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Spinal Cord Injury
SCI
| Question | Answer |
|---|---|
| complete cord involvement | complete loss of motor and sensory function, cannot send signals below level of injury |
| incomplete cord involvement | some movement and sensation below injury |
| central cord syndrome | motor and sensory fxn abnormalities occur in upper or lower extremities |
| spinal cord shock | no reflexes, no bladder control, no bowel tone, no sweating and flaccid or paralysis occurs |
| course of spinal shock | SCI --> chemical mediator release --> vasoconstriction below injury --> ischemia below injury --> SC cannot do job without blood flow |
| C4 injury | tetraplegia results in complete paralysis below neck --> NEEDS MECHANICAL VENT REST OF LIFE |
| C6 injury | partial paralysis of hands and arms and lower body |
| T6 injury | tetraplegia --> paralysis below chest |
| L1 injury | paraplegia --> paralysis below waist |
| Assessment of SCI | airway and ventilation keep MAP above 85 and O2 above 92% GI tract--> decreased motility, gastric distention, NPO and NG tube constipation common, neurogenic bladder or incontinence also common watch for skin breakdown |
| nursing care | potential for decreased BP due to spinal shock, fluids, improve venous return to prevent DVTs, do ABGs, watch respiratory pattern, encourage use of IS, suction |
| what drugs increase venous return | salt tablets and midodrine |
| vitals that are common | decreased BP and bradycardia (atropine or pacemaker) |
| what diet for stroke patients is necessary | high protein, high calorie |
| bladder / bowel management | in/out cath on regular schedule or foley, encourage a bowel regimen and use rectal stimulants |
| temperature control | what environment is is what body will be, no excessive covers, no excessive exposure |
| stress ulcers | common 1-2 weeks after injury, stool and gastric contents tested daily for blood, use H2 receptor blockers and PPIs to help |
| autonomic hyperreflexia nursing management | elevate HOB, sit upright, notify HCP, assess and remove cause! immediate catheterization, remove stool impaction, remove restrictive clothing and tight shoes |
| clinical manifestations of autonomic hyperreflexia | high BP, headache, diaphoresis, decreased HR, flushing of skin, anxiety and nasal congestion |
| causes of autonomic hyperreflexia | distended bladder, full bowel |
| how to prevent sensory deprivation in SCI patients | stimulate above injury, use prism glasses, allow for visitors |
| How to manage pain in SCI patients | inflammatory or opioids, neuropathic pain use neurontin, mood and stress reduction |
| reflexes in SCI patients | return of reflexes will be hyperactive, have spasms so use baclofen |
Created by:
ebrewer12
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