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