SCI Quiz 1

Spinal Cord Function

• The primary function of the spinal cord involves transmitting nerve signals between the brain and body.
• The spinal cord is a major communication pathway.

Causes of Spinal Cord Injuries

• Motor vehicle accidents are the leading cause of spinal cord injuries.
• Motor vehicle accidents account for nearly half of all spinal cord injury cases.

Tetraplegia

• Cervical spine injuries (C1-C7) can result in tetraplegia, causing a loss of function in all four limbs.

Autonomic Dysreflexia

• Patients with T6 spinal cord injuries are at risk for autonomic dysreflexia.
• Autonomic dysreflexia is a life-threatening condition common in spinal cord injuries at T6 and above.

Brown-Séquard Syndrome

• Brown-Séquard Syndrome is an incomplete spinal cord injury.
• It involves damage to one side of the spinal cord, causing motor loss on one side and sensory loss on the opposite side.

Priority Nursing Intervention for Suspected Spinal Cord Injury

• The priority nursing intervention for a patient with suspected spinal cord injury is to immobilize the spine.
• Immobilizing the spine prevents further injury and is the first step in managing spinal cord trauma.

Risk of Spinal Shock

• Patients with spinal cord injuries at T2 are at risk for spinal shock.
• Spinal shock is a temporary loss of reflexes, sensation, and motor control after spinal cord injury.

Nurse intervention C4 spinal cord Injury

• Check for a noxious stimulus (e.g., full bladder) for a patient with a C4 spinal cord injury who develops a pounding headache, flushed face, and a blood pressure of 200/110 mmHg.
• These symptoms indicate autonomic dysreflexia, often triggered by bladder distension or constipation.

Neurogenic Bladder

• Encourage frequent self-catheterization for a patient with neurogenic bladder after a spinal cord injury.
• Intermittent catheterization helps prevent urinary retention and reduces the risk of infection.

Preventing Deep Vein Thrombosis (DVT)

• Applying sequential compression devices can help prevent deep vein thrombosis (DVT) in a patient with a spinal cord injury.
• Spinal cord injury patients are at high risk for DVT due to immobility, and compression devices promote circulation.

Autonomic Dysreflexia Triggers

• Common triggers for autonomic dysreflexia in patients with spinal cord injuries include full bladder, skin irritation, constipation, and extreme cold temperatures.
• Autonomic dysreflexia is often triggered by bladder distension, skin irritation, constipation, or environmental factors.

Nursing Actions for Spinal Shock

• Appropriate nursing actions for a patient with spinal shock include monitoring for hypotension and administering atropine for bradycardia.
• Additional nursing actions are providing ventilatory support if needed and performing frequent neurological assessments.
• Spinal shock leads to hypotension and bradycardia, potentially requiring atropine and close monitoring.

Preventing Pressure Ulcers

• Statements indicating understanding of pressure ulcer prevention include changing positions every 2 hours and checking skin daily for redness.
• Further statements indicating understanding are keeping skin dry and clean, and using a pressure-relieving cushion in a wheelchair.
• Regular repositioning, skin inspections, and using pressure-relieving devices help prevent pressure ulcers.

Complete Spinal Cord Injuries

• A complete spinal cord injuries results in the loss of all motor and sensory function below the level of injury.
• Complete SCI means there is no motor or sensory function below the level of injury.

Spinal Cord Injury Location

• The cervical spine is the most commonly injured area of the spine due to its flexibility and exposure.

Laminectomy

• The purpose of a laminectomy in spinal cord injury patients is to remove part of the vertebra to relieve pressure on the spinal cord.
• A laminectomy removes part of the vertebra (lamina) to relieve pressure on the spinal cord.

Risk Factors for Spinal Cord Injury

• Engaging in high-risk behaviors increases a person's risk for spinal cord injury.
• Risk-taking behaviors, such as reckless driving and extreme sports, increase the likelihood of SCI.

Ventilatory Support

• A C4 spinal cord injury level is most likely to require long-term ventilatory support.
• Injury at or above C4 affects the diaphragm, often requiring mechanical ventilation.

Priority Nursing Intervention for T8 Injury

• Monitoring for autonomic dysreflexia is a priority nursing intervention for a patient with a spinal cord injury at T8.
• Autonomic dysreflexia occurs in patients with injuries at T6 or above.

Urinary Retention

• Performing intermittent catheterization is the best nursing intervention for a patient with an L3 spinal cord injury experiencing urinary retention.
• Intermittent catheterization reduces the risk of infection while managing urinary retention.

Discharge Planning

• A discharge plan for a patient with a T10 spinal cord injury should include bowel and bladder training.
• A T10 injury causes paraplegia and impairs bowel/bladder function.

