Acute Neuro Injuries with Chronic Care Flashcards
What is the definition of a spinal cord injury?
A disruption of nervous system function which can result in complete or incomplete loss of motor and sensory function below the level of injury; the cord is severed.
What can be the cause of a spinal cord injury?
MVA, falls, violence, sports, drug and alcohol association.
What does a cervical spinal cord injury effect?
Cannot move from the neck down
What does a thoracic spinal cord injury effect?
Cat move from midback down
What does a lumbar spinal injury effect?
Cant move from the lower back down
What is a complete spinal cord injury?
Loss of sensory and motor function below the level of injury
What is an incomplete spinal cord injury?
A mixed loss of voluntary motor and sensory function below the injury
What is a primary injury?
The initial disruption of axons which is permanent
What is a secondary injury?
Ongoing damage from the initial injury like hypoxia, ischemia, calcium influx, lactate build up, free radicals, and edema that may be reversible
What are some concerns of the initial injury?
Neurogenic shock, relative hypovolemia, peripheral vasodilation, and spinal shock.
How does a spinal cord injury present itself clinically?
Its related to the degree and level of injury, the main concerns are airway, ventilation, blood volume, and preventing secondary infection
Why would you immobilize a patient with a spinal cord injury?
To prevent further damage and keep bones aligned; provide skin care and special beds to prevent pneuomnia and sores.
When would you surgically repair a spinal cord injury?
If there is cord compression, bone fragments, unstable vertabrae, and decreased neuro status.
Fusion of vertabrae can ___________ the patient.
Stabilize
Why would you give vasopressors to a spinal cord injury patient?
To prevent secondary injuries, and keeping the MAP up will perfuse the spinal cord
What will happen to the respiratory system with a spinal cord injury?
Loss of function, hypoventilation, decrease tidal volume, pulmonary edema, risk for infection
What can happen to the cardiovascular system with spinal cord injury?
Vasodilation, decrease BP, HR, and CO, relative hypovolemia
How would you care for the GI/GU system with a spinal cord injury?
Cath for distention and retention, Reglan and PPI’s for the stomach, watch for ulcers
What are concerns with thermoregulation with spinal cord injury patients?
The patient loses the ability to sweat and shiver
What are metabolic needs of the spinal cord injury patient?
NG suctioning can cause metabolic alkalosis, there is decreased tissue perfusion, abnormal electrolyte levels, and may need tube feeds
What are concerns with nutrition in a spinal cord injury?
The GI tract may stop functioning, may need to suction and provide TPN with high calorie and protein.
What is autonomic dysreflexia?
With T6 injuries and higher, there is a massive uncompensated cardiovascular response by the SNS. It causes severe HTN, a throbbing headache, sweaty, decreased HR, blurry vision, and anxiety.
What causes autonomic dysreflexia?
Pee poop pain. Distended bladder or rectum or pain.
