LESSON PLAN ON

PROLAPSED DISC

Submitted to: Smitha Miss

Submitted by: Ms. Sancty Thomson
Submitted on:
Name of the Lecturer: Ms. Sancty Thomson
Subject: Medical Surgical Nursing
Unit:
Topic: Prolapsed Disc
Date:
Time:
Venue: Caritas College of Nursing
Group:
No. of students:
Method of teaching: Lecture cum discussion
Teaching aids: Blackboard, Power Point
Previous Knowledge: Basic aspects of patient care in medical surgical nursing
GENERAL OBJECTIVE:
On completion of the class, the students will acquire an in-depth knowledge of prolapsed disc and acknowledge the
importance of developing the attitude and skills in providing care to patients with prolapsed disc.

SPECIFIC OBJECTIVE:
At the end of the teaching, the student will able to
 simple introduction about skeletal system
 definition of bone prolapsed disc
 bone tumor classification
 clinical manifestation of bone tumor
 pathophysiology of bone tumor
 diagnostic evaluation of bone tumor
 explain in detail about medical and surgical management
 describe the nursing management
Specific Time Content Teaching AV Aids Evaluation
Objectives Learning
Activity
• Introduction:
Skeleton system
Introduce the 1 Min
topic to the The skeleton is the name given to the collection of Teacher
class introduces the
bones that holds our body up. It does three major jobs. topic

• It protects our vital organs such as the brain, the

heart and the lungs.
• It gives us the shape that we have
• It allows us to move.
When we were born our skeleton had around 350
bones. By the time we become an adult, we will only
have around 206 bones.
Bone comes in several shapes and sizes the structure
and composition of bone in the same in all.Bone is
composed of protein,minerals and cells.
 Teacher
Announcement of the Topic: announces the
topic and writes
Bone tumor on the black
board

Review:
What is a bone tumor?

 BULGING DISC
at the end of the 1 Min  HERNIATED DISC Teacher defines
session, the bone tumor Define bone tumor
student will be  DEGENERATED DISC
able to define
bone tumor
 THINNING DISC
 Risk factors:
• Paget’s disease of the bone
1 Min • Radiation therapy for cancer
Teacher describes
• Metastasis from other organs the risk factors of Slide show
risk factors of Bone Tumor
Bone Tumor • Abnormal healing of an injury
• Inherited genetic syndromes, eg. Hereditary
retinoblastoma

Classification
Origin:- Primary
-Secondary: 95%, breast, lung, prostate, kidney
explains the 10
and thyroid. Slide show What are the types of
classifications Min Cell Type: Teacher defines bone tumor? Explain.
of bone tumor Osteoma: An osteoma is a benign bone tumor that the types of Bone
Tumors
typically forms on the skull. It can also develop on the
long bones of the body, such as the shin and thigh
bones.
Osteosarcoma: It also known as osteogenic sarcoma,
is the most common type of cancer that originates in
the bones. It primarily affects teenagers and young
adults, although it can occur in younger children and
older individuals as well.

Cartilage:
Chondroma: A chondroma is a benign cartilaginous
tumor that typically forms within the bones
Chondrosarcoma: It, is a rare type of cancer,
typically originates in the bones but can occasionally
occur in the soft tissue near bones

Marrow:
Hemangioma: A hemangioma, also known as an
infantile hemangioma or hemangioma of infancy, is a
bright red birthmark. It appears as a rubbery bump or
flat red patch and is made up of extra blood vessels in
the skin
Angiosarcoma: Angiosarcoma is a rare type of cancer
that forms in the lining of blood vessels and lymph
vessels. It can occur anywhere in the body, but it most
often affects the skin on the head and neck.

Fibrous Tissue
Fibroma: A fibroma is a noncancerous (benign) tumor
or growth consisting of fibrous, connective tissue.
These tumors can appear almost anywhere in and on
your body.

Fibrosarcoma: Fibrosarcoma, also known as

fibroblastic sarcoma, is a malignant mesenchymal
tumor derived from fibrous connective tissue
 • Pathophysiology of Bone Tumor:
A tumor in the bone causes the normal bone tissue act
by osteolytic response (bone destruction) or
osteoblastic response (bone formation) Teacher Slide show What is the
enumerate the 5 Min enumerates the pathophysiology of bone
pathophysiology pathophysiology tumor?
of bone tumor Primary bone tumor cause bone destruction which of Bone Tumor.
weakens the bone causing bo ne fractures. Students take
down notes

Adjacent normal bone resorption of the tumor by

altering its normal pattern of remodeling

The bone’s surface changes and the contours enlarge

the tumor area.

Malignant bone tumors invade and destroy adjacent

bone tissue. They invade and weaken the structure of
bone until it can no longer with stand the stress of
ordinary use, fractures commonly results.

