Recognizing Hematoma Symptoms After Decompression Laminectomy

Following a decompression laminectomy, which symptom indicates a developing hematoma?

• A. Severe Headache
• B. Weakness/Numbness in Feet
• C. Increased Pain in the Back
• D. Loss of Bladder Control

Answer: (B)

Following a decompression laminectomy, the development of a hematoma can lead to increased pressure on the spinal cord and nerve roots. Weakness or numbness in the feet is indicative of this pressure affecting the nerve pathways, potentially signaling that a hematoma is compressing the spinal structures. This symptom suggests that the nerve function is compromised, possibly due to swelling or bleeding in the area surrounding the surgical site. While severe headache, increased back pain, or loss of bladder control can indicate various complications, they are not as directly related to the development of a hematoma in comparison to the neurological symptoms presented by weakness or numbness in the feet. Changes in motor function, like weakness, serve as critical indicators of possible neural compromise and should prompt immediate evaluation for potential hematoma formation.

When a patient undergoes a decompression laminectomy, it’s crucial to stay vigilant for signs of complications—particularly the dreaded hematoma. Imagine this: your patient is recovering well, but suddenly you notice something off. Now, which symptoms do you prioritize in your nursing assessment? Well, here’s the thing. Weakness or numbness in the feet is a significant red flag that you can’t afford to ignore.

Why is that, you might wonder? As the surgical site heals, a hematoma can develop, applying pressure on the spinal cord and the nerve roots. This is not just a minor concern; it suggests that the delicate nerve pathways are at risk. Think about it—if you've ever pinched a nerve, you know just how painful and debilitating that can feel. Now, extrapolate that to something happening internally after surgery. Scary, right?

Let’s break down the options you might encounter. A severe headache could indicate various complications, but it’s not a direct signal of hematoma formation. Increased pain in the back also raises alarms, yet again, it’s not directly focused on the hematoma. And although loss of bladder control can be alarming, it doesn’t scream “watch out for a hematoma!” in the same way that the symptoms of weakness or numbness in the feet do.

So, to put it simply, changes in motor function, like weakness, are the key indicators here. They provide crucial insights into possible neural compromise. If you spot these symptoms, you have to act fast; after all, timely intervention can make a world of difference. You want to ensure that your assessments are sharp because missing these signs could lead to compromised recovery—or worse.

In your journey to prepare for the Certified Medical-Surgical Registered Nurse (CMSRN) exam, recognizing these indicators isn’t just an academic exercise; it's a real-world necessity. You'll bring your knowledge into play during your clinical practice, affecting how you respond to potential complications post-surgery. So, remember, when it comes to assessing your patients after a decompression laminectomy, prioritize those neurological symptoms. They might save a life!