Deck 1 Flashcards
Spinal cord injury level that causes difficulty breathing?
3-5 however ATI says C4
Spinal cord injury level that causes difficulty breathing?
3-5 however ATI says C4
What would you assess for with a Spinal cord injury T6 and above?
Autonomic dysreflexia (hypertension and bradycardia)
What symptoms does autonomic dysreflexia cause?
hypertension and bradycardia
Bradycardia: (20-40 bpm) - lack of perfusion
Hypertension: (200-280 systolic) - can lead to stroke
What are the triggers of autonomic dysreflexia?
Full bladder- administer in and out catheter (straight cath)
Full bowel- perform digital stimulation in the rectum to relieve bowel.
administer antispasmodics
Normal value for ICP? KNOW THIS
10-15
Findings of increased ICP?
-headache
-LOC changes
-seizures
-dilated pupils
-nausea and vomiting
-posturing
1 intervention for Autonomic Dysreflexia and increased ICP
SIT PATIENT UP
Decerebrate posturing
wrists turned outwards
damage to brainstem(which houses medulla oblongata) - controls breathing, heartrate, circulation
dangerous
Decorticate posturing
arms towards the body’s core (de-CORE-ticate)
legs extended
damage is to the cerebrum - less dangerous
What is your first intervention if a patient starts posturing?
Call the doctor as soon as possible, as this indicates a neuro change and possible increase in ICP
Patients with a Frontal lobe injury
impulsive!
changes in personality - typically not very nice
very hypersexual
SET BOUNDARIES and document these boundaries.
SAFETY is priority.
Set bed alarm, bed in low position, room close to nurses station, and assign a sitter.
C1-C7
Cervical Spine (The neck)
Spinal shock
Means spinal cord is injured
irritates the sympathetic nervous system and causes it to work poorly.
leads to neurogenic shock
Mannitol for ICP
Osmotic diuretic that pulls fluid from the brain’s cells and the rest of the body and into the vessels - gets secreted in urine
What are adverse effects of Mannitol?
Dehydration of Brain
Pulmonary Congestion
Cushing’s triad
-bradycardia
-widening pulse pressure
-HTN
“ominous sign” of increased ICP
Neurogenic Shock
loss of sympathetic tone
Hypotension
Bradycardia
Gillian-barre syndrome
Very similar to MS
autoimmune - affects myelin sheaths
Paralysis starts at the feet and ascends up both sides, and can be deadly as it paralyzes the diaphragm
they are going to need respiratory assistance ASAP!
Contact house supervision ASAP for a vent bed!
Describe the paralysis pattern of Guillain-Barre Syndrome
Paralysis starts from the feet bilaterally and ascends up both sides (bilateral ascending pattern)
Biggest complication for ALS (Amyotrophic lateral sclerosis, aka Lou Gehrigs disease), Myasthenia gravis, and Gillian-Barre?
Respiratory complications
Biggest complication for ALS (Amyotrophic lateral sclerosis, aka Lou Gehrigs disease), Myasthenia gravis, and Gillian-Barre?
Respiratory complications
What is DIC?
-Disseminated intravascular coagulation
Clotting and bleeding at the same time
- blood clots form throughout the body’s small blood vessels, using up clotting factors and platelets. → leading to severe bleeding and organ damage→which leads to more clotting = its a cycle
What are the main findings of DIC?
Epistaxis (nosebleed)
look at their IV site (will be leaking)
blood-tinged urine
pale
low BP
How do we treat DIC? (Disseminated intravascular coagulation)
Heparin
