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N353: Practice of Nursing II > MedSurg Mod 6: CNS Disorders > Flashcards

MedSurg Mod 6: CNS Disorders Flashcards

1
Q

How are head injury, Increased ICP, intracranial surgery, seizure and other complications all interrelated?

A

Head Injury –> ICP, Seizures and Complications, Surgery

Intracranial Surgery Increased ICP and Seizures and other Complications

Increased ICP Seizures and Other complications

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2
Q

What is the one thing independent from most other CNS injury relationships

A

Spinal Cord Injury

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3
Q

Head Injury

A

involves trauma to the scalp, skull, and brain

It results in anything from a mild concussion to coma to even death

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4
Q

TBI

A

Traumatic brain injury

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5
Q

What is the most common cause of TBI

A

falls (any age)

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6
Q

Open TBI

A

Skull opened

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7
Q

Closed TBI

A

skull is still closed

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8
Q

Diffuse TBI

A

widespread damage

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9
Q

Focal TBI

A

localized damage to one brain area

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10
Q

TBI damage and what you see is dependent on ___ and ___

A

location and severity

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11
Q

Epidural Hematoma (Hemorrhage)

A

Above the dura and under the skull

a medical emergency that is usually due to a rupture of a middle meningeal Artery

can cause brain herniation leading to loss of consciousness and focal neuro deficits like pupil dilation and paralysis of an extremity

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12
Q

Subdural Hematoma (Hemorrhage)

A

Below the dura, Between the Dur and Brain

usually venous in origin - bleeding not as dramatic but this can be both good and bad

may be acute, subacute, chronic (elderly, people on anti coagulants)

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13
Q

Intracerebral Hematoma (Hemorrhage)

A

withIN the brain tissue

result of focused injury or system issues (focal rather than systemic)

Major risk factor is HTN –> CVA

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14
Q

Concussion

A

Global and Microscopic

Widespread homogenous impairment of brain cells (cells under perform)

No visible bleeding occurs

Confusion, irritability, Disorientation, and HA occur

harder to measure and no real fix just cures itself over time

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15
Q

Contusion

A

Localized and macroscopic

structural damage to cells (cells die)

effects peak 18-36 hours post injury

coup contrecoup injuries cause this

can increase ICP d/t bleeding

blurred vision, disorientation, unsteady gait, vomiting, slurred speech, and coma can occur

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16
Q

Just because evidence of damage is easier to see with a contusion does not mean…

A

it will tell what type of injury occurred like hypoxia, impact, foreign body etc - it just tells us there is cellular damage

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17
Q

Can a concussion and contusion occur simultaneously

A

yes

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18
Q

Damage at the brain cell level is not dependent on…

A

actual injury

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19
Q

Coup-Contrecoup injury

A

2 injuries from one impact - a rebound effect

a focal injury

commonly associated with a contusion occurring

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20
Q

Diagnosis for Head Injuries

A

CT or MRI - identifying and evaluating injuries to brain tissue

Skull X Rays - look at penetrating injuries to the skull and if skull is damaged

Angiography

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21
Q

What is the number1 concern of head injuries

A

bleeding and increased ICP

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22
Q

Medical care for Head Injuries

A

1 - Control ICP

  1. Reduce cellular demands
  2. Surgical intervention
  3. Minimize secondary injury
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23
Q

Intracranial Bolt (ICB)

A

Bolt put in brain tissue that can monitor ICP

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24
Q

Why may mechanical ventilation and a respiratory be used on a head injury patient

A
  1. To aid if respiratory centers are damaged or at risk and prevent hypoxemia: Lactic Acidosis increased –> increased vasodilation occurs to compensate –> increased ICP will occur!
  2. to prevent hypoxemia and hypercapnia as a result of cerebral vessel vasodilation causing increased ICP
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25
Q

Why do head injury patients sometimes undergo medically induced comas?

