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N4: Test 2 > Traumatic SCI > Flashcards

Traumatic SCI Flashcards

1
Q

What is the primary function of the spinal cord?

A

Central relay for motor and sensory information between the brain and body

Also coordinates reflexes.

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2
Q

What are common causes of spinal cord injury (SCI)?

A
  • Motor vehicle accidents
  • Falls
  • Acts of violence
  • Sports injuries

Other potential causes include diving accidents and industrial mishaps.

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3
Q

What are the mechanisms of spinal cord injury?

A
  • Cord Compression
  • Penetrating Trauma
  • Traction
  • Laceration or Rupture

Each mechanism describes a different way the spinal cord can be damaged.

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4
Q

What does the location of a spinal cord injury determine?

A

Which body functions are affected

Location is defined by vertebral level or neurological level of injury.

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5
Q

What is affected in cervical injury at C4?

A

Affects breathing and may require ventilation

The C4 vertebra innervates (sends signals to) the diaphragm.

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6
Q

What is the difference between complete and incomplete spinal cord injury?

A
  • Complete: Total loss of motor and sensory function below the injury
  • Incomplete: Some sensory and motor functions may remain

Incomplete injuries allow for the possibility of recovery.

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7
Q

What are the two types of spinal cord injuries?

A
  • Primary Injury
  • Secondary Injury

Primary injuries occur at the time of trauma, while secondary injuries develop after the initial injury.

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8
Q

What characterizes a primary spinal cord injury?

A

Occurs at the time of trauma and is usually permanent

It results from disruption of axons, blood vessels, and cell membranes.

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9
Q

What are some types of primary spinal cord injury?

A
  • Cord compression
  • Penetrating trauma
  • Traction injury
  • Laceration
  • Rupture

Each type refers to a specific way the spinal cord can be damaged.

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10
Q

What defines a secondary spinal cord injury?

A
  • Ongoing damage after the initial trauma
  • Minutes to months

Secondary injuries can occur from ischemia, edema, and microhemorrhages.

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11
Q

What are the effects of cervical injuries C1-C3?

A

Often fatal and will be ventilator dependent

These injuries result in paralysis of all four limbs (quadriplegia/tetraplegia).

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12
Q

What is spinal shock?

A

Complete but temporary loss of all motor, sensory, reflex, and autonomic function BELOW injury

Usually resolves in 24-48 hours when deep tendon reflexes return.

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13
Q

What is the priority nursing intervention for spinal shock?

A

Maintain mean arterial pressure (MAP) at 85 or greater
* MAP: indicator of blood flow to vital organs & tissue.

Hyperperfuse= This helps prevent ischemia.

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14
Q

What vasopressor meds are used for spinal shock?

A

Atropine, Dopamine, Epinephrine
* used to help raise and maintain BP.

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15
Q

What are common complications Post cervical spine surgery?

A
  • Breathing issues
  • Pneumonia
  • Bleeding
  • Swallowing difficulties

These complications arise due to nerve involvement and reduced mobility.

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16
Q

what is autonomic dysreflexiw

A
  • sudden and serious condition
  • injuries above the T6 level (mid-thoracic)
  • occurs when the body reacts in an exaggerated way to a stimulus below the level of the injury, like a full bladder, constipation, or tight clothing
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17
Q

What level of injury is associated with autonomic dysreflexia?

A

Damage at T6 and above

Autonomic dysreflexia is characterized by a sudden and dangerous increase in blood pressure.

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18
Q

What are the nursing goals in the field for an acute unstable spinal cord injury?

A
  • No. 1 - Immobilize the patient
  • Stabilize vital signs (ABC)
    -Maintain systolic BP >90
  • Transport to a trauma center

Immobilization prevents secondary injury and is crucial for patient safety.

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19
Q

Fill in the blank: The _________ test is always used to check neurological status in spinal cord injury.

A

[Dermatome]

It evaluates sensory function to determine the level of injury.

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20
Q

What care is needed for SCI patients to prevent urinary tract infections?

A
  • Proper catheter care
  • Hydration
  • Signs of infection (fever, cloudy urine, foul odor)

Effective monitoring can greatly reduce the risk of UTIs.

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21
Q

What is the role of corticosteroids in spinal cord injury treatment?

A

High-dose corticosteroids are controversial and may be used to reduce inflammation

Their use is debated due to potential side effects.

22
Q

Anticoag drugs used for SCI

A
  • enoxaparin (Lovenox)
  • warfarin
  • aspirin
  • heparin
23
Q

What is the purpose of a log roll technique in spinal cord injury care?

A

To move the patient in alignment as a unit

This technique helps prevent further injury during patient handling.

24
Q

True or False: Flaccid paralysis occurs below the level of injury in spinal shock.

