NRSG 421 Final Exam - Complete Solutions For
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Terms in this set (94)
7 cervical
12 thoracic
Spinal cord components 5 lumbar
5 sacral
4 coccygeal
Ages, 16/18, male, high risk activity, driving and
drinking, car accidents
Spinal cord injury risks
*C4,C5,C6,T12=most common
Damage to the spinal cord, resulting in functional
loss and mobility/sensation
Spinal injury
Results from = concussion, contusion, compression,
tearing, laceration, transection, ischemia
18 inches, nerves within cord carry messages from
Spinal cord brain> Spinal nerves> Upper motor neuron> And
back
Lower motor neuron, branch from the spinal cord to
specific areas of body
spinal nerve
Sensory: body to brain
Motor: back to body part to initiate action
1. mechanism of injury
Classification of SCI 2. level of injury
3. degree of injury
, Flexion: ruptures posterior ligaments
Hyper extension: ruptures anterior ligaments
Mechanism of injury Compression fracture: crushed vertebrae, spinal
cord compression
Flexion - rotation: tearing of ligament structures that
stabilizes spine *most severe
cervical (7) thoracic (12) lumbar (5) sacral
level of injury of SCI
* cervical/lumbar most common due to greatest
flexibility/movement
Complete: total loss of sensory and motor function
below level of injury
degree of injury
Incomplete/partial: mix, loss of voluntary motor
activity and sensation, some tracts intact
CT scan, cervical x-rays (C7 and T1 hard to see), MRI
SCI diagnostic studies
(soft tissue) neurologic exam, CT angiogram
-Patent airway
-Adequate ventilation/breathing
-Adequate circulating blood volume
SCI immediate goals
-immobilize spine
-Medical sedation/restraints
-keep MAP >85
Respiratory: determine how well they breathe,
oxygen/suction, abdominal pressure, when
coughing, incentive spirometer, monitor breath
sounds
*Quad coughing
SCI NRSG Interventions
Skin care, VTE, prophylaxis, bladder/bowel
management, temp control, stress, ulcers,
fear/anxiety, impaired mobility
*log rolling
, Hemodynamic phenomenon, within 30 minutes of
injury at T5 or above, last up to 6 weeks, blood flow
to low, lose SNS
Neurogenic Shock -Trouble keeping heart rate, BP, temp stable
Results in: massive vasodilation> Pooling of blood
vessels> Tissue hypoperfusion> Impaired cellular
metabolism
inability to regulate core body temperature is
sweating/adding layers
Poikilothermic
tx: fluids (careful of overload), vasopressors(
bradycardia, hypotension) dopamine, epi/no epi,
atropine
Spinal cords response to inflammation caused by
injury
*Not hemodynamic
S/S: flaccid paralysis, loss of reflexes, paralytic,
Spinal shock absence of deep tendon reflexes, impaired
proprioception, decreased visceral and somatic
sensations, urinary and fecal retention, anhidrosis
(absence of sweating)
Keep MAP> 85, corticosteroids
Every Question
Save
Terms in this set (94)
7 cervical
12 thoracic
Spinal cord components 5 lumbar
5 sacral
4 coccygeal
Ages, 16/18, male, high risk activity, driving and
drinking, car accidents
Spinal cord injury risks
*C4,C5,C6,T12=most common
Damage to the spinal cord, resulting in functional
loss and mobility/sensation
Spinal injury
Results from = concussion, contusion, compression,
tearing, laceration, transection, ischemia
18 inches, nerves within cord carry messages from
Spinal cord brain> Spinal nerves> Upper motor neuron> And
back
Lower motor neuron, branch from the spinal cord to
specific areas of body
spinal nerve
Sensory: body to brain
Motor: back to body part to initiate action
1. mechanism of injury
Classification of SCI 2. level of injury
3. degree of injury
, Flexion: ruptures posterior ligaments
Hyper extension: ruptures anterior ligaments
Mechanism of injury Compression fracture: crushed vertebrae, spinal
cord compression
Flexion - rotation: tearing of ligament structures that
stabilizes spine *most severe
cervical (7) thoracic (12) lumbar (5) sacral
level of injury of SCI
* cervical/lumbar most common due to greatest
flexibility/movement
Complete: total loss of sensory and motor function
below level of injury
degree of injury
Incomplete/partial: mix, loss of voluntary motor
activity and sensation, some tracts intact
CT scan, cervical x-rays (C7 and T1 hard to see), MRI
SCI diagnostic studies
(soft tissue) neurologic exam, CT angiogram
-Patent airway
-Adequate ventilation/breathing
-Adequate circulating blood volume
SCI immediate goals
-immobilize spine
-Medical sedation/restraints
-keep MAP >85
Respiratory: determine how well they breathe,
oxygen/suction, abdominal pressure, when
coughing, incentive spirometer, monitor breath
sounds
*Quad coughing
SCI NRSG Interventions
Skin care, VTE, prophylaxis, bladder/bowel
management, temp control, stress, ulcers,
fear/anxiety, impaired mobility
*log rolling
, Hemodynamic phenomenon, within 30 minutes of
injury at T5 or above, last up to 6 weeks, blood flow
to low, lose SNS
Neurogenic Shock -Trouble keeping heart rate, BP, temp stable
Results in: massive vasodilation> Pooling of blood
vessels> Tissue hypoperfusion> Impaired cellular
metabolism
inability to regulate core body temperature is
sweating/adding layers
Poikilothermic
tx: fluids (careful of overload), vasopressors(
bradycardia, hypotension) dopamine, epi/no epi,
atropine
Spinal cords response to inflammation caused by
injury
*Not hemodynamic
S/S: flaccid paralysis, loss of reflexes, paralytic,
Spinal shock absence of deep tendon reflexes, impaired
proprioception, decreased visceral and somatic
sensations, urinary and fecal retention, anhidrosis
(absence of sweating)
Keep MAP> 85, corticosteroids
