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Module 7 > Spinal Cord Injury New > Flashcards

Spinal Cord Injury New Flashcards

1
Q

Spinal cord injury

A

Result of trauma
Degenerative loss of motor , sensory and autonomic function

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2
Q

Apoptosis

A

Programmed cell death
Lesion in spinal cord and similar cells began to die in a programmed aesthetic

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3
Q

Spinal shock

A

Not a true shock
Loss of deep tendon and sphincter reflexes ..loss of sensation .. flaccid paralysis below the lesions

Only temporary ..last days2weeks

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4
Q

Neurogenic shock

A

Pipe problem ( vessels)
Vessels vasodilate and increase HR , decrease BP .. blood rushes to peripheral and does not go to the heart to be oxygenated so blood is not going to the brain

Pt present as warm and dry not blue or pale or pink..

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5
Q

Intervention for neurogenic shock

A

Give 500 ml-1L of fluid to see if it work ..if not D/C
Treat with a vasopresser

Give ted hose, compression hose, sequential compression , belly binder - according to physician orders.

NOT a true shock

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6
Q

How long does it take to diagnosis a spinal cord injury?

A

One year

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7
Q

How do you know if spinal shock resolved ?

A

Return of movement or motor skills

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8
Q

How to avoid Hyperextension injury in the hospital

A

Important to teach pt to use the call light so they dont hurt themselves even more

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9
Q

Compression fracture

A

Falling on feet
Or directly on head which causes spine to compress

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10
Q

Common cause of flexion rotation injury

A

Car accident spinning

Look for fractured calcaneus .. tells us large possibility that we have spinal column injury

Forced one way but twisted another

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11
Q

How is SCI classified by?

A

Mechanism of injury
Level of injury
Degree of injury

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12
Q

Level of injury consist of

A

Skeletal level and neurologic level

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13
Q

Skeletal level

A

Bones and ligaments

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14
Q

Neurologic level

A

Lowest segment of spinal cord with normal sensory and motor function on both sides of body

  • if all i can do is nod head .. pretty bad
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15
Q

If cervical cord is involved (c4 injuries)

A

Can cause tetraplegia ( all 4 limbs)

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16
Q

Para plegia

A

Two limbs (c6)

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17
Q

Degree of injury

A

Complete cord involvement
Incomplete (partial ) cord involvement)

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18
Q

Cervical and lumbar

A

Most common places to be injured

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19
Q

Complete cord involvement

A

Internal decapitation , gun shot wound, stab wound, penetrating injury to the cord

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20
Q

Incomplete partial cord involvement

A

Mixture of anything

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21
Q

Incomplete syndrome

A

Central cord
Brown séquard

22
Q

Central cord

A

Occurs most commonly in cervical cord region
Motor weakness and sensory loss is present
But loss in the arms is greater than loss in the legs

Be watchful with these pt .. dont have enough to bare their own weight

Does not last forever

23
Q

Brown séquard

A

Damage to half of spinal cord

Loss of motor function, position , vibration sense,
On same side of injury

On opposite side loss of pain and temp sensation below level of lesion

Results from penetrating injury to spinal cord

24
Q

Proprioception

A

Not being able to tell the position of your limb
What is being experiences of brown séquard

25
Q

Sequelae

A

Secondary things that happen to spinal cord injury
Such as pneumonia , bed sores ,

26
Q

higher the injury

A

The more serious the sequelae

27
Q

What is a big thing we worry about with spinal cord injuries and their respiratory system

A

Atelectosis ( collapsed aveoli) - PREVENTION
Use IS with Fio2 , TCDB , consistently turning pt to suction or get pt to cough it up or (forcibly have them cough)

28
Q

Injury at c1-3

A

Apnea, inability to cough
Big injury and may not be able to breath on own
May have to be intubated right away ..
Get the box for meds, tube , scope, wire and tape

29
Q

Injury at c4 level

A

Poor cough, diaphragmatic breathing , hypoventilation

SOOOO lay them flat on back , put hands under diaphragm (Heinrich maneuver) tell them to cough and push on diaphragm… also know as assisted coughing… teach family this!!!

30
Q

Injury at c5-t6

A

Decrease respiratory reserve c6-t8 lose intercostal muscles
Have pt and family involved in care

31
Q

SPI is a million dollar injury in the first

A

7 days

32
Q

In regards to the cardiovascular perspective ..Above level t6 can cause

A

Brady cardia <60 bpm

Give vasopressor or atropine
Plan for a pacemaker at some point
Avoid increase in vagal stimulation

33
Q

Examples of increase in vagal stimulation

A

Rest in between turning and suctioning

34
Q

Urinary retention

A

Most common in SPI

35
Q

Why should we wait to insert a permanent catheter for SCI

A

Bladder reflex may come back so we want to wait
If we put a permanent when they dont need one and it can increase risk for infection ..

36
Q

What becomes available for urinary retention for SCI

A

Intermittent catheterization program

And another thing we look at is do they need a suprapubic catheter.. much cleaner

37
Q

What can we do for SCI and bowel issues

A

Start a bowel program so we can tell when they need to go

Taking stool softener or laxative

38
Q

As bowel reflexes return what is important that we teach on

A

Bowel program

39
Q

Poikilothermism

A

Spinal cord pt takes on the ambient room tempature .. antipyretics do not help

So at risk for for hypothermia or heat exhaustion

We are the keeper of tempature

40
Q

As far as thermoregulation SPI pt have decrease

A

Ability to seat and ability to shiver

41
Q

Why do we stabilize SCI through traction ro realignment?

A

Eliminate damaging motion at injury site
Intended to prevent secondary damage

42
Q

Bone graft is going to come off of where?

A

Illiac crest

43
Q

If cord is compressed they decompress it .. why do they do the anterior first

A

If we turn them over on belly we run the risk of a code if something happens to them

44
Q

Kinetic roto- rest bed

A

Moves from flat to 90 degrees to help move secretion

Good thing

45
Q

Nursing intervention for autonomic dysreflexia

A

High fowlers
Assess the cause
Call physician
Immediate catheterization
Teach s/s and causes to fam and pt

46
Q

What is autonomic dysreflexia caused by

A

Sustained at t6 or below
Restrictive clothing
Full bladder
Pressure areas
Fecal impaction

47
Q

S/s of autonomic dysreflexia

A

Increase BP ( severe and rapid)
Flush faced
Headache
Distended neck veins
Decrease hr
Increase sweating
Vasodialation above

48
Q

Below level of injury autonomic dysreflexia s/s

A

Vasoconstriction below level of injury
Pale
Cool
No Sweating

49
Q

Age groups from SCI

A

Young men and elderly

50
Q

What is a problem with SCI and when we intubate them

A

They may never get exubated

51
Q

SCI at risk for

A

Ulcers, atelectasis and pneumonia

Module 7 (25 decks)

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