NURSING 101 Neuro_-_86_-_Case_Study

Neuro – 86 - Case Study Scenario: T.W. is a 22-year-old man who fell 50 feet (15 meters) from a chairlift while skiing and landed on hard-packed snow. He is now at the emergency department (ED) with spinal cord injury (SCI) with paraplegia from a suspected T5-T6 fracture. Chart View Physician’s Orders: ● Insert indwelling urinary catheter ● ECG monitoring ● Immobilize the cervical spine ● Oxygen at 4 L per nasal cannula ● Neurologic assessment every hour ● Apply warming blankets as needed 1. Describe a plan for implementing these orders. First I would immobilize the cervical spine to prevent further damage. Then give him oxygen 4l nasal cannula right away. A foley catheter should be inserted to help him pass his urine while being confined to a bed. Apply a warm blanket for him to stay warm. Hook him up to an ECG monitor and give him neurologic assessments every hour. 2. What are the nursing priorities at this time? To prevent any further spinal damage. He should be handled with care. Support provided with any movements. check his external stimulus often and maintain his airway. 3. Which assessment would you complete first? C a. Auscultating breath sounds b. Testing the peripheral reflexes c. Determining pupil response to light d. Assessing ability to move the extremities 4. What other interventions would likely be done by the ED nurse? assess B/P and support blood flow to the spinal cord. Diagnose if the patient has undergone any neurogenic shock. Assess for swelling in the spinal cord and get physical therapy help. 5. Awareness of the prehospital management of a SCI is critical to T.W.’s ultimate neurologic outcome. What actions will the nurse take to ensure this goal is met? This study source was downloaded by