Rehabilitation SCI

Question 1

Rehabilitation and Home Care

Answer 1

Organized around individual client’s goals and needs
Clients should expect
- to be involved in therapies
- to learn self-care
Can be very stressful
Frequent encouragement

Question 2

Respiratory Rehabilitation

Answer 2

Phrenic nerve stimulators or electronic diaphragmatic pacemakers increase mobility
Teach cervical level injury clients who are not ventilator dependent
- assisted coughing
- chest physio
- regular use of spirometry or deep breathing exercises

Question 3

Neurogenic Bladder

Answer 3

Any type of bladder dysfunction related to abnormal or absent bladder innervation
Common problems: urgency, frequency, incontinence, inability to void, and high bladder pressures resulting in reflux of urine into kidneys
- intermittent catheterization is recommended q4h

Question 4

Neurogenic Bowel

Answer 4

Voluntary control may be lost
High-fibre diet and adequate fluid intake
Suppositories, small volume enemas, or digital stimulation by client or nurse
Carefully record bowel movements

Question 5

Neurogenic Skin

Answer 5

Prevention of pressure ulcers and other types of injury to insensitive skin is essential.
Teach these skills and provide information about daily skin care.
Careful positioning and repositioning should be done every 2 hours with gradual increase in time
Pressure-relieving cushions must be used in wheelchairs.
Protect skin by avoiding thermal injury.
Teach family members skin care as well.

Question 6

Sexuality

Answer 6

Important issue regardless of client’s age or gender
Nurse must
have an awareness and an acceptance of personal sexuality.
have knowledge of human sexual responses.
use medical terminology.
Injury level and completeness of injury are needed to understand the male client’s potential for orgasm, erection, and fertility, and the client’s capacity for sexual satisfaction.
Treatments for erectile dysfunction include drugs, vacuum devices, and surgical procedures.
Effects of spinal cord injury on female sexual response are less clear.
Women of child-bearing age remain fertile and have the ability to become pregnant or to deliver normally through birth canal.

Question 7

Evaluation

Answer 7

Establishes a bladder management program based on neurological function, caregiver status, and lifestyle choices
Develops no complications of immobility
Experiences no episodes of dysreflexia

Question 8

Age-Related Considerations

Answer 8

• Spinal cord injury clients are living much longer lifespans
• Aging has serious impact on the older adult with a spinal cord injury
• Health promotion and screening are important