A

to decreased CNS activity and reduce too much work in the brain in order to reduce cellular demands

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26
Q

What is the secondary injury to watch for with head trauma that can skyrocket ICP

A

edema

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27
Q

Goals of Nursing Care of Head Injuryu

A
  1. Address acute issues like respiratory, cerebral circulation, safety
  2. Prevent and treat secondary complications like infection, pneumonia, skin integrity, safety, and positioning
  3. Prevent treat and minimize consequences via behavior, physical rehab like OT and PT, and education
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28
Q

What to do first for nursing care of head injuries

A

Assess all systems for direct impact (PRIMARY COMPRIOMISE):

a. Patent Airway and Optimal Breathing pattern –> Monitor O2 sat, respiratory rate, lung sounds, VS

b. Optimal Cerebral tissue perfusion –> monitor mentation

c. Appropriate fluid balance –> monitor labs for H&H and lytes

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29
Q

What to do second for nursing care of head injuries

A

Assess all symptoms for secondary impact (secondary compromise):

a. s/s of infection

b. complications

c. consequences

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30
Q

What is an important issue to teach patient and family about?

A

Post concussion syndrome

how difficult it is to measure concussion

when to monitor and notify MD

how changes depend on location and severity

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31
Q

What are the s/s of post concussion syndrome

A

HA

Dizziness

Lethargy

irritability

emotional lability

fatigue

poor concentration

decreased attention span

memory difficulties

intellectual dysfunction

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32
Q

How long does post concussion syndrome last

A

may last 1 week or 1 year even

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33
Q

When to monitor and notify an MD regarding head injuries post care?

A

Difficulty in awakening or speaking

confusion

severe HA

vomiting

unilateral weakness

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34
Q

Functions of Frontal Lobe

A

behavior

intelligence

memory

movement

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35
Q

Functions of Temporal Lobe

A

behavior

hearing

memory

speech

vision

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36
Q

Function of Parietal Lobe

A

intelligence

language

reading

sensation

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37
Q

Functions of Occipital lobe

A

vision

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38
Q

Functions of Brain Stem

A

Blood pressure

breathing

consciousness

heartbeat

swallowing

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39
Q

Function of Cerebellum

A

balance

coordination

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40
Q

Reasons Intracranial Surgery is Done

A
  1. Reduce elevated ICP
  2. remove tumor/foreign body
  3. evacuate a blood clot
  4. control hemorrhage
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41
Q

Ectomy

A

removal

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42
Q

Plasty

A

repair

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43
Q

Craniectomy

A

removal of part of skull to allow room for swelling

it gives access to brain tissue like an epidural hematoma or allow some brain swelling to occur

the skull pieceis either frozen or put in the peritoneum

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44
Q

Cranioplasty

A

Repair of the skull using a metal or plastic plate

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45
Q

Approaches for Intracranial Surgery

A

Supratentorial (above the tentorium fibrous tissue)

Infratentorial (below)

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46
Q

Medical Interventions to do Pre Operatively for Intracranial Surgery

A

Define diagnosis/surgical approach

general pre and post op considerations

medications - anti seizure, corticosteroids for edema, hyperosmotic agent (mannitol), diuretics, antibiotics, anti anxiety

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47
Q

Nursing interventions to do pre operatively for intracranial surgery

A

document baseline neurological status

routine pre operative care and education

continue with established care - diet, activity, medications, etc

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48
Q

Why give corticosteroids for intracranial surgery

A

to reduce cerebral edem

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49
Q

Why give hyperosmotic agents like mannitol for intracranial surgery

A

it pulls water into the bloodstreaam thus pulling fluid out of swollen brain tissue

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50
Q

Medical interventions to do post operatively for intracranial surgery

A

reduction of cerebral edema via mannitol and Decadron (a corticosteroid)

relive pain with narcotic analgesics

prevent seizure with Dilantin and valium

monitor intracranial pressure with an implanted ICP monitor

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51
Q

Nursing interventions to do post operatively for intracranial surgery

A

assess every hour the neurologic status via Glasgow coma scale or FOUR score, repsiratory status, ABGs, labs, VS, intracranial pressure readings (read ICP but not put monitor in)

proper positioning depending on surgical approach

routine post op care such as C-DB, I&O checks including tubes and ventilation, and dressings and drainage

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52
Q

Why must we check with the MD first regarding C-DB after intracranial surgery

A

it can increase the pressure in the chest and above into the head

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53
Q

ETT

A

endotracheal tube

breathing tube from ventilator

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54
Q

Glasgow Coma Scale

A

The most widely used method for evaluation of coma

simple

has a number of shortcomings such as limited utility in intubated patients and inability to assess brainstem reflexes

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55
Q

FOUR Scale (Full Outline of UnResponsiveness)

