1010- Test 3 Spinal Cord Injuries

Front 1

The spinal cord runs thru the ____ from the foramen magnum to ____.

Back 1

vertebral column
L1-L2

Front 2

A person paralyzed from the waist down is ______.

Back 2

paraplegia

Front 3

A person paralyzed on all four extremities is ______.

Back 3

tetraplegic

Front 4

4 causes for SCIs are

Back 4

-vertebral fractures
-osteoporosis
-metastatic cancer
-whiplash

Front 5

_____ happens when bones in the disc weaken and collapse causing pressure on the spinal cord/nerve.

Back 5

Osteoporosis

Front 6

_____ happens when the cord injury occurs. Reflexes are lost causing flaccid paralysis and anesthesia.

Back 6

Spinal Cord Shock

Front 7

During spinal cord shock, swelling occurs _____.

Back 7

above and below the injury.

Front 8

Swelling from spinal cord shock takes ____ to subside.

Back 8

4-6 weeks

Front 9

Spinal Cord Shock is characterized by...

Back 9

postural hypotension
bradycardia
flaccid paralysis of skeletal muscles
elimination dysfunction
loss of perspiration
loss of sensation
hypothermia
paralytic ileus

Front 10

4 things used to manage spinal cord shock include:

Back 10

glucocorticoids
tilt table
TEDs or ACE wraps
ICP

Front 11

_____ are used with spinal cord shock to decrease edema around the spinal cord.

Back 11

Glucocorticoids

Front 12

____ is used with spinal cord shock to keep a stable BP when vertical.

Back 12

Tilt table

Front 13

_____ is an overactivity of the autonomic nervous system causing a sudden onset of hypertension.

Back 13

Autonomic Dysreflexia

Front 14

Another name for autonomic dysreflexia is ______.

Back 14

sympathetic storming

Front 15

Autonomic dysreflexia occurs with patients who have a SCI at _____ and above.

Back 15

T6

Front 16

Autonomic dysreflexia/sympathetic storming occurs after...

Back 16

cord shock subsides.

Front 17

Autonomic dysreflexia is usually caused by

Back 17

overfilling of the bladder or some other perineal stimulation.

Front 18

Manifestations of Autonomic dysreflexia are:

Back 18

-hypertension
-headache
-flushing of face
-sweating
-bradycardia
-anxiety
-decreased pulse

Front 19

Emergency management of autonomic dysreflexia/sympathetic storming includes:

Back 19

-sit client up
-alleviate cause (empty bladder, check for fecal impaction and decubiti)
-Administer ordered antihypertensive or vasodilator

Front 20

The antihypertensive or vasodilators used to treat Autonomic dysreflexia are

Back 20

Procardia and Nitrostat

Front 21

After a SCI, emergency care includes:

Back 21

-stabilize head and neck
-jaw thrust for CPR
-stabilize spine with tongs and skeletal traction until fusion
-halo brace
-daily pin care (4x/day)

Front 22

Immediate nursing priorities for a patient with a SCI include:

Back 22

-respiratory
-BP control
-skin care- decubiti
-elimination
-nutrition
-UTI
-grief

Front 23

Long term problems that come with a SCI are:

Back 23

-skin care
-contractures and spasticity
-bowel and bladder training
-bone decalcification
-DVTs
-Infection
-mobility
-sexuality
-depression
-finances
-life role changes

Front 24

_____ medications are used to treat SCIs.

Back 24

Antispasmodic

Front 25

______ is an antispasmodic that acts on the CNS to reduce excessive reflex spasms and allow the muscle to relax.

Back 25

Loresal (Baclofen)

Front 26

____ is an antispasmodic that acts on muscle cells but can cause adverse muscle weakness and hepatitis.

Back 26

Dantrium (Dantolene)

Front 27

_____ is an antispasmodic that acts on the CNS to reduce muscle spasms, pain, tenderness and improve mobility.

Back 27

Flexeril (Cyclobenzaprine)

Front 28

The adverse effect of Loresal (Baclofen) is...

Back 28

can cause seizures and paranoid ideations therefore wean off slowly!!!

Front 29

The adverse effects of Dantrium (Dantolene) include

Back 29

adverse muscle weakness
hepatitis therefore watch for jaundice

Front 30

The adverse effects of Flexeril (Cyclobenzaprine) include:

Back 30

-CNS depression
-anticholinergic activity

Front 31

Causes of a herniated intervertebral disc include _____, ____ or client issues such as...

Back 31

single traumatic event
cumulative trauma
genetics, age, posture, body mechanics, physical condition

Front 32

Diagnosis of a herniated intervertebral disc includes:

Back 32

CT scan
myelogram
MRI

Front 33

The ____ is becoming the more preferred means of diagnosis for a herniated intervertebral disc because it is noninvasive.

Back 33

MRI

Front 34

Low back pain radiating down the thigh near the sciatic nerve and possible weakness or paralysis of the foot and leg are manifestations of a ______.

Back 34

lumbar herniated disc

Front 35

Upper back and arm pain and numbness along with loss of reflexes and strength in the upper extremities are manifestations of ______.

Back 35

cervical herniated disc.

Front 36

Treatment options for a herniated intervertebral disc include:

Back 36

-Antispasmodic medications and exercise
-Laminectomy and Discectomy
-Spinal fusion
-Vertebralplasty

Front 37

A ____ would be needed with a herniated intervertebral disc if the injury involves more than one disc.

Back 37

Spinal fusion

Front 38

_____ is injecting special cement in to raise bone. It is done in the OR, very effective and has no anesthesia complications.

Back 38

Vertebralplasty

Front 39

When giving NSAIDS, watch for

Back 39

-GI distress
-hearing deficits
-renal impairment
-avoid alcohol
-vision changes

Front 40

Pre-op teaching for Vertebral surgery includes

Back 40

-log rolling
-incentive spirometer
-lying flat to eat

Front 41

If a patient has a lumbar procedure, assess the...

Back 41

lower extremities
pedal pulses
moving foot and legs

Front 42

If a patient has a procedure on the upper extremities assess ____ and ____.

Back 42

hands and head.

Front 43

After vertebral surgery, the nurse should monitor

Back 43

-neurological function
-hematoma formation
-CSF leakage
-urinary dysfunction
-infection
-pain
-positioning
-mobility

Front 44

_____ is an inflammation around the disc. There is pain with no redness or drainage.

Back 44

Diskitis

Front 45

After vertebral surgery the HOB should be

Back 45

slightly elevated.