NRSG 421 Final Exam Questions And Correct Answers
Spine components - ANS 7 cervical
12 thoracic
5 lumbar
5 sacral
4 coccygeal
Spinal cord injury risks - ANS Ages, 16/18, male, high risk activity, driving and drinking,
car accidents
*C4,C5,C6,T12=most common
Spinal injury - ANS Damage to the spinal cord, resulting in functional loss and
mobility/sensation
Results from = concussion, contusion, compression, tearing, laceration, transection,
ischemia
Spinal cord - ANSWER 18 inches, nerves within cord carry messages from brain> Spinal
nerves> Upper motor neuron> And back
spinal nerve - ANSWER Lower motor neuron, branch from the spinal cord to specific
areas of body
Sensory: body to brain
Motor: back to body part to initiate action
,Classification of SCI - ANSWER 1. mechanism of injury
2. level of injury
3. degree of injury
Mechanism of injury - ANSWER Flexion: ruptures posterior ligaments
Hyper extension: ruptures anterior ligaments
Compression fracture: crushed vertebrae, spinal cord compression
Flexion - rotation: tearing of ligament structures that stabilizes spine *most severe
level of injury of SCI - ANSWER cervical (7) thoracic (12) lumbar (5) sacral
* cervical/lumbar most common due to greatest flexibility/movement
degree of injury - ANSWER Complete: total loss of sensory and motor function below
level of injury
Incomplete/partial: mix, loss of voluntary motor activity and sensation, some tracts
intact
SCI diagnostic studies-ANSWER CT scan, cervical x-rays (C7 and T1 hard to see), MRI
(soft tissue) neurologic exam, CT angiogram
SCI immediate goals -ANSWER -Patent airway
-Adequate ventilation/breathing
-Adequate circulating blood volume
-immobilize spine
, -Medical sedation/restraints
-keep MAP >85
SCI NRSG Interventions -ANSWER Respiratory: determine how well they breathe,
oxygen/suction, abdominal pressure, when coughing, incentive spirometer, monitor
breath sounds
*Quad coughing
Skin care, VTE, prophylaxis, bladder/bowel management, temp control, stress, ulcers,
fear/anxiety, impaired mobility
*log rolling
Neurogenic Shock - ANSWER Hemodynamic phenomenon, within 30 minutes of injury at
T5 or above, last up to 6 weeks, blood flow to low, lose SNS
-Trouble keeping heart rate, BP, temp stable
Results in: massive vasodilation> Pooling of blood vessels> Tissue hypoperfusion>
Impaired cellular metabolism
Poikilothermic - ANSWER inability to regulate core body temperature is sweating/adding
layers
tx: fluids (careful of overload), vasopressors( bradycardia, hypotension) dopamine,
epi/no epi, atropine
Spinal shock - ANSWER Spinal cords response to inflammation caused by injury
*Not hemodynamic
Spine components - ANS 7 cervical
12 thoracic
5 lumbar
5 sacral
4 coccygeal
Spinal cord injury risks - ANS Ages, 16/18, male, high risk activity, driving and drinking,
car accidents
*C4,C5,C6,T12=most common
Spinal injury - ANS Damage to the spinal cord, resulting in functional loss and
mobility/sensation
Results from = concussion, contusion, compression, tearing, laceration, transection,
ischemia
Spinal cord - ANSWER 18 inches, nerves within cord carry messages from brain> Spinal
nerves> Upper motor neuron> And back
spinal nerve - ANSWER Lower motor neuron, branch from the spinal cord to specific
areas of body
Sensory: body to brain
Motor: back to body part to initiate action
,Classification of SCI - ANSWER 1. mechanism of injury
2. level of injury
3. degree of injury
Mechanism of injury - ANSWER Flexion: ruptures posterior ligaments
Hyper extension: ruptures anterior ligaments
Compression fracture: crushed vertebrae, spinal cord compression
Flexion - rotation: tearing of ligament structures that stabilizes spine *most severe
level of injury of SCI - ANSWER cervical (7) thoracic (12) lumbar (5) sacral
* cervical/lumbar most common due to greatest flexibility/movement
degree of injury - ANSWER Complete: total loss of sensory and motor function below
level of injury
Incomplete/partial: mix, loss of voluntary motor activity and sensation, some tracts
intact
SCI diagnostic studies-ANSWER CT scan, cervical x-rays (C7 and T1 hard to see), MRI
(soft tissue) neurologic exam, CT angiogram
SCI immediate goals -ANSWER -Patent airway
-Adequate ventilation/breathing
-Adequate circulating blood volume
-immobilize spine
, -Medical sedation/restraints
-keep MAP >85
SCI NRSG Interventions -ANSWER Respiratory: determine how well they breathe,
oxygen/suction, abdominal pressure, when coughing, incentive spirometer, monitor
breath sounds
*Quad coughing
Skin care, VTE, prophylaxis, bladder/bowel management, temp control, stress, ulcers,
fear/anxiety, impaired mobility
*log rolling
Neurogenic Shock - ANSWER Hemodynamic phenomenon, within 30 minutes of injury at
T5 or above, last up to 6 weeks, blood flow to low, lose SNS
-Trouble keeping heart rate, BP, temp stable
Results in: massive vasodilation> Pooling of blood vessels> Tissue hypoperfusion>
Impaired cellular metabolism
Poikilothermic - ANSWER inability to regulate core body temperature is sweating/adding
layers
tx: fluids (careful of overload), vasopressors( bradycardia, hypotension) dopamine,
epi/no epi, atropine
Spinal shock - ANSWER Spinal cords response to inflammation caused by injury
*Not hemodynamic
