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Spinal Cord Injury
N/A
42
Nursing
Undergraduate 4
09/10/2012

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Cards

Term
Primary Injury
Definition
Results from disruption of neurologic tissue or vascular supply: occurs with disruption of vasculature supply.
Term
Secondary Injury
Definition
Occurs following primary injury as a result of this primary injury (usually edema and result of inflammation) occurs within the first 24 hours.
Term
Vertical Compression, Axial Loading
Definition
vertical force applied on spinal cord (diving head first into pool) compression of the spinal cord. injuries cause burst fractures of vertebral body that sends bony fragments into spinal canal or into spinal cord.
Term
Hyperextension
Definition
injury causing neck pushed backward. head getting suck on toilet, seen with rear end collisions.
spinal cord is stretched no problem with bone itself with spinal cord.
Term
Rotation
Definition
severe rotation of neck or body results in tearing of posterior ligaments & displacement (rotation) of the spinal column.
Term
functional injury
Definition
degree of disruption of normal spinal cord function (complete vs. incomplete) depends on what specific and motor structures within cord are damaged.
Term
When can spinal cord injury be classified?
Definition
not for several days after injury until spinal shock has resulted.
Term
complete vs. incomplete injury?
Definition
complete is no feeling or movement below point of injury, incomplete is there is some feeling below the point of injury.
Term
What requirements do people with c1 and c4 injuries need?
Definition
require electric wheelchair with breath, head or should controls
Term
what requirements do people with c5 injuries need?
Definition
electric wheel chair with hand controls, may require adaptive devices with ADL's
Term
what requirements do people with c6 injuries need?
Definition
independent manual wheel chair, head controls adaptive devices for ADL's
Term
what requirements does someone with c7 injury need?
Definition
manual wheel chair
Term
what requirements does someone with c8-T1 injury need?
Definition
may need adaptive devices for ADL's
Term
When does spinal shock occur and how long does it last?
Definition
shortly after injury, 30-60 minutes can last days to months long.
Term
when does spinal shock resolve
Definition
spontaneously
Term
six manifestations of spinal shock
Definition
bradycardia
hypotension
flaccid paralysis
absence of contractions
bowel dysfxn
bladder dysfxn
Term
three treatments that can be provided to someone experiencing spinal shock
Definition
fluids to control hypotension
temporary pacer
vasopressors
Term
what is spinal shock
Definition
physiological or anatomical transection of spinal cord that results in temporary loss or depression of all or most spinal reflex activity below level of injury.
Term
what patients does neurogenic shock occur in?
Definition
T6 and higher injuries
Term
what is neurogenic shock?
Definition
transient loss of all normal reflexes below level of injury: this occurs because of unopposed parasympathetic stimulation leading to decreased vascular tone, resistance, dilation.
Term
4 symptoms that occur with neurogenic shock
Definition
hypotension
bradycardia
decreased CO
Cannot sweat below level of lesion
Term
two treatments for neurogenic shock
Definition
fluids
atropine
careful not to cause vagal stimulation.
Term
what differentiates neurogenic shock from hypovolemic shock
Definition
bradycardia
Term
Quaraplegia
Definition
injury from c1-t1
Term
paraplegia
Definition
T2-L1
Term
incomplete SCI
Definition
mixed loss of voluntary motor and sensory function below level of lesion, incomplete exists if any function remains below the level of injury.
Term
Brown-Sequard Syndrome?
Definition
loss of voluntary motor or same side as injury with loss of pain, temp & sensation on other side below level of injury mostly from knife or sharp instrument.
Term
posterior spinal cord syndrome?
Definition
loss motor function, loss of pain and sensation below level of injury
Term
Anterior spinal cord syndrome?
Definition
loss motor function, pain, temp, touch, paralysis below injury
Term
Central cord syndrome
Definition
motor and sensory deficit more pronounced in UE than LE, often spastic mostly in cervical spine and caused from hyperextension.
Term
Why are Halo vests being used?
Definition
metal ring attached to skull with four screws for cervical immobilization, keeps immobile until they go to surgery helps you turn and move patient without mobilizing spinal cord
Term
Nursing care provided to those with halo vest (3)
Definition
should be turned every 2 hours
log roll patient using 2-3 nurses with someone standing at head of bed and at patients feet
perform pin care
Term
Why is methylprednisolone used in patients with spinal cord injury?
Definition
thought to prevent secondary injury in SC improves nerve impulse conduction. Steroid that reduces inflammation, decreases immunity. taken to prevent secondary injury because it helps to decrease swelling and inflammation. only for first 48 hours then treatment stops.
Term
what is dose methylprednisolone
Definition
3-8 hours post injury with loading dose 30 mg/kg bolus and continuous infusion 5.4 mg/kg/hr x 23 hours (48 possible)
Term
four D's of psychosocial nursing management?
Definition
dependency
divorce
drug addiction
depression
Term
What happens to metabolism following SCI
Definition
hypermetabolic, burning 3000 calories a day
Term
what can you do to help patients avoid stress ulcers
Definition
H2 receptor blockers or proton pump inhibitors to help acid control to help with injury itself.
Term
What should you be doing with your SCI patient to prevent contractors
Definition
ROM and hand splints and foot drop splints
Term
Why do you need to suction carefully with SCI patients
Definition
because stimulation of the vasgus nerve will cause bradycardia
Term
what is quad coughing/coughalator
Definition
push up on patients diaphragm to give support to diaphragm and push secretions up.
Term
mechanical ventilation at night may be necessary for what patients
Definition
c3-c5 patients
Term
most common cause of mortality in SCI patients
Definition
renal failure
then UTI
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