A

a more in depth assessment tool used on neuro unites

provides further neurological details (gives a full status)

better predictor of outcome

useful for intubated patients and assessing reflexes

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56
Q

What sort of score is better on the GCS

A

a higher score

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57
Q

What sort of things does the FOUR scale look at

A

more detailed things like eyes, motor response, brainstem response, and respiration

allows for checking someone who is not fully awake but to monitor best motor response they need to be awake

may be useful for someone comatose post op

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58
Q

Potential intracranial surgery post op complications

A

bleeding and hypovolemic shock

fluid and electrolyte disturbances

infection

increased ICP

seizures

Diabetes insipidus

SIADH

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59
Q

What are the 4 specific complications arising from surgery to the head

A
  1. Increased ICP
  2. Seizures
  3. Diabetes Insipidus (d/t damage)
  4. SIADH (d/t damage)
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60
Q

What is intracranial pressure

A

balance of brain tissue, blood and CSF

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61
Q

normal ICP level

A

7-15 mmHgh

62
Q

Monroe Kellie Doctrine

A

increase in any compartment –> compensatory changes in others

63
Q

Increases in ICP could be due to what things

A

injury

brain tumors

subarachnoid hemorrhage

toxic or viral encephalopathies

64
Q

Early (S/S) Human responses to increased ICP

A

change in LOC

pupillary changes

impaired ocular movements

weakness in one side or extremity

headache that is constant and is increasing in intensity while aggravated by movement and straining

65
Q

Late (S/S) Human Responses to increased ICP

A

further deterioration of LOC

respiratory pattern alterations

loss of brainstem reflexes like pupillary, gag, swallowing, corneal

Cushing’s triad

hemiplegia or flaccidity

posturing

66
Q

What are the 3 things in Cushing’s Triad

A
  1. HTN/Widening Pulse Pressure
  2. bradycardia
  3. Bradypnea
67
Q

What is one of the most negative findings of increased ICP

A

Decorticate or Decerebrate Posturing

68
Q

I.C.P. acronym for human responses to increased ICP

A

I - increasing pulse pressure

C - Changes in loc, respiratory, speech, heart rate

P - pupils, puking, pain, posturing

69
Q

Decorticate Posturing

A

Sign of severe damage to the brain at the cOrticOspinal tract

Arms are adducted and flexed, hands clenched, may be unilateral or bilateral to the core

serious but mOre favOrable than decerebrate

may progress to decerebrate posture of the 2 can alternate

70
Q

Decerebrate Posturing

A

indicates severe damage to the brain at the Brainstem level

Arms are adducted, extended, and pronated with wrists flexed, head and neck arched Backwards, and muscles tightened and held rigidly

is Badder than decorticate

71
Q

Diagnostics for Increased ICP

A

presenting s/s

H&P

MRI and CT scan to show underlying cause like tumor or hematoma

spinal tap (if there is no concern for increased ICP)

direct monitoring

72
Q

Why can a spinal tap only be done if there is no concern for increased ICP

A

because a hole in the lumbar region can cause herniation of the brain into the spinal canal

73
Q

Direct Monitoring or ICP

A

done via catheters and equipment in the skull and brains

done in the ICU and can see pressure changes early and measure the degree of them to initiate appropriate treatment

also gives access to CSF for sampling and evaluation to treatment response(s)

74
Q

It is important to know what about nursing interventions for increased ICP

A

not all of them are always done all the time, critical thinking will let you choose to most appropriate one for the specific patient manifesting a specific human response at a specific time

75
Q

Nursing Interventions for cerebral perfusion

A

elevate HOB 30-45 degrees and put head in neutral position with cervical collar if needed

position to avoid extreme hip flexion (can increase pressure in head and chest)

note abdominal distension

avoid Valsalva maneuver

avoid enemas and suppositories’ (can increase pressure d/t position)

avoid isometric exercises increasing SBP

pre oxygenate and hyperventilate prior to suctioning since it can take O2 away

avoid high levels of PEEP (positive end expiratory pressure)

space nursing interventions

assess level of cognition, orientation, and ability to follow commands

avoid emotional distress and frequent arousal from sleep

AVOID INCREASING PRESSURE

76
Q

Nursing Interventions for airway clearance

A

elevate HOB

auscultate lung fields

O2 as needed

monitor pulse oximetry

suction as needed

hyperoxygenation for suctioning - suctioning of nares is a no no

note nasal drainage

77
Q

Why should you never suction the nose

A

because if there is head injury damage in this area could lead to suctioning brain

