2.29 SCI 4 Flashcards
(38 cards)
some SCI respiratory characteristics
- ind in airway clearance
- weak functional cough
- nonfunctional cough
independent in airway clearance
- forceful, loud, 2 or more coughs per exhalation
- get stuff out of the mouth
weak functional cough
- soft, less functional
- 1 per exhalation
- ind for clearing throat
- assistance needed to clear secretions
nonfunctional cough
- sigh
- trying, but don’t have negative pressure
- no true cough
- need assistance their entire life for airway clearance
SCI pts and lung function
they lose a lot of lung function depending on level of injury
treatment for respiratory issues
- incentive spirometry
- teach them how to use accessory muscles to breathe
- quad cough
- abdominal bracing may help so the diaphragm works against some resistance
- some percussion therapy or postural drainage etc
teaching how to use accessory muscles to breathe
- act like a frog trying to suck up a big
- “sniff” and feel what happens to your neck
quad cough causes
forceful expiration
Why are SCI pts at risk for decubitus ulcers?
- sedentary
- lack of sensation
- poor circulation
- initial weight loss (lose muscle mass and cushioning over bony prominences)
- nutrition, etc
Positioning with an SCi pt
- positioning is huge: need to offload all the time
- full weight shift off of the surface
pressure ulcers put pts at risk for
infection
PT treatment of SCI pts with ulcers
- positioning
- padding
- changing positions
- specialized beds
- watch skin
s/s orthostatic hypotension
- dizzy
- lightheaded upon changing from supine to sitting
- happens a lot with SCI pts
SCI pts at risk for passing out
- sequelae
- lose color top down
- may have blank stare
- may only make short answer
- steps become very slow, etc
important things to prevent orthostatic hypotension
- TED hose
- hydration
TED hose
keep everything without motor control with a little bit of pressure to facilitate blood flow
hydration concerns with SCI pts
- elderly and SCI pts don’t want to hydrate a lot because it takes a lot of energy to go to the bathroom
- have to always do intermittent catheterization
When does a DVT often occur with SCI pts?
typically occurs early on in their therapy as their body is trying to figure out the new norm
Why is it important to monitor for DVT in an SCI pt?
they won’t be able to feel pain or warmth
s/s of an active PE
- having trouble breathing
- tired and haven’t done anything
What should you do if a pt is showing s/s of an active PE?
- need to check out their O2 stat
- sit them down and check them
blood thinners
- coumadin
- lovenox
DVT that becomes a stroke: What is FAST
- Face
- Arms
- Speech
- Time
signs that a DVT may be becoming a stroke?
- drooling
- coughing with each swallow
