Exam Study Guide 3- Spinal Cord Injuries (PrepU)
What type of airway would be used?
-Endotracheal tube -Provides an airway from the nose or mouth to an area above the mainstem bronchi
Autonomic Dysreflexia Definition
-Exaggerated sympathetic nervous system response -A Hypertensive emergency
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.
When a pt is in a cervical collar, what position should they be in until a spinal injury is ruled out?
Flat, except for logrolling as needed
What causes Autonomic Dysreflexia?
Spinal cord injuries above T6
Injury at C2 and C3
The patient should have GOOD... -Head and neck sensation The patient should have SOME... -Neck control -Time spent independent of mechanical ventilation for short periods of time
Injury at C4
The patient should have GOOD... -Head and neck sensation -Motor control The patient should have SOME... -Shoulder elevation -Diaphragm movement
Tetraplegia Results when ...
There is a high cervical spine injury
Predominant risk factors for SCI
-Young age (most between 16 and 30 years old) -Gender (80% of those living with SCI are male) -Alcohol/drug use
What usually develops Immediately after a SCI?
A paralytic illeus
Injury at C5
The patient should have FULL... -Head and neck control -Shoulder strength -Elbow flexion
What nursing intervention should the nurse perform when a client with spinal trauma may not be able to cough?
-Suctioning the airway helps remove secretions -An artificial airway increases the production of respiratory secretions
Why are client with spinal trauma often given an artificial airway? Why do they need mechanical ventilation?
-To prevent hypoxemia, the client may need more oxygen than is available in the room air. -Mechanical ventilation provides a means to regulate the respiratory rate, volume of air, and percentage of oxygen when a client fails to breathe independently.
Areflexia occurs when there is...
A loss of sympathetic reflex activity below the level of injury within 30 to 60 minutes of a spinal injury.
How is a paralytic illeus treated in SCI patients?
A nasogastric tube is often required
What would you know is an acute emergency and is seen in clients with a cervical or high thoracic spinal cord injury after the spinal shock subsides?
Autonomic Dysreflexia
When in a spinal cord injury does Autonomic Dysreflexia occur?
Only after spinal shock has resolved
Characteristics of Autonomic Dysreflexia
-Potentially life-threatening hypertension -Bradycardia -Severe, pounding headache -Nausea Blurred vision -Flushed skin -Diaphoresis -Goosebumps -Nasal congestion -Anxiety
Paraplegia Occurs with...
Injuries at the thoracic level
Why is a nasogastric tube indicated in a paralytic illeus for SCI patients?
Relieves distention and to prevent vomiting and aspiration
