SCI

Question 1

What are common findings with spinal shock?

Answer 1

Decreased reflexes.
Loss of sensation
Flaccid paralysis below the level of injury.

Question 2

What are the signs of neurogenic shock?

Answer 2

Loss of vasomotor tone
Hypo and brady
Associated with T6 injury or higher.

Question 3

Tetraplegia is associated with an injury to where?

Answer 3

C8 and above

Question 4

Paraplegia is associated with an injury where?

Answer 4

T1 and down

Question 5

An injury between C3-5 would injure what nerve/

Answer 5

Phrenic

Question 6

Describe complete cord involvement

Answer 6

Total loss of sensory and motor function below injury.

Question 7

Describe a partial or incomplete cord injury

Answer 7

Mixed loss of voluntary motor and sensation.

Some tracts still intact.

Question 8

If an injury occurs above C4 that what treatment will be expected?

If below C4?

Answer 8

Vent.

Pt will have diaphragmatic breathing and hypoventilation if phrenic is functioning.

Question 9

Cervical and thoracic injuries cause paralysis of what?

What will this lead to?

Answer 9

Abdominal and intercostal muscles.

PNA and atelectasia due to ineffective cough.

Question 10

Any cord injury above T6 greatly decreases what?

What will be the pt S/S?

Will pt need to be on tele?

Answer 10

Effects of SNS.

Brady, hypo, hypovolemia

Yes.

Question 11

What are common manifestations with an SCI for the urinary system?

Answer 11

Retention.
Bladder atonic and distended.
Bladder hyperirritable (reflex emptying)

Question 12

A pt with a cord injury above T5 will exhibit what? In relation to GI

Answer 12

Hypomotility. Ileus, distention.

May get ulcers or intraabdominal bleed. Watch H/H

Question 13

What point on the cord needs to be injured to have a neurogenic bowel?

Answer 13

T12 or below.

Will have decreased sphincter tone

Question 14

In regards to the integumentary system, what problems may arise?

Answer 14

Breakdown from immobility

Infection or sepsis from pressure injury.

Question 15

What is Poikilothermism?

Answer 15

When the body adjusts to the temperature of the room.

Question 16

What is the gold standard for diagnostic testing of an SCI?

Answer 16

CT

Question 17

What is the leading cause of death from an SCI?

Answer 17

DVT-leading to a PE

Question 18

Why do we give methylprednisolone (MP)?

Answer 18

Aides in recovery of neurological function.
No help if given 8 hours post injury.

Give early and in large doses.

Question 19

With an injury at or above C3, what things will you see?

During the first 48 hours?

Answer 19

Resp distress
ABG’s deteriorate.
ETT/vent

Spinal cord edema which will decrease the level of function.

Question 20

What are some cardiac issues?

Answer 20

Brady-give atropine(anticholinergic).

Increase in vagal stimulation due to suctioning and turning. (Arrest)

Question 21

What happens to the GI tract in the first 48-72 hours?

Answer 21

May stop functioning.
Give NGT. 
Strict I/O.
Give high protein/calories.
Swallow eval

Question 22

In regards to GI and GU, what will happen immediately after injury?

Answer 22

Retention and constipation.

Question 23

While the pt is rehabbing, what might you see that will need to be explained to family?

Answer 23

Hyperactive and exaggerated responses
Erections
Spasms.

Question 24

What are the clinical manifestations of autonomic dysreflexia?

Answer 24

HTN, blurry vision, severe HA, sweaty, brady,

Piloerection, flushing, anxiety.

Question 25

What is the underlying cause of autonomic dysreflexia?

Answer 25

An uncompensated CV reaction by the SNS

Question 26

What is the most common cause of autonomic?

Answer 26

Bladder and rectum retention.

Possibly tight clothing.

Question 27

Is autonomic an emergency?

Answer 27

Absolutely

Question 28

What are the primary interventions of the nurse for autonomic?

Answer 28

Eleva-te HOB to 45.
Call Doc.
Assess cause
Immediate catheterization or dig stim.
Teach family.