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G240 Exam #4 > SCI > Flashcards

SCI Flashcards

1
Q

Risk factors SCI (3)

A
  • males
  • adolescent
  • drug/alcohol abuse
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2
Q

Complete transection

A
  • complete severing of spinal cord

- patient paralyzed below point of injury

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3
Q

What is a primary injury SCI?

A

caused by the initial event

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4
Q

what is a secondary injury SCI?

A

cascade of events in the body after the initial trauma –> body’s attempt to deal with the injury

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5
Q

s/s complete spinal cord injury

A
  • loss of sensation/motor function

- paraplegia or tetraplegia

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6
Q

s/s incomplete spinal cord injury

A
  • spinal cord still able to relay some messages to and from brain
  • partial motor/sensory dysfunction below level of injury
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7
Q

Assessment and dx SCI (7)

A
  • Xray
  • CT
  • MRI (shows soft tissue injury)
  • assess for additional injuries
  • monitor VS
  • continuous tele monitoring
  • assess CSM to determine level of injury
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8
Q

Emergency management SCI- 5

A
  • patient is immobilized
  • head and neck maintained in neutral position
  • no flexion, extension, rotation of spine
  • stabilize any other life threatening injuries
  • one member of the team must assume control of the patients head
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9
Q

medical management goals for SCI-3

A

-prevent secondary injury, observe s/s of progressive neuro defeats, and prevent complications

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10
Q

situations when surgery is indicated for SCI (4)

A
  • compression of spinal cord is evident
  • injury results in a fragmented or unstable vertebral body
  • involves a wound that penetrates the cord
  • neuro status is deteriorating
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11
Q

Nursing Management for SCI (9)

A
  • assess respiratory function
  • maintain body alignment/spinal precaution
  • prevention of DVT/PE
  • prevent skin breakdown
  • maintain bowel-bladder function
  • promote effective coping mechanisms
  • monitor for potential complications
  • comfort measures for patient with traction with tongs or halo brace
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12
Q

Preventing skin breakdown SCI -3

A
  • reposition q 2 hours
  • should be kept clean with mild soap, rinsing well, and blotting dry
  • lubricate pressure sensitive areas with lotion or oil
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13
Q

maintain bowel/ bladder function SCI- 3

A
  • bladder –> foley usually inserted initially then discontinued ASAp
  • Bowel –> paralytic ileus usually develops (NG tube needed to decompress, normal bowel activity usually comes back within a week)
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14
Q

comfort measures for patient with traction with tongs or spinal halo-4

A
  • areas around the four pin sites of halo devicese are cleaned at least once a day and observed for s/s infection
  • observe for loosening (torque screwdriver should be nearby for tightening)
  • skin under the halves should be inspected for excessive perspiration, redness, and skin blistering
  • vest can be opened ,for the skin to be washed (worn 23 hours/day)
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15
Q

potential complications of SCI- 6

A
  • spinal shock
  • neurogenic shock
  • VTE
  • pressure ulcers
  • respiratory complications
  • autonomic dysreflexia
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16
Q

What is spinal shock?

A

sudden loss of reflex activity below the level of injury

17
Q

phases of spinal shock-4

A
  • areflexia (0-1 days)
  • initial return of reflex activity (1-3 days)
  • initial hyper-reflexia (1-4 weeks)
  • final hyper-reflexia (1-12 months)
18
Q

Sign that means a patient is coming out of spinal shock

A

return of reflex activity

19
Q

What is neurogenic shock?

A

loss of autonomic nervous system function below level of injury

20
Q

s/s neurogenic shock and how long it lasts

A
  • hypotension
  • bradycardia
  • decreased CO
  • peripheral vasodilation
  • respiratory dysfunction
  • organ dysfunction or failure
  • inability to perspire in paralyzed areas

lasts 1-3 weeks

21
Q

What is autonomic dysreflexia?

A

exaggerated autonomic response to stimuli

22
Q

When can autonomic dysreflexia occur?

A

only after spinal shock has resolved

23
Q

autonomic dysreflexia is a _________

A

life threatening emergency

24
Q

At what spinal nerve and above does autonomic dysreflexia occur

A

T6 or above

25
Q

s/s autonomic dysreflexia-6

A
  • severe HA
  • hypertension
  • bradycardia
  • diaphoresis above injury
  • nasal congestion
  • nausea
26
Q

What triggers autonomic dysreflexia?

A
  • bladder distention (most common)
  • bowel distention
  • stimulation of the skin
27
Q

Nursing interventions for autonomic dysreflexia-5

A
  • sit patient up to lower BP
  • empty bladder via urinary cath
  • inspect rectum for stool/impaction
  • identify areas of pressure on the skin
  • identify temp stimuli

G240 Exam #4 (7 decks)

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