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Med Surge

Spinal cord injury

QuestionAnswer
Nursing interventions for TPA vitals q 15 min for 2 hrs then 30 min for 6 hrs
Korsocoffs syndrome vitamin b1 def(thiamine) Delerium tremors pscyhosisis
Drug to increase hR atropine
Autonomic Dysreflexia EMergency- exaggerated response to stimuli; S/s: extreame HTN, Diaphoretic, headache
Interventions for autonomic dyreflexia #1 elevate HOB 45 degrees Call Dr Vasopressor
Primary and Secondary SCI Primary- initail trauma, permenant Secondary- cascade of primary, reversible 4-6hrs, #1 thing to watch for @ the level of injury
Neurological level of injury lowest level at which sensory/motor fxn is normal on both sides
Complete cord injury total loss of sensory and motor fxn below injury
Incomplete cord injury mixed loss of voluntary motor activity and sensation and leaves some tracts in tact
Spinal shock no relfexes loss of sensation flaccid paralysis below level of injury lasts day to months
Neurogenic shick decreased BP Decreased HR no sweating decreased CO No tone below the lesion
Emergency Management of SCI Immobilize( move as a unit), stabilize, extrication. Goal is to prevent secondary injury
Medical management of SCI in acute phase IV corticosteriod in first 24-48 hrs Vasopressor to maintain BP Oxygen Traction may be needed ( Halo device, GFardner wells) Surgery indicated if cord compress, wound penetrating cord, thoracic or lumbar vertebrae
Central Cord Syndrome S/S Loss of motor in upper extremities; sensory loss is varaiable Usually hyperextension injury
Anterior Cord syndrome loss of motor, pain and temp below the lesion Light touch, position, and vibration remain intact disk herniation or injury to anterior spine
Brown-Sequard Syndrome (Lateral) ipsilateral paralysis with loss of touch, pressure, vibration on SAME side Loss of pain on the opposite side result from hemisection of cord(knife wound)
c1-c3 require ventilator c4 may be able to breathe on own
Created by: heatherlynn131
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