Question

A 45-year-old lab technician complains of pain and “electrical shock” sensations in his left hand at night. He also notices increasing clumsiness and weakness of his left hand. On physician exam you note decreased sensation to light touch, pinprick, and temperature, on the palmar surfaces of the thumb and first two fingers on the left hand. The thumb is weak and its muscle is atrophied. Tapping the palmar surface of the left wrist sends “electrical shocks” through the first two fingers. The right hand is entirely normal in function and sensation. The patient is otherwise healthy.

1. Based on the information provided, what do you think the diagnosis would be and why?

2. What nursing plan of care would you expect to provide for this patient and why?

3. What nursing education should you provide for this patient and their family and why?

Answer 1

☆ The diagnosis of the patient would be carpal tunnel syndrome. Because this patient has the typical features of the condition. As mentioned in the scenario.,the pain of carpal tunnel syndrome get worse at night and patient will have numbness on the thumb, index finger and the middle finger. It cause atrophy to the muscle of thumb.

☆ NURSING DIAGNOSIS

* Acute pain related to inflammation secondary to median nerve compression

INTERVENTION	RATIONALE
*Assess the characteristics of the pain	*To plan treatment measures
*Encourage the patient to involve in diversional activities	*To change the attention of the from the pain
*Instruct the patient to take medication as per physician's order	*NSAIDs helps to reduce the pain

NURSING DIAGNOSIS

*Self care deficit related to pain secondary to carpal tunnel syndrome

INTERVENTION	RATIONALE
*Assess the activity level of the patient	*To plan the care accordingly
*Provide comfort measures	*To reduce the pain related to nerve compression
*Teach exercises to prevent the carpal tunnel syndrome	*To prevent complications

* Assist the client to improve self care - To improve the activity tolerance

☆ *Instruct the patient to avoid weight lifting and vigorous hand movements

*Encourage the patient to perform hand exercises to prevent complications

*Instruct the patient to take medication as prescribed by the doctor

*Advice the patient to use ergonomic instruments and take breaks from job.

Patient and family cooperation is necessary for the treatment of carpal tunnel syndrome and its complications.