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NRSG 202 > Seminar 11 > Flashcards

Seminar 11 Flashcards

1
Q

What are the 3 classifications of a spinal cord injury

A

-Mechanism of injury
-level of injury
-degree of injury

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2
Q

What are the different mechanisms of injury

A

Traumatic
non traumatic

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3
Q

what are the different degrees of injury

A

-Complete (spinal cord is completely severed)
-incomplete (Some movement of sensory below the level of injury)

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4
Q

what is the gold standard diagnostic test for imaging soft tissues

A

MRI

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5
Q

what level of injury results in a total loss of respiratory muscle function

A

Anything above C4

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6
Q

what level of injury results in neurogenic shock

A

Injury at T5 or higher

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7
Q

what are clinical manifestations of neurogenic shock

A

-Bradycardia
-Peripheral Vasodilation

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8
Q

what level of injury determines if a person will have a spastic or flaccid bladder

A

-Above T12 spastic bladder
-below T12 Flaccid

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9
Q

What are some common bladder complications after a SCI

A

-Urinary retention
-Bladder becomes atonic (unable to contract) and overdistended

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10
Q

What level of injury results in neurogenic bowel

A

injury at T5 or above

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11
Q

what is the main clinical manifestation of neurogenic bowel

A

mostly causes hypomotility which results in constipation paralytic ileus etc

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12
Q

what level of injury determines if someone will have a spastic bowel or flaccid bowel

A

-T12 or above will result in a spastic bladder
-T12 or below will result in a flaccid bladder

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13
Q

what is poikilothermia and why does it occur in people with SCI

A

Inability to maintain core temperature because the injury prevents temperature sensation from reaching the hypothalamus

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14
Q

When is a DVT most likely to occur in a SCI

A

most likely to occur within the first 3 months after injury

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15
Q

what level of injury can result in autonomic dysreflexia

A

T6 or higher

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16
Q

what is autonomic dysreflexia

A

when the sympathetic NS becomes hyperactive after an SCI because of sustained stimulus at or below level of injury which can lead to seizures, strokes and MI (from the increase in BP and increased work on the heart from the SNS activation)

17
Q

what are clinical manifestations of autonomic dysreflexia

A

-bradycardia
-everything else is a symptom of SNS stimulation ie hypertension blurred vision diaphoresis flushing etc

18
Q

what are examples of things that could cause autonomic dysreflexia

A

-restrictive clothing
-pressure areas
-full bladder or UTI
-fecal impaction

19
Q

what are nursing interventions for autonomic dysreflexia

A

-elevate head of bed to 45 degrees
-remove stimulus that is causing the problem

20
Q

what are the 3 things that make up ICP

A

Brain tissue
Blood
Cerebrospinal fluid

21
Q

what is usually the earliest sign of increased ICP

A

Changes in LOC

22
Q

what are late stage signs of increased ICP

A

-Cushing’s Triad
-Decrease in motor function

23
Q

what is the normal range for ICP

A

5-15 mm Hg

24
Q

what position is best for a client with increased ICP

A

positioned with the HOB elevated to 30 degrees

25
Q

what would the GCS score be for a mild brain injury

A

GCS of 15-13

26
Q

what would the GCS score be for a moderate brain injury

A

GCS of 12-9

27
Q

what would the GCS score be for a severe brain injury

A

score of 8-3

28
Q

what is diffuse axonal injury

A

when the axons in the brain shear from the brain shifting around inside the skull

29
Q

how long does it take until a person starts to show symptoms of a DAI

A

12-24 hours

30
Q

what are clinical manifestations of DAI

A

-decreased LOC
-Increased ICP
-Decerebrate (straight arms parallel to the body) or decorticate posturing (Arms are bent towards the center of the body)
-persistent vegetative stateif DAI is severe

31
Q

what is a coup countercoup injury

A

when there is damage from the primary impact (coup) and damage from the secondary impact when the brain bounces back and hits the opposite side of the skull from where the force was applied (Countercoup)

32
Q

what is a traumatic subarachnoid hemorrhage

A

hemorrhage that is a result of traumatic force that damages the vascular structures of the subarachnoid space

NRSG 202 (10 decks)

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