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15 Cards in this Set
- Front
- Back
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Spinal shock stage |
Flacid below injury, areflexia, loss of sensation, atonic bowel&bladder in injury is above S4, spinal shock (hypotension and bradycardia) if above T6, skin pink and warm due to arterial dilation. |
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After spinal shock |
Rigidity, spastic b&b, hyperreflexia, loss of sensation, autonomic hyper/dysreflexia (bp up to 300, bradycardia), skin cool and pale |
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S&s hyperreflexia |
Bradycardia, severe HTN, headache, flushing, piloerection, skin cold and clammy, nasal congestion, diaphoresis |
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Levels of injury |
Diaphragm c3-5, scapula c5-6, intercostal t1-11, abdominal t7-12 |
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Management of SCI |
Immobilization of spine, methylpredinosolone, management of complications, rehab |
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Quadraplegia v paraplegia |
Paraplegia is T1 and below. Quad is C8 and up. |
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Causes of autonomic dysreflexia |
Fecal impaction, bladder distenstion, sensory stimulation below SCI |
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Methylprednisolone protocol |
Loading dose 30 mg/kg over 15 min. Maintenance dose 5.4 mg/kg/hr For: 23 hrs if caught <3 hrs. 47 hrs if 3-8 hrs. |
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Complications of SCI |
Altered resp function, dc CO rt spinal shock, autonomic dysreflexia, thromboemboli, fluid/electrolyte imbalance rt paralytic ileus during spinal shock, stress ulcer, selfcare deficit/neglect, ineffective therapeutic regimen, altered bowel/bladder |
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Trigeminal neuralgia |
5th cranial nerve. Sharp pain, tearing of eye. Antiseizure meds, nerve block, decompress nerve |
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Bells palsy |
Unilateral. CN VII. linked with HSV. ear pain and tinnitus. Drooping mouth, inability to close eyelid. Inability to frown smile or whistle. Recover in 6 weeks. Prednisone and acyclovir to treat. Hot packs to face to help with pain. |
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Gillian-Barre |
Autoimmune attack of myelin sheath. Decreased neurotransmission. Ascending weakness/paralysis. Peaks at 14 days. RESPIRATORY IMPAIRMENT POSSIBLE! Return of function is descending. CSF has increased protein after 7-10 days. Supportive care. Give IG and plasmaphoresis. Paralytic ileus may arise. |
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When to feed |
Not until after bowel sounds resume for ng feed. Not until gage return for PO. |
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Botulism |
Gi absorption of neurotoxin from C. Botulinum. N/V/cramping 6 hr-2 days later. Convergence of eyes, photophobia, ptosis, no EOM, blurred vision, diplopia, dry mouth, resp and cardiac failure. Confirm w stool sample or EMG. Antitoxin therapy and enemas. Max monitor. |
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Tetanus |
Found in soil in garden, mold, manure. Incubation 7-21 days. Stiff neck/jaw. Tonic spasms. High mortality. Dx with leukocytosis and positive culture. Tx anticonvulsant, diazepam, possible ventilation with sedation, tetanus toxoid, tetanus IG, PCN. Max monitor. |
