Neurological Alterations (Spinal Cord Injuries)

Question 1

What is a spinal cord injury ?

Answer 1

Autonomic dysreflexia

Question 2

What is the Pathophysiology of Autonomic Dysreflexia ?

Answer 2

Life-threatening emergency that can occur with an upper spinal cord injury (above T6). sometimes called hyper-reflexia

• Exaggerated response to certain stimuli that are harmless to someone without a spinal cord injury

Question 3

What are signs and symptoms of Autonomic Dysreflexia ?

Answer 3

It is a syndrome characterized by…

• Severe HTN
• Headache
• Bradycardia
• Nasal stuffiness
• Flushing
• Sweating (especially on the forehead)
• Blurred vision
• Nausea
• Anxiety
• Sudden onset & is a neurological emergency if not Tx promptly

Question 4

Why is Autonomic Dysreflexia a neurological emergency, if not treated promptly ?

Answer 4

A Hypertensive stroke could occur

Question 5

What are causes of Autonomic Dysreflexia ?

Answer 5

• Distended bladder
• Constipation or impaction
• Stimuli to the skin (like: pressure, pain, or temperature)

Question 6

What are the Tx’s for Autonomic Dysreflexia ?

Answer 6

• 1st: sit the client up to lower the BP
• Put the bed bound client in Semi fowlers
• Treat the cause
  - insert a catheter
  - remove any impaction (with a topical anesthetic)
  - look for skin pressure, painful stimuli, or a cold draft or breeze in the room
• Antihypertensives may still be required if the BP remains elevated after the stimulus is removed
• Teach prevention measures