Spinal Shock Assessment

• Assessment findings suggesting spinal shock in a patient with an acute spinal cord injury include hypotension and absent reflexes.
• Spinal shock results in flaccid paralysis, hypotension, and loss of reflexes.

Medications

• Corticosteroids are commonly used in the acute phase of spinal cord injury.
• High-dose corticosteroids may reduce inflammation and secondary damage.

Preventing Pressure Ulcers

• Interventions important in preventing pressure ulcers include repositioning every 2 hours and keeping skin dry and clean.
• Further interventions include using pressure-relieving devices.
• Repositioning, keeping skin clean, and using pressure-relieving devices help prevent pressure ulcers.

Long-Term Complications

• Osteoporosis, neurogenic bladder, autonomic dysreflexia, and deep vein thrombosis (DVT) are potential complications of long-term spinal cord injury.
• Osteoporosis, neurogenic bladder, autonomic dysreflexia, and DVT are common complications.

Autonomic Dysreflexia Interventions

• Appropriate nursing actions for a patient experiencing autonomic dysreflexia include identifying and removing the triggering stimulus and checking for bladder distension.
• Removing the trigger, checking for bladder issues, and treating hypertension are key interventions.

Rehabilitation Goals

• Rehabilitation goals for a patient with a spinal cord injury should prioritize maximizing functional independence and preventing contractures.
• Additional rehabilitation goals are teaching self-catheterization, and providing psychological support.
• Rehabilitation focuses on independence, preventing complications, and psychological well-being.

C6 Injury

• Checking the patient's blood pressure is the priority action for a nurse caring for a patient with a C6 injury in a wheelchair who suddenly reports dizziness and nausea.
• Symptoms suggest orthostatic hypotension, common in SCI patients.

Preventing VTE

• Performing passive range-of-motion exercises is the most appropriate nursing intervention to prevent venous thromboembolism (VTE) in a patient with an SCI.
• Immobility in SCI increases VTE risk; passive exercises promote circulation.

Neurogenic Bladder and UTI

• The statement "I don't need to worry about bladder infections because I empty my bladder regularly" by a patient with a T4 spinal cord injury indicates a need for further teaching.
• Neurogenic bladder increases UTI risk, even with routine catheterization.

C5 Injury

• A patient with a spinal cord injury at C5 is at risk for loss of respiratory function.
• C5 injuries can impair diaphragm function, leading to respiratory distress.

Bradycardia

• The best explanation for a T2 spinal cord injury patient experiencing bradycardia is that the injury disrupts sympathetic nervous system control over the heart rate.
• SCI above T6 disrupts the sympathetic nervous system, causing bradycardia.

Autonomic Dysreflexia Findings

• Findings that indicate a patient with a spinal cord injury is experiencing autonomic dysreflexia include severe hypertension, bradycardia, and diaphoresis above the level of injury.
• Hypertension, bradycardia, and sweating above the injury level are classic signs

Bowel Management

• Statements indicating proper understanding of bowel management with a spinal cord injury include: "I should eat a high-fiber diet.", "I will schedule my bowel program at the same time each day.”, and "I should drink plenty of fluids."
• A high-fiber diet, scheduling bowel movements, and staying hydrated help regulate bowel function.

Long-Term Spinal Cord Injuries

• Common complications in patients with long-term spinal cord injuries include urinary tract infections, chronic pain, pressure ulcers, and contractures.
• SCI patients are prone to UTIs, chronic pain, pressure ulcers, and contractures due to immobility.

Promoting Independence

• Interventions that will help promote independence for a patient with an SCI at C7 include upper extremity strengthening exercises and using a motorized wheelchair.
• Additional interventions are practicing transfers from bed to wheelchair and learning to use adaptive devices.
• Strength training, wheelchair skills, and adaptive devices enhance independence.

Realistic Goal

• A realistic goal for a patient with a C6 spinal cord injury in rehabilitation is the use of adaptive devices for feeding and dressing.
• C6 injuries impair fine motor function, but adaptive devices aid self-care.

Spinal Cord Injury Assessment

• Check the catheter for kinks or obstruction if a spinal cord injury patient has a distended bladder and is sweating excessively above the injury site.
• Bladder distension can trigger autonomic dysreflexia. The cause must be removed immediately.

SCI Orthostatic Hypotension

• Apply compression stockings for a patient with a spinal cord injury at T10 complains of dizziness when changing positions.
• Compression stockings prevent orthostatic hypotension in SCI patients.

SCI Adaptation

• An outcome that indicates a spinal cord injury patient is adapting well to rehabilitation is when the patient verbalizes frustration about mobility but participates in rehabilitation.
• Frustration is normal, but participation in rehab indicates adaptation.