SCI complications B Flashcards
autonomic dysreflexia
occurs with injuries at or above T6; disrupt sympathetic responses
Autonomic dysreflexia is considered a medical emergency why?
Massive sympathetic response; there is vasoconstriction, leading to hypertension and decreased HR.
In autonomic dysreflexia the brain is unable to send descending inhibitory signals due to SCI
S/S of autonomic dysreflexia
Increased BP, decreased HR, headache, flushing, profuse sweating, anxiety, constricted pupils, blurred vision, piloerection (goosebumps)
With autonomic dysreflexia SBP increases to…
20 to 30 mmHg
SCI patients typically have lower SBP between 90-100 mmHg.
Vasoconstriction below level of injury and vasodilation above level.
what causes autonomic dysreflexia
bowel and bladder distension, infection, impaction, cauterization block, abdominal binder.
skin breakdown, pressure sores, ingrown toenail, and similar stimuli.
treatment for autonomic dysreflexia
- sit patient up and immediately remove noxious stimuli, loosen clothing, unclamp catheter, loosen abdominal binder. lowering legs will help decreased BP.
- check vitals and give HTM drugs if unable to find triggering factor.
- get help
Neurogenic shock
occurs w/ SCI above T6
Tone and spasticity
hyperreflexia, hypertonia, positive clonus
seen w/ injuries above T10 after spinal shock
spasticity is velocity dependent
Increased tone can cause pain, contracture, interference w/ transfers, interferes w/ ADL
Cardiovascular Issues
orthostatic hypotension, seen in SCIs above T6
-Blurred vision, ringing in ears, light headedness, fainting
-slow progression to vertical position elevate head of bed and progress to reclining wheelchair w/ elevated leg rest; use tilt tables.
Abdominal binder and compression stockings used to minimize effects.
Temperature control
Hypothalamus can no longer control cutaneous blood flow or level of sweating
