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PathoPharm 2 > ch 60 spinal cord injury > Flashcards

ch 60 spinal cord injury Flashcards

1
Q

most unstable type of spinal cord injury

A

flexion-rotation injury

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2
Q

after how many hours does permanent spinal cord damage occur from edema

A

24+ hours

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3
Q

vertebral level where there is the most damage to vertebral bones and ligaments

A

skeletal level of injury

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4
Q

lowest segment of spinal cord with normal sensory and motor function on both sides of body

A

neurologic level of injury

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5
Q

how many cervical vertebrae

A

8

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6
Q

how many thoracic vertebrae

A

12

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7
Q

how many lumbar vertebrae

A

5

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8
Q

what level vertebrae fracture can kill someone

A

C1/C2

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9
Q

3 types paralysis

A

tetraplegia (neck down)
paraplegia (waist down)
hemiplegia (one side body)

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10
Q

biggest concern with cervical and upper thoracic injuries (3)

A
  • impaired breathing
  • impaired ability to regulate bp
  • impaired heart function
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11
Q

nursing considerations for pts with injury at or above C4 level

A
  • need ventilator

- need cardiac support

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12
Q

resp S+S for pts with injury below C4

A

-labored breathing and hypoventilation

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13
Q

any cord injury above level T6 affects what body system

A

sympathetic nervous system

cardiovascular

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14
Q

cardiovascular S+S with injuries above level T6

A
  • bradycardia

- hypotension

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15
Q

what meds should be given to pt with level T6 injury or above when they get to ER to help manage hypotension (3)

A
  • domaine
  • epinephrine
  • atropine
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16
Q

S+S autonomic dysreflexia (5)

A
  • blurred vision
  • throbbing headache
  • marked diaphoresis above injury level
  • bradycardia
  • severe increase bp
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17
Q

what are pts who have level T6 injury or higher at risk for

A

autonomic dysreflexia

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18
Q

triggers of autonomic dysreflexia (4)

A
  • full bladder/UTI
  • restrictive clothing
  • pressure areas
  • fecal impaction
19
Q

Tx autonomic dysreflexia

A
  • find underlying cause

- nifedipine

20
Q

bladder complication after spinal cord injury

A

-neurogenic bladder: difficulty urinating independently

21
Q

Tx neurogenic bladder

A

self intermittent catheterization

22
Q

med Tx neurogenic spasticity (3)

A
  • anticholinergic (oxybutynin, tolterodine)
  • alpha blocker (terazosin, doxazosin)
  • antispasmodics (baclofen)
23
Q

SE anticholinergics (oxybutynin, tolterodine) (5)

A
  • headache
  • dizziness
  • dry mouth
  • constipation
  • dry eyes
24
Q

contraindications anticholinergics (oxybutynin, tolterodine) (2)

A
  • urinary retention

- uncontrolled narrow angle glaucoma

25
Q

GI issues after level T5 injury or above (5)

A
  • hypomobility
  • paralytic ileus
  • gastric distention
  • peptic ulcers
  • neurogenic bowel
26
Q

meds for peptic ulcers (3)

A
  • PPIs (-prazole)
  • high dose corticosteroids
  • H2 blockers (famotidine)
27
Q

inability to defecate independently

A

neurogenic bowel

28
Q

Tx neurogenic bowel (4)

A
  • scheduled toileting
  • stool softener
  • suppository
  • high fiber diet and adequate fluid intake
29
Q

adjustment of body temp to room temp

A

poikilothermism

30
Q

how is thermal regulation impaired with spinal cord injury

A

-decreased ability to sweat and shiver

31
Q

admin/nursing considerations for antispasmodics (baclofen and dantrolene) (4)

A
  • monitor for weakness
  • avoid driving
  • don’t stop taking abruptly
  • do not take with alcohol or CNS depressants
32
Q

what imbalance can NG suctioning lead to

A

metabolic alkalosis

33
Q

nutritional considerations for spinal cord injury pts

A
  • high calorie
  • high protein
  • high nitrogen
  • NG tube
34
Q

scale for classifying extent of impairment from spinal cord injury

A

ASIA scale

american spinal injury association

35
Q

Dx spinal cord injury

A
  • x-rays

- CT

36
Q

immediate Tx spinal cord injury

A
  • patent airway
  • good ventilation
  • adequate circulation (dopamine, epinephrine)
  • protect further cord damage
  • increase bp with meds
37
Q

after spinal cord injury: temporary neurologic syndrome, reversible

A

spinal shock

38
Q

S+S spinal shock (3)

A
  • loss of reflexes
  • loss of sensation
  • flaccid paralysis below level of injury
39
Q

prophylactic Tx to prevent spinal shock

A

high dose corticosteroids

40
Q

after spinal cord injury: loss of vasomotor tone, generally associated with injury T6 or higher

A

neurogenic shock

41
Q

S+S neurogenic shock (3)

A
  • hypoTN
  • bradycardia
  • decreased CO
42
Q

med Tx neurogenic shock (2)

A
  • atropine (for bradycardia)

- dopamine/norephinephrine/vasopressin (for bp)

43
Q

nursing admin considerations for vasopressors (dopamine, norepinephrine, vasopressin) (3)

A
  • monitor bp q15mins
  • watch IV site for extravasation
  • know target mean arterial pressure (ex: MAP>65)

PathoPharm 2 (33 decks)

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