78
Q

Nursing interventions for fluid balance/imbalance

A

monitor VS

monitor I&O

monitor skin turgor, mucous membranes, serum and urine osmolality

monitor IVF carefully

observe for CHF and pulmonary edema if giving mannitol - dont wanna give so much fluid we cause CHF

good oral hygiene - non drying mouth rinse and lip lubrication

79
Q

Nursing interventions for bowel and bladder function

A

monitor UO every 2-4 hours

test urine for specific gravity and glucose

monitor bowel sounds

monitor for abdominal distension

test stools for occult blood

80
Q

Nursing interventions for infection

A

aseptic technique when managing the intra ventricular catheter/direct ICP monitoring

observe character of the CSF drainage - report cloudiness and blood

monitor for s/s of meningitis - fever, chills, nuchal rigidity, increasing and persistent headache

monitor temp, labs, urine, and lungs

81
Q

Nursing Interventions to control ICP

A

Lots of MEDS:

Mannitol
corticosteroids
Dilantin
antibiotics
anti-anxiety

82
Q

Mannitol

A

osmotic diuretic

83
Q

Purpose of corticosteroids for ICP

A

reduce cerebral edema

84
Q

Dilantin

A

prophylaxis for seizure activity

85
Q

What complications should be monitored for with increased ICP

A

brain stem herniation

respiratory distress or failure

pneumonia

aspiration

pressure ulcer

DVT

contractures and positioning

seizures

Diabetes insipidus

SIADH

86
Q

What are some miscellaneous nursing interventions for increased ICP

A

Keep CO2 down in the 25-30 mmHg by hyperventilating the patient

prevent hyper or hypothermia with temperature control

BP control - high enough to perfuse the brain but not so high that is increases ICP and causes damage

Sedation

87
Q

Seizure - Pathology

A

uncontrolled abnormal recurring electrical discharges in the brain

88
Q

Causes of Seizures

A
  1. idiopathic
  2. acquired - via CV disease, hypoxemia, fever, head injury and surgery, HTN, CNS infection, metabolic and toxic conditions (renal failure and hypoglycemia), brain tumor, drug and ETOH withdrawal, allergies
89
Q

Classifications of Seizure

A

Generalized

Partial

90
Q

Generalized Seizures

A

involves the whole brain

91
Q

Partial Seizure

A

focal seizures beginning in one part of the brain

can be simple or complex

92
Q

Simple Partial Seizure

A

partial seizure where consciousness remains intact

93
Q

Complex Partial Seizure

A

partial seizure where there is impairment but no loss of consciousness

94
Q

Manifestations of Seizure

A

Not all seizures cause all of these things

Loss of consciousness

Excessive movement - not all cause convulsions though

Loss of muscle tone (drop attacks)

disturbances of behavior, mood, sensation, perception

95
Q

Status Epilepticus

A

Emergency

seizure lasting longer than 5 minutes

seizure activity occurs without waking occurring in between

with something like a tonic clonic seizure a lot of energy and O2 is needed for all that activity so the brain may not be perfused

96
Q

Things to Assess about a Seizure

A

precipitating factors

presence of an aura

initial presentation

types of movements

areas of the body involved

eyes: size of pupils, open or closed, any deviations

incontinence

duration

periods of unconsciousness

paralysis or weakness after the seizure

inability to speak

movement at the end of the seizure

post-ictal period

cognitive status after the seizure

97
Q

What may be the first thing indicating an impending seizure

A

an aura

98
Q

Post-ictal period

A

period after seizure ends where the person may be confused and embarrassed and not 100% again

99
Q

What to do if someone is having a seizure

A

Maintain and protect airway - turn sideways, suction available, intubation potentially

Limit seizure duration with medications like valium, Ativan, and Dilantin

prevent patient and personal injury

observe the seizure activity - monitor neuro/cardio/pulmonary

documentation

100
Q

What to do after someone has had a seizure

A

reorient patient when awake

provide comfort and reassurance

treat any injury from seizure activity

maintain seizure precautions

anti seizure medications if ordered

education of medication, triggers, at home and school care

have crowds leave so not everyone is staring and make sure everyone knows what to do fi the person has a seizure

101
Q

What to do if someone has a hx of status epilepticus

A

limit seizure duration with medications like IV valium, Ativan, and Dilantin

establish and protect the airway - turn sideways and intubate potentially

neuro/cartdio/pulmonary monitoring

maintain safety

documentation

102
Q

Diabetes Insipidus (DI)

