•No part of the body should be twisted or turned, and the patient is not allowed to sit up.
•If cervical fracture is found the patient may be placed on a rotating specialty bed with cervical
traction
•Or in a cervical collar with a hard bed
•Or a halo vest
nursing interventions for spinal cord injury - answer✔- immobilization
- assess resp dysfunction
- assess cardio fxn
- monitor s/s of hypovolemic shock
- assess nutritional status and presence of stress ulcers
- assess urinary and bowel fxn
- assess environment for temp control
- assess pain
- SCD, TED
- medications
surgery options for spinal cord injury - answer✔Surgery is indicated if:
•Compression of the cord is evident.
•Fragmented or unstable vertebral body.
•A wound that penetrates the cord.
•Neurologic status is deteriorating.
•Early stabilization improves outcome
•Goal: stabilize & remove pressure to preserve function
Medication
•High-dose IV corticosteroids (methylprednisolone)
spinal shock s/s - answer✔decreased reflexes, loss of sensation, and flaccid paralysis below the
level of injury
nursing diagnosis for high cervical spinal cord injury if pt is intubated - answer✔risk for injury
what can be done to combat venous pooling and low bp in a patient with spinal cord injury -
answer✔tilt gunnery or wheelchair
What is neurogenic bladder - answer✔-Lack of nerve supply to the bladder
-Person can't feel when bladder is full
-Must use catheter to void
clinical manifestations of neurogenic bladder - answer✔- poor voiding due to inability to feel
need to void
- overflow incontinence so full bladder cannot feel, incontinent
assessment and diagnostic findings for neurogenic bladder - answer✔measurement of fluid
intake, urine output, and residual urine volume; urinalysis; and assessment of sensory awareness
of bladder fullness and degree of motor control.
Medical management for neurogenic bladder - answer✔continuous, intermittent, or self-
catheterization
an external condom-type catheter
a diet low in calcium (to prevent calculi)
encouragement of mobility and ambulation.
Medications for neurogenic bladder - answer✔Parasympathomimetic medications, such as
bethanechol (Urecholine), may help to increase the contraction of the detrusor muscle.
coup-contrecoup brain injury - answer✔When the brain continues to move forward after a rapid
stop, striking the inside of the skull, resulting in a compression injury or bruising to the anterior
of the brain and stretching or tearing to the posterior of the brain.
diffuse brain injury - answer✔Include concussions and diffuse axonal injuries
Involve microscopic damage to cells
Most common mechanisms of injury include acceleration-deceleration injuries and rotational
forces
involves large portion of the brain
Concussion (brain injury) - answer✔blow to head causing trauma from minor to severe. if lose
consciousness may result in memory loss
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