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38 Cards in this Set

  • Front
  • Back

What are the three way trauma/insult can be classified?



-Cultural (trauma can be experienced differently depending on your culture)

What re the most frequently involved Vertebrae?

-5th,6th,7th Cervical

-12th Thoracic

-1st Lumbar

Prior to WW2 why was life expectancy shorter?

What changed?

Catheter was introduced

Whats DABDA stand for?






How does a SCI impact someone?

-Can disrupt the development of someone depending on their age

-Can alter family dynamics (economically, socially)

-May be expensive d/t no benefits

-High costs of rehab and long term care

-Cost to health care system is 1.6-3 million per SCI patient

Whats a Primary Injury?

initial insult or trauma which tend to be permanent (if the nerves are severed which they usually are for primary then you likely will not regain function)

What is Secondary Injury?

Can result from swelling, schema, deem, or bleeding which will likely resolve

What is the difference between transient and transection?

Transient - possibility to regain function

Transection - complete tear of spinal cord

When is the potential for Reversal?

Within hours to 72 hours

What depends on the function you will have post injury?

The severity and level of the injury

How do you asses Spinal Cord Injury?

-Motor function

-Sensation: Tongue blade

-Bladder paralysis and distention (Bladder scan, catheter)

-paralytic ileum - bowel sounds?

-Hyperthermia (body temp may be thrown off)

What is Spinal Shock?

Complete loss of reflex, motor, sensory, autonomic activity

- Muscles below the injury without sensation, paralyzed, flaccid, absent reflexes

What happens with Spinal Shock?

- Bladder paralysis and distention

- Paralytic ileus: may have abdominal distention. Tx: NG tube, medication to promote peristalsis

-Bowel function usually returns within a week: test this by listening to bowel sounds

- Diet: high fiber ad high protein and calories

Whats Neurogenic Shock?

Result of loss of autonomic nervous system function below the injury

Whats affected with Neurogenic Shock?

-Vital signs: decreased BP and HR, cardiac output, venous pooling in extremities and peripheral vasodilation

-Tx - correct underlying cause

What can cause Neurogenic shock

Spinal cord injury, spinal anesthesia, nervous system damage

What are the symptoms of Neurogenic Shock?

Warm/dry skin, bradycardia, decrease in BP, venous pooling in the extremities and peripheral vasodilation

What does SCI affect?

-mobility and skin breakdown


-Finances and support

-Mental Health

-Muscle wasting, atrophy


What are some symptoms of SCI?

- Acute pain in back or neck, may radiate along involved nerve

-Absence of pain does not rule out spinal injury


-Presume SCI until ruled out

What should you be aware of with a high cervical injury?

Airway and respirations

What are some things you can do for Acute Phase Management of SCI?

-Medication prevent swelling and damage: Steroid (ex: prednisolone or methoprednisolone)

-Respiratory monitoring - may have to intubate

-Support oxygen function

-Surgery possibility: compression, unstable vertebrae, penetrated wound, bony fragment, unstable client

-Traction surgery possibly: can include fraction reduction and it can be done externally if you want to put it back into alignment

-Stabilize spinal cord - neck collar

-Support neurological and cardiac functioning

Whats Tetraplegia?

Loss of movement and sensation in all four extremities and trunk

Whats Paraplegia?

Loss of motion and sensation in the lower extremities and all or parts of the trunk

What are potential causes of SCI?

falls, gunshots, spinal cord lesions, MS, congenital cause

Why might a patient have a wee cough and difficulty clearing throat?

SCI may have affected chest and abdominal muscles

-you can help clear by suctioning, chest physio (clap on chest)

Facts about mobility in SCI patients

-Mobility is only initiated once spine stabilized

-Brace, vest, crutches

-If transection injury you can mobilize sooner

-Mobilizing early the better- use muscles to avoid atrophy

-Important to maintain proper alignment

- Helps prevent DVTs

How do you prevent Contractures?

-Range of motion (mobility)


How do you prevent DVTs? (most common in, S&S, prevention)

-Most common in the lower legs

-Medications (anticoagulants, compression stockings

-Change in colour, pain, swelling, hot

Whats orthostatic hypotension?

When you get up BP is unstable and low

-can use vasopressor meds that vasoconstrictor to help

-compression stockings, abdominal binders (helps venous return and supports diaphragm)

Whats autonomic dysreflexia?

Its an acute emergency

-BP up and HR down

-Its an exaggerated autonomic response

-It is after spinal shock is resolved due to nervous system being easily stimulated

What are the causes of Autonomic Dysreflexia?

Distended bladder, Stool stuck in the rectum, cold draft blowing onto patient

Symptoms of autonomic dysreflexia

Pounding severe headache, nausea and vommiting, HTN, diaphoretic(sweating), bradycardia

How do you manage Autonomic Dysreflexia?

-Sitting position to lower BP

-Asses bladder and rectum

-Skin examined for breakdown look for any cold draft or object on skin that is causing this exaggerated response

-Find underlying cause

Which SCI can start mobilizing sooner

Transection injury

How do you prevent disuse syndrome in clients with tetraplegia, paraplegia?

Range of movement 4 times a day to prevent risk of contractors, DVTs ect

What are the systems at risk for SCI patients?

-GU: over distention and no sensation (risk of: post renal, kidney failure, infection)

-Neurogenic bladder

-GI: function usually returns within one week

-Diet: high calories, high fiver and high protein

-Digital Stimulation: insert finger into the rectum to initiate BM

-Impaction: client is at risk for solid stool stuck in rectum

-Skin integrity: watch pressure points especially sacrum, turn every 4 hours, Braden scale

-Sexual expression: counselling, meds and prosthetics

Nursing Interventions for SCI patients (in terms of bladder)

With the GU system the bladder can become over distended and have no sensation which causes the risk of injection, kidney failure, post renal failure ect. Therefore you need to manage fluid intake to 2 litres to manage a neurogenic bladder, catheterization (empty bladder frequently) and look for S&S of infection.

Patients with paralysis are at increased risk for infection and sepsis what are the most common sources of infection?

Urinary tract

Respiratory Tract

Pressure Ulcers