Created by Natashia Reyes
about 9 years ago
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Question | Answer |
What are Risks for Spinal Cord Injuries | Cancer, Populations (men & young), and disease processes (bones, arthritis, meningitis) |
What Are Concurrent Injuries that Occur | Concussion, contusion, transection or disruption of the spinal cord |
What is a Complete Cord Transection | A cord transection is either complete or incomplete of all spinal tracts. With complete all cord medications function below the level of injury are permanently lost. |
What is an Incomplete Cord Transection What is Possible with Lacerations | all function is lost temporarily; however potential for recovery remains based on the location and severity of injury to individual tracts. Laceration though may produce permanent deficits. |
How Does Interruption In Vascular Supply Affect the Spinal Cord | Interruption in the vascular supply to a spinal cord may result in cord ischemia (lack of 02) or necrosis (tissue death) |
Know Research the Interventions and Levels of Spinal Injuries | Slide Information that is Written |
Collaborative Management Medications What Must you Keep Mean Arterial Pressure Above | High dose corticosteroids (dexamethasone IV), **Vasopressor agents, MAINTAIN mean arterial pressure ABOVE 90 mm Hg, Antispasmodic drugs, anticholinergic drugs, opioids |
What is Collabortaive Surgical Management When Early Suregery is Indicated | Early surgery indicated if evidence of cord compression, progressive neurologic deficit, compound bony fracture/bony fragments, penetrating wounds |
What are Other Collaborative Surgery Management Methods | Laminectomy (stabilize portion of spine), fracture stabilization (if required), surgery and/or skeletal traction (halo traction ) or crutchfield tongs |
What is Spinal Shock, How is it Identified | A sudden depression of reflex activity Below Level of spinal injury, muscular flaccidity, lack of sensation and reflexes (RAAppearance) |
What is Neurogenic Shock What are S/S of Neurogenic Shock and What May Occur | It is d/t the loss of function of the Autonomic NS. B/p, HR, & cardiac output are Decreased. Venous pooling occurs due to peripheral vasodilation, paralyzed portions of the body do not perspire |
SUPER IMPORTANT What is Autonomic Dysreflexia (AD) & In Which SC Lesions does it Typically Occur | Occurs after spinal shock has resolved and may occur years after the injury in persons with spinal cord lesions @ T6 and above |
What Happens with Sympathetic Nervous System Response in AD | Sympathetic nervous system response is exaggerated, symptoms include pounding headache, increase in blood pressure (SBP>300 mm Hg), profuse diaphoresis, nausea, nasal congestion and bradycardia (crossed out tachycardia) |
What are Triggering Stimuli of Autonomic DYsreflexia | distended bladder (most common cause), distention or contraction of visceral organs (such as constipation), or stimulation of the skin-like things that cause pain below the level of injury |
How Does AD OCcur and What are KEY S/S | It is Massive uncompensated cardiovascular reaction mediated by sympathetic ns. SNS responds to stim of sensory receptors-parasympathetic unable to counteract responses. Hypertension and Bradycardia |
What are Nursing Interventions for AD | Elevate HOB, notify HCP, Assess for and remove cause (obviously before notifying provider in case resolvable), immediate catheterization, remove stool impaction if cause, remove constrictive clothing and tight shoes, patient and family teaching |
What is to be Expected iwth Rehabilitation and Home Care | Should be organized around an individuals needs and goals, patient is expected to be involved in therapies, to learn self care, it can be very stressful frequent encouragement is needed |
What is Involved with Proper Care of Neurogenic Bladder What are Drugs & Drainage Methods | Anticholinergic drugs, a-Adrenergic blockers, antispasmodic drugs. Bladder reflex training, indwelling, intermittent, external catheterization. Urinary diversion surgery, and patient teaching |
Describe Neurogenic Bladder and What can be Done | Voluntary control may be lost, high fiber diet, adequate fluid intake, suppositories, small volume enemas, digital stimulation (mandatory for upper motor neuron injury), stool softener, oral stimulant laxatives, valsalva maneuver with manual stimulation-for lower motor neuron inj. use of gastrocolic reflex |
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