CLINICAL FEATURES
  Bone pain gradually increases overtime
 Swelling and tenderness near the affected site.
Describes the 5 Min  Weakened bone leading to fracture
clinical features Teacher details Slide show What are the clinical
of bone tumor  Fatigue the clinical
manifestations of
manifestations of bone
tumor?
Bone Tumor
 Un intended weight loss
 Anemia, malaise and fever
 Painless mass
 Varying degrees of disability
 Obvious bone growth
 With spinal metastasis, spinal cord compression
may occur
 Results in neurological deficit

DIAGNOSTIC STUDIES:
• History collection (health habits, past illnesses,
 treatments taken, review the medical records)
• Physical examination (general signs of health, signs
Teacher explains Slide show Describe the diagnostic
of illness such as lumps, painless masses) diagnostic evaluations of bone
Describes the 2 Min evaluations of tumor?
diagnostic • Imaging studies to determine the location and size Bone Tumor
methods of bone
tumor of bone tumors:
• Bone
scan
• CT
scan
• MRI
scan
• PET
scan: Positron Emission Tomography
• X Ray:
chest Xrays are performed to determine the
presence of lung metastasis
• Needle or surgical biopsies: for histologic
identification.
explains the 10 Teacher explains Slide show Explain the treatment
methods of Mins medical methods of bone tumor?
treatment of management of
bone tumor Bone Tumor
Treatment:
 Systemic Therapy
1.Chemotherapy
2. Hormone therapy
3. Immunotherapy ex. Interferon α
 Local Therapy
1.Radiation therapy
2. surgery
 Nutritional Therapy
Provide foods high in protein, vitamins and folic
Acid.
Systemic therapy
Chemotherapy: Chemotherapy is used to kill tumor
cells when they have spread into the blood stream
Hormone therapy

Hormone Therapy: removal of the organs which

produce hormones which can promote the growth of
certain types of cancer (such as testosterone in males
and estrogen in females), or drug therapy to keep the
hormones from promoting cancer growth.

Local therapy
Radiation Therapy: Radiation therapy uses high-dose
x-rays to kill cancer cells and shrink tumors. may be
given either before or after surgery

Pain Medications
 Narcotics
 analgesics
Ex. Biphosphonates are drugs that can be used to
reduce bone pain and slow down bone damage in
people who have cancer that has spread to their
bones,increase bone strength
Ex. Metastron also known as strontium-89 chloride is
an intravenous medication given to help with the pain
and can be given in three-month intervals

Surgical Treatment
 Amputation removes all or part of an arm or leg
when the tumor is large and/or nerves and blood
vessels are involved.
 Rotationplasty is a form of amputation, in which
 the patient's foot is turned upwards in a 180 degree
turn and the upturned foot is used as a knee.

 Bone graft - affected bone is removed, bone from

elsewhere from the body is taken.
 Artificial bone affected bone is removed, putting an
artificial bone in.

Slide show Detail the epidemiology

enumerates the 1 Min Teacher of bone tumor.
epidemiology of Epidemiology enumerates the
bone tumor epidemiology of
 Age: Bone tumor is more common in children and bone tumor

young adults when bones grow rapidly

 The incidence of bone cancer is higher in families
with familial cancer syndromes. The incidence of
bone cancer in children is approximately 5 cases per
million children each year, in united states
 10
explains the Mins Teacher details Slide show Explain nursing
nursing nursing management for bone
management of Nursing Management management of tumor.
bone tumor Bone Tumor

▪ Acute pain related to disease process

(compression/destruction of nerve tissue, infiltration

of nerves or their vascular supply, obstruction of a
nerve pathway, inflammation).

▪ Imbalanced nutrition: less than body requirements

related to consequences of chemotherapy, radiation,

surgery, eg, Anorexia, gastric irritation, taste
distortions, nausea.

▪ Fatigue related to altered body chemistry: side

effects of pain & other medications, chemotherapy.

▪ Risk for infection related to immunosuppression .

Risk for fluid volume deficit related to excessive

 losses(vomiting, diarrhea) or impaired intake

▪ Risk for altered oral mucous membranes related to

side effect of some chemotherapeutic agents.

▪ Risk for impaired skin integrity related to effects of

radiation and chemotherapy.

▪ Situational low self-esteem related to feelings of

lack of control and doubt regarding acceptance by Teacher clarifies

summarizes the 5 Min the doubts and
nursing others. summarizes the
management of topic.
bone tumor Teacher asks
▪ Fear/anxiety related to threat of death. student questions.

Summary:
During this class we have discussed about the
definition, risk factors, clinical manifestation,
pathophysiology, diagnostic evaluation, medical,
surgical and nursing management of Bone Tumor.