Final: Spinal Cord Injury
brown- sequard syndrome
1 side of spinal cord injury impaired loss to injured side pain and temperature sensation intact
Tetraplegia
Injury to C1-8 None or impaired use of arms/legs
Autonomic dysreflexia is an acute emergency that occurs with spinal cord injury as a result of exaggerated autonomic responses to stimuli. Which of the following is the initial nursing intervention to treat this condition?
Raise the head of the bed and place the patient in a sitting position.
A client with a T4 level spinal cord injury (SCI) is complaining of a severe headache. The nurse notes profuse diaphoresis of the client's forehead and scalp. Which of the following does the nurse suspect?
autonomic dysreflexia
The client has been brought to the emergency department by their caregiver. The caregiver says that she found the client diaphoretic, nauseated, flushed and complaining of a pounding headache when she came on shift. What are these symptoms indicative of?
autonomic dysreflexia
s2-s4
bowel control if damaged, help scheduler regular bowel pattern, catheterization
nursing care for autonomic dysreflexia
change HOB to 90 degrees and lower pt legs losen restrictive clothing catheterize prn if distended or look for clog check if bowel is impacted look for infection or source if bp does not go down and is above 150 SBP call MD
posterior cord syndrome
coordination difficulties pain and temperature intact
C5
deltoid/bicpts
c8-t1
hand
Cauda Equina
S1-S5 nerves damaged pt will have sexual, bowel, bladder dysfunction but motor intact
autonomic dysreflexia
high BP due to uncontrolled sympathetic nervous system typically seen in injuries about T7 considered a medical emergency
polkilothermia
hypo or hyperthermia in spinal injury pt because pt has no ability to sweat, shiver, vasodilate, vasoconstrict below SCI
what assessments should you expect in spinal cord injury patient
hypothermia bradycardia deoendent edema in feet neuropathic pain temperature intolerance impaired cough rounded belly spasticity
anterior cord syndrome
loss of pain and temperature sensation paralysis below injury flexion injury
causes of autonomic dysreflexia
main cause is bladder
spasticity
may occur as spinal shock wears off
central cord syndrome
more arm than leg paralysis control over bowel and bladder hyperextension and stenosis injury
autonomic dysreflexia sx
more than 40 SBP above baseline HA vision change Diaphoresis Nasal congestion
quad cough
technique is for patients without abdominal muscle control such as those with spinal cord injuries. While the patient breathes out with a maximal expiratory effort, the patient or nurse pushes inward and upward on the abdominal muscles toward the diaphragm, causing the cough.
c7
tricepts
c6
wrist
For a patient with an SCI, why is it beneficial to administer oxygen to maintain a high partial pressure of oxygen (PaO2)?
Because hypoxemia can create or worsen a neurologic deficit of the spinal cord
Paraplegia
Complete use of arms, non/limited use of legs
respiratory function in SCI
pulmonary complication #1 cause of death pneumonia, atelectasis, PE
A client with a T4-level spinal cord injury (SCI) is experiencing autonomic dysreflexia; his blood pressure is 230/110. The nurse cannot locate the cause and administers antihypertensive medication as ordered. The nurse empties the client's bladder and the symptoms abate. Now, what must the nurse watch for?
rebound hypotension