Nursing perioperative management of type I Chiari malformation in adult: A case study using Roy's adaptation model

Introduction

Chiari malformation is a structural defect in the skull that causes part of the brain to push into the spinal canal. Chiari malformations are almost always present at birth, though symptoms may not develop until later in childhood. In adult years, problems can include persistent headaches, neck pain, and weakness and/or numbness and tingling in the arms and legs, which makes it a disease of interest to present as a clinical case with a nursing model care plan.

Case

This is a 43-year-old female patient with type I Chiari malformation. She has neck and shoulder pain, stiffness in the hands, as well as hypotonus and hypotrophy in the upper limb. The patient underwent foramen magnum decompression surgery.

Care plans

We used Roy's adaptation model for the nursing care plan. The main needs we find are respiration (risk for ineffective breathing pattern), mobility (impaired physical mobility), sensation (acute pain), protection (risk for infection, and risk for bleeding), fluid and electrolyte (risk of fluid and electrolyte imbalance), and self-concept (anxiety).

Conclusion

The Roy's adaptation model approach was useful in this case as it focuses on the patient's adaptability and is suitable for use in perioperative nursing management of type I Chiari malformation in adults. A collaborative approach is essential for planning and carrying out care.