Podcast
Questions and Answers
Which age group is most commonly affected by spinal cord injuries?
Which age group is most commonly affected by spinal cord injuries?
Which of the following is a non-traumatic cause of spinal cord injury?
Which of the following is a non-traumatic cause of spinal cord injury?
What is the most common level of spinal cord injury according to the text?
What is the most common level of spinal cord injury according to the text?
Which mechanism of injury involves the chin hitting an object and the head being thrown back?
Which mechanism of injury involves the chin hitting an object and the head being thrown back?
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What type of injury results in a rupture of the anterior ligament with fracture of posterior elements of the vertebral body?
What type of injury results in a rupture of the anterior ligament with fracture of posterior elements of the vertebral body?
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Which of the following is NOT a risk factor for spinal cord injury according to the text?
Which of the following is NOT a risk factor for spinal cord injury according to the text?
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What is the vertebrae most frequently involved in spinal cord injuries?
What is the vertebrae most frequently involved in spinal cord injuries?
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What is the most common type of injury resulting in a rupture of the posterior ligament leading to forward dislocation of vertebrae?
What is the most common type of injury resulting in a rupture of the posterior ligament leading to forward dislocation of vertebrae?
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What is a common trauma-induced cause of spinal cord injuries?
What is a common trauma-induced cause of spinal cord injuries?
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Study Notes
Spinal Cord Injury Management
- Bony fragments in the spinal canal can lead to deteriorating neurologic status, requiring surgery to reduce the spinal fracture or dislocation or decompress the cord.
Nursing Management
- Ineffective breathing pattern is related to weakness/paralysis of intercoastal muscles, abdominal muscles, and inability to expectorate secretions.
- Ineffective airway clearance is related to weakness of intercoastal muscles.
- Impaired physical mobility is due to motor and sensory impairment.
- Impaired urinary elimination is due to inability to void spontaneously.
- Acute pain is related to treatment and immobility.
Assessment
- Vital signs should be monitored, including sensation, motor function, and reflexes.
- Risk for hypotension: administer IV fluids, monitor fluid resuscitation, and administer vasopressor to maintain BP.
Airway Management
- Maintain airway through chest physiotherapy, suctioning, and assisted cough, considering contraindications.
- Monitor ABG and observe for aspiration.
- Provide abdominal binder for abdominal support to facilitate diaphragmatic breathing and increase venous return.
Rehabilitation
- Focus on functional establishment, respiratory management, and self-care.
- Assist with dressing, turning self on bed, mobility, self-feeding, transferring from place to place, bathing, and bladder and bowel function.
Psychological Support
- Provide psychological counseling to allow ventilation of feelings, clarify doubts, and offer vocational rehabilitation.
Initial Care
- Stabilize the spine in emergency situations, ensuring the client's neck is in a neutral position, spine in neutral alignment, and preventing flexion.
- Use a spinal board, hard collar, self-fastening ties across the torso and legs, and log rolling maneuver for transfer.
Medical Management
- Maintain vital functions by monitoring ABG levels, administering vasoactive agents for BP, and methyl prednisolone for SCI less than 8 hours old.
- Use H2 receptor blocking agents to reduce gastric and intestinal bleeding.
- Monitor for complications, including spinal shock, atelectasis, pneumonia, hypotension, DVT, GI bleed, pressure ulcers, joint contractures, and psychological dysfunction.
Surgical Management
- Indications for surgery include compression of the cord, fragmented or unstable vertebral body, and penetrating wounds that involve the cord.
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Description
Test your knowledge on nursing management for spinal cord injuries, including interventions for ineffective breathing pattern and airway clearance. Learn about laminectomy procedures and patient care post-surgery.
