SCI/Pressure Ulcer

Question 1

What are 3 contributing factors for bedsores?

Answer 1

Pressure: constant pressure on any body part
Friction: skin rubs against bed/clothing
Shear: 2 surfaces move in opposite directions

Question 2

You and the team are seeing a patient 2 days post SCI. Based upon the initial assessment it appears as if the patient is injured at C6. The patients family inquires about the prognosis what should we do?

Answer 2

Explain to the family that the patient will be re-evaluated 3 days post injury because of spinal shock.

Question 3

How often should patients perform pressure relief techniques to prevent skin breakdown?

Answer 3

30min-1hr

Question 4

A patient who is paraplegic wants to prevent pressure ulcers… What is a cushion that is contraindicated?

Answer 4

Donut style cushion

Question 5

Describe how someone with C1-C3 SCI may typically present?

Answer 5

ventilator dep. sip/puff, power w/c with tilt

Question 6

What level of SCI is diaphragm involved?

Answer 6

C4

Question 7

Describe how a patient may present with C4 SCI

Answer 7

may require vent but may progress without one.
dept for feed/dress/B&B

Question 8

What muscle movement is displayed at C5?

Answer 8

elbow flexion

Question 9

Describe how a patient may present at a C5

Answer 9

set up and AE for dressing
I feeding
Max A slide board tx

Question 10

What are some splints that may be used for a patient with a C5 injury?

Answer 10

Wrist cock up-day
Intrinsic plus-night
Universal cuff or moble arm support

Question 11

When can a pt perform wrist extension?

Answer 11

C6

Question 12

Describe how someone with a C6 injury may present

Answer 12

I with feeding
I UBD
I complete pressure relief
I bed mobility

Question 13

What are some pieces of AE a client may need with a C6 injury?

Answer 13

tenodesis splint
transfer board
built up handle

Question 14

What movements may a client display at C7-C8

Answer 14

elbow extension/flexion of middle finger

Question 15

Describe how someone with a C7-8 injury may present

Answer 15

I with all self care, some support w/ B&B
w/c push ups for pressure relief
manual w/c

Question 16

When could a patient potentially begin walking short distances with braces?

Answer 16

T2-6

Question 17

When can patients walk with crutches? When are they able to walk with canes?

Answer 17

L1-2
L3-5

Question 18

What is the best way for a patient with a C6 to perform pressure relief?

Answer 18

sit up using loops and forward weight shift.

Question 19

If a patient is observed chewing and using a mouth stick to play games what is the highest level at which the pts SC has been injured?

Answer 19

C1-C3

Question 20

What are strategies that can help a client with a SCI maintain their skin integrity?

Answer 20

use a long curved mirror to inspect bony prominences, avoid shearing when transferring and rolling side to side using a touch to check method