Examen
NURS 2400 Exam 1
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NURS 2400 Exam 1acute injury phase - ANS-(Phase of SCI)
- less than 48 hours after traumatic event
- injured glial and nerve cell int he SC begin to die
- blood vessels in your spinal cord affected by the injury may lose function
- inadequate blood supply to spinal cord -- ischemia
- blood vessel injury may cause hemorrhaging which can expose the spinal cord to
inflammatory cells that can stay in the spinal cord for several weeks after the injury
- spinal cord can swell, causing further spinal cord copression
airway, breathing, circulation - ANS-Priority in emergency care of SCI
anaphylactic shock - ANS-- first, pruritus, flushing, urticaria; second, throat fullness,
anxiety, chest tightness, SOB, and lightheadedness; third altered mental status, resp
collapse, and circulator collapse
- labs have no role
- clinical diagnosis defined by airway compromise, hypotension, or invovlement of
cutaneous, respiratory or GI system
- look for exposure to food, drug, or insect bite
- management: ABCs, IV line, cardiac monitor, pulse ox, IV fluids, oxygen, epinephrine,
Second line = corticosteroids, H1 and H2 blockers
anterior cord syndrome - ANS-(type of incomplete spinal injury)
- injury to the anterior two thirds of the spinal cord, especially the anterior spinal artery
-paraplegia below level of injury, * bilateral loss of pain and temperature sensation with
preservation of proprioception and vibratory senses
- have worst prognosis for recovery
autonomic dysreflexia - ANS-- potentially life threatening medical emergency that
affects with SCI at the T6 or higher
- triggered by irritant below the level of injury
- overextended bladder is the most common cause
-Symptoms = high BP, pounding HA, flushed face, sweating above the level of injury
and goosebumps below the level of injury, bradycardia
- Tx = sit up, take off restrictive clothing, check BP, check bladder, and check skin, -->
find trigger and then give anithypertensive
autonomic dysreflexia - ANS-Prevention of _________:
, -avoid by emptying bladder and bowels
- avoid skin breakdown (pressure sores, ingrown toenails, etc)
- do not wear tight or restrictive clothing
- take medication as prescribed to control pain
blood volume - ANS-- what makes up _____: platelets, RBCs, WBCs, plasma
- what alters blood volume ______: hemorrhage, plasma loss, redistribution of
extracellular volume
bowel - ANS-_____ and shock:
- hypoactive, decreased activity, decreased bowel sounds
brown sequard syndrome - ANS-(type of incomplete spinal injury)
- hemisection of the spinal cord, usually caused by a penetrating trauma
- same side = motor paralysis and loss of proprioception and vibratory senses
- opposite side = loss of pain and temperature sensation
- best prognosis out of all
cardiac output - ANS-the amount of blood pumped per minute into the aorta by the left
ventricle
cardiogenic - ANS-(shock)
- defined as shock resulting from inadequate cardiac function
-S/S; cool mottled skin, tachypnea, tachycardia, hypotension, altered mental status,
narrow pulse pressure, rales and/or murmur
- Causes: intrinsic = myocardial injury, tachycardia, valvular defect; extrinsic= pericardial
tamponade, tension pneumothorax, large pulmonary emboli
- evaluation= EKG, chest x ray, CBC, cardiac enzymes, coag studies, echocardiogram
Cardiovascular - ANS-____ and shock:
- tachycardia, low BP
cardiovascular - ANS-_____ function and SCIs:
- minutes after SCI = massive release of catecholamines = hypertension and
tachycardia
- next phase --> paralysis of sympathetic tone = hypotension, vasodilation, bradycaruda
- neurogenic shock
- monitoring = EKG, telemetry, I&Os
- medications - antihypertensive drips (*REVIEW*)
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