A

True

This paralysis results from nerve damage affecting muscle control.

25
Q

What is the impact of lumbar and sacral injuries on bowel and bladder control?

A
  • Cessation of bowel movements
  • Urinary retention
  • Affects sexual function in men

Injury above S2 in males allows erection but not ejaculation.

26
Q

Q: What types of urincary catheters are recommended for managing urinary retention in SCI patients?

A

A: Use intermittent catheterization (temporary) or a urinary retention catheter as needed.

27
Q

What does thick, yellow or green sputum indicate?

A

Infection

Indicates a potential respiratory infection.

28
Q

What does clear or white sputum suggest?

A

Mild secretion buildup

May indicate less severe respiratory issues.

29
Q

What subjective feelings should be assessed in patients regarding respiratory health?

A

Shortness of breath, chest tightness, discomfort when breathing

Important for evaluating respiratory function.

30
Q

What skin color changes should be monitored in respiratory assessments?

A

Cyanosis, paleness, cool clammy skin

Indicates hypoxia or poor perfusion.

31
Q

What is the purpose of using an incentive spirometer?

A

Promote lung expansion and prevent atelectasis

Encourages deep breathing to improve oxygenation.

32
Q

What is a quad cough?

A

Manual pressure applied to abdomen while coughing

Assists in expelling secretions.

33
Q

List early signs of respiratory complications that patients should recognize.

A
  • Increased coughing
  • Difficulty clearing secretions
  • Shortness of breath
  • Fever or chills
  • Changes in sputum

Important for timely intervention.

34
Q

What causes orthostatic hypotension in spinal cord injury (SCI)?

A

Impaired vasoconstriction and blood pooling

Results from interruption of normal reflex arcs.

35
Q

What intervention should be taken if a patient experiences orthostatic hypotension?

A

Lower the head of the bed or lie flat

Helps increase venous return and improve circulation.

36
Q

What are TED hose used for?

A

Improve venous return and reduce blood pooling

Provide gentle compression in lower extremities.

37
Q

What is the role of a pneumatic compression device?

A

Promote circulation in lower extremities

Assists in preventing blood pooling.

38
Q

How should patients be taught to reposition if experiencing orthostatic hypotension?

A

Change positions slowly, lie flat, elevate legs

Helps prevent sudden drops in blood pressure.

39
Q

What is constipation during spinal shock?

A

Bowel becomes areflexic or flaccid

Normal bowel reflexes are disrupted due to neurological loss.

40
Q

What interventions can help with constipation in spinal shock?

A
  • Rectal stimulation
  • Digital stimulation
  • Suppositories or mini-enemas

Necessary to encourage bowel movements.

41
Q

What are stress ulcers?

A

Physiologic responses to severe trauma or stress

Typically occur in the stomach or duodenum due to increased gastric acid.

42
Q

What medications can prevent stress ulcers?

A
  • Histamine H2 blockers
  • Proton Pump Inhibitors (PPI)

Reduce gastric acid secretion to prevent ulcer formation.

43
Q

What is neurogenic bladder?

A

Spastic (Upper Motor Neuron) vs. Flaccid (Lower Motor Neuron) bladder

Requires different management strategies.

44
Q

What are the risks associated with the integumentary system in patients with SCI?

A

Risk for pressure ulcers

Prevention includes turning schedules and skin assessments.

45
Q

What types of pain are associated with SCI?

A
  • Nociceptive Pain
  • Neuropathic Pain

Nociceptive is musculoskeletal or visceral; neuropathic is burning or tingling.

46
Q

What are clinical signs of autonomic dysreflexia?

A
  • Severe headache
  • Hypertension
  • Bradycardia
  • Sweating above injury level

Requires prompt nursing actions.

47
Q

What is neurogenic shock?

A

Loss of vasomotor tone, hypotension, bradycardia

A serious complication of SCI.

48
Q

What nursing actions are necessary for managing pneumonia and UTI in SCI patients?

A
  • Use incentive spirometry
  • Ensure hydration
  • Implement bladder training

Prevention strategies are crucial.

49
Q

What are the goals of rehabilitation and home care for SCI patients?

A
  • Regain autonomy
  • Prevent complications
  • Train on bowel and bladder management

Focus on improving quality of life.

50
Q

What is important to include in discharge planning for SCI patients?

A
  • Patient understanding of diagnosis
  • Support systems
  • Medication administration
  • Recognition of complications
  • Home care practices

Ensures continuity of care post-discharge.

51
Q

What is the role of collaborative care in SCI management?

A

Involve an interdisciplinary team for comprehensive care

Coordination with various therapies enhances rehabilitation.

N4: Test 2 (4 decks)

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