A

deficiency of ADH secretion

fluid Drains out

103
Q

Result of DI

A

polydipsia and polyuria

low urine specific gravity

dehydration

104
Q

Causes for DI

A

increased ICP

surgical ablation or irradiation of the pituitary

infections of CNS

105
Q

Syndrome of Inappropriate ADH (SIADH)

A

Excess ADH secretion

fluid Stays in

106
Q

Result of SIADH

A

fluid retention, no edema = dilutional hyponatremia

107
Q

Causes of SIADH

A

increased ICP

bronchogenic carcinoma (paraneoplastic syndrome: ADH secreted by tumor cells)

severe pneumonia

hemothorax

108
Q

The important goal of managing DI and SIADH is…

A

identify and treat/eliminate underlying causes

109
Q

Medical management of DI

A

replace fluids - hourly IV fluid volume dependent on UO

replace ADH with vasopressin

110
Q

Complications of DI

A

dehydration

electrolyte imbalance

unintentional weight loss

111
Q

Medical management of SIADH

A

restrict fluid intake - 1200 to 1800 mL/day to increase serum sodium

replace sodium with a hypertonic saline

112
Q

Complications of SIADH

A

water overload

electrolyte imbalances

fluid shifts

113
Q

Vasopressin

A

an external form of ADH given to DI patients

114
Q

Risk factors for spinal cord injuries

A

youth

male

drug and alcohol use

115
Q

Causes for Spinal Cord INjuries

A

non traumatic things like tumors

traumatic things like MVA, GSW, sports injuries

116
Q

What areas of the spines are more likely to have injuries occur and why?

A

C5 to C7 and T12 to L1 (cervical and thoracic region)

this is because these areas are more mobile and no protected by things like the ribcage

117
Q

What can the damages be like in spinal cord injuries

A

ranges from full recovery to complete cord transection with paralysis below the injury level

118
Q

Primary Spinal cord injury

A

the permanent effect

119
Q

Secondary Spinal cord injury

A

potentially reversible effect of injury that can be reversed if treated within 4 hours of injury

120
Q

What areas may be effected by C5 to C7 damage

A

Tetraplegia - same as quadriplegia:

Deltoids

biceps

wrist extender

triceps

hand

chest muscles

abdominal muscles

leg muscles

bowel

bladder

sexual function

121
Q

`What areas may be effected by T12 to L1 damage

A

Paraplegia: (it is lower)

leg muscles

bowel

bladder

sexual function

122
Q

How may a cervical, thoracic, lumbar, and sacral lesion impact mobility?

A

Cervical - wheelchair bound unable to move arms too - quadriplegia

Thoracic - wheelchair bound but able to move arms - paraplegia

Lumbar - need assistance with crutches and supports due to leg paresis and maybe monoplegia of a single leg

Sacral Lesion - crutches due to monoplegia or paresis of legs

123
Q

What are the acute complications of spinal cord injuries? (at time of injury)

A

impaired spontaneous respirations and gas exchange

hypotension related to vasodilation and loss of reflexes

FIRST CONCERN IS BREATHING ESPECIALLT WITH CERVICAL INJURIES

124
Q

Interventions for the acute phase of spinal cord injuries

A

chest PT

mechanical ventilation

possible tracheostomy placement

elevation of feet

IV fluid resuscitation or vasopressor agents

125
Q

What is the goal for HR and SBP during acute spinal cord injury

A

HR >60

SBP > 90

126
Q

Medical Care for a Spinal Injury patient

A

Prevent further injury by keeping immobilized until diagnosis

maintain airway

administer methylprednisolone

stabilize spine with reference to actual injury

ASIA impairment scale

127
Q

Methylprednisolone

A

decreases inflammation near injury which appears to reduce damage to nerve cells

decreases edema and inflammation and stabilized the nerve cells in that region

128
Q

American Spinal Injury Association (ASIA) Impairment Scale

A

a scale that can determine extent of injury and where it may lead rehabilitation wise

