Nursing Diagnosis and Interventions for Tuberculous Spondylitis / Pott disease

1. Chronic Pain: joints and muscles related to the inflammation of the joints.

Goal:
  • Comfortable feeling fulfilled
  • Pain is reduced / lost

Expected outcomes:
  • Clients reported a decrease in pain.
  • Demonstrate behavior that is more relaxed.
  • Demonstrate skills in the study of pain reduction with increasing success.

Interventions:
  • Assess the location, intensity and type of pain; observations on the progress of pain to a new area.
  • Provide appropriate analgesic therapy clinicians and examine its effectiveness against pain.
  • Use the back brace or corset when it is planned that way.
  • Give encouragement to change positions frequently to light and enhance a sense of comfort.
  • Teach and assist in alternative pain management techniques.

Rational :
  • Pain is a subject of experience that can only be defined by the client themselves.
  • Analgesics are drugs to reduce pain and how it reacts to pain clients.
  • Corset to maintain the spine.
  • With the change-change positions so that the muscles do not keep that muscle spasm and tension becomes limp and reduced pain.
  • Alternative methods such as relaxation times faster relief of pain or to distract the client so that the pain is reduced.
2. Body Image Disturbance related to disorders of body structures.

Goal: Clients can express their feelings and be able to use adaptive coping.

Expected outcomes : Clients can express feelings / care and use positive coping skills to address the image.

Interventions:
  • Give the client a chance to express feelings. Nurses must listen attentively.
  • With clients looking for alternative positive coping.
  • Develop communication and building relationships between families and friends as well as clients provide recreational activities and games in order to cope with changes in body image.

Rational:
  • Improving self-esteem and foster client relationships of mutual trust and the expression of feelings of self-acceptance can help.
  • Support nurses on the client can increase client confidence.
  • Providing encouragement for clients to view themselves in a positive way and not feel low self esteem.

Tuberculous Spondylitis - 11 Functional Health Patterns
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