evaluates level and completeness of injury

determines treatment and rehabilitation plan

129
Q

Pharmaceutical therapies for spinal cord injuries

A

glucocorticoids

vasopressors like dopamine

plasma expanders like dextran

atropine

muscle relaxants and anti spasmodic

histamine 2 receptor antagonists

anticoagulants

stool softeners

vasodilators

anti seizure medications

130
Q

Why give glucocorticoids to SCI patients

A

to suppress the immune response

131
Q

Why give vasopressors like dopamine to SCI patients

A

to help stop hypotension via vasoconstriction

132
Q

Why give plasma expanders like dextran to SCI patients

A

to maintain volume and treat shock

133
Q

Why give atropine to SCI patients

A

it can fight bradycardia by speeding up HR

134
Q

Why give histamine 2 receptor antagonists to SCI patients

A

to prevent GI ulcers by decreasing acid production

135
Q

Why give anticoagulants to SCI patients

A

to prevent DVT

136
Q

why give vasodilators to SCI patients

A

used if blood pressure got too high after vasopressors - to bring HTN down

137
Q

Recovery Concerns (possibly for rest of life) for SCI patients

A

aspiration risk if injury was high on the spine

ineffective thermoregulation

spinal shock (temporary)

ineffective airway clearance

impaired physical mobility

DVT

imbalanced nutrition

urinary incontinence

bowel incontinence and/or constipation

impaired skin integrity

ineffective coping

anticipatory grieving (of things lost)

sexual dysfunction

138
Q

Autonomic Dysreflexia

A

reaction of the autonomic (involuntary) nervous system to overstimulation and generally occurs with injuries above T6

it is the sudden onset of HTN

Thinks “auTonomic” - there are 6 letters after T so T6 + injuries

139
Q

What area of the spine commonly has autonomic dysreflexia issues

A

anywhere T6 and above

140
Q

What s/s occur with sudden onset of autonomic dysreflexia

A

severe HTN

severe throbbing HA

profuse diaphoresis and flushing

nasal stuffiness

blurred vision

nausea

bradycardia

141
Q

Interventions for Autonomic Dysreflexia

A

elevate HOB to sitting position

check BP

check remove and treat possible causes !!! like a kinked catheter or distended bladder and bowel

administer anti hypertensive meds prn

monitor every 3-4 hours after symptoms subside

142
Q

What exactly occurs in autonomic dysreflexia?

A

some afferent stimulus makes the body have a massive sympathetic response causing vasoconstriction, but the brain cannot control below the injury so it slows heart rate to try and stop vasoconstriction

the sympathetic response below the injury from the stimulus and the brain knowing this is happening but cannot reach down that low so it impacts and controls the heart leading to both BRADYCARDIA AND HTN simultaneously

143
Q

Halo traction

A

External fixation device to stabilize the CERVICAL spine

immobilizes cervical spine fractures and is a form of skeletal traction with pins going into the skull and a metal ring connecting them - this cannot be removed as it is skeletal traction - and the ring is attached to a jacket by rods

144
Q

What does halo traction allow for

A

early mobilization and rehabilitation

145
Q

Can halo traction be removed

A

it is skeletal traction and skeletal traction is not removed

146
Q

What is a big risk with Halo traction

A

fall risk since there is more weight on the head allowing for easy tripping and falling

147
Q

Nursing care for person in halo traction

A

wrench taped to front at all times for emergency access

fall risk

NEVER grasp the rods to assist the patient in repositioning

pin care

skin assessment of areas under the jacket which does not come off but can (usually) be released for skin assessment

148
Q

Nursing Care for SCI

A

suction set up at bedside

supplemental O2 therapy

encourage coughing

turning and positioning

Chest PT

core temp every 4 hours during the first 72 hours after injury

control environmental temperature

monitor for abdominal and bladder distension

bladder training

check post void residual via bladder scan and catheterize only if necessary

baseline weight

presence and absence of bowel sounds determines nutrition route

education on calorie activity relationship

AE stockings and SCDs

subcutaneous heparin or lovenox

education on s/s of DVT

encourage independence in ADLs

use adaptive equipment in bed and for transfers

prevent contractures - wrist drop, foot drop - with ROM

safety - assist with transfers and ambulation’s

use of braces and wheelchairs

GOOD SKIN CARE

149
Q

Why use AE hose on a SCI patient

A

there may be vasodilation so this helps with venous return

150
Q

Why is it so important to teach an SCI patient about DVT signs

A

they may not necessarily be able to feel pain

151
Q

What are some ways to go about good skin care for a SCI patient

A

wheelchair pressure reduction seating cushions

teach strategies for frequent position changes - with the commercials, after every radio song, etc

teach skin inspection with a mirror

152
Q

What sort of skin ulcers are common in SCI patients

A

ischial ulcers are common d/t lack of sensation

N353: Practice of Nursing II (14 decks)

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