NUR 2212 Final
Spinal Cord Injury - answer Pathophysiology: Damage to the spinal cord injury (SCI)
include: transient concussion from which the client fully recovers, contusion, laceration
and compression of the spinal cord, and complete transection of the spinal cord which
results in paralysis below the level of the injury. The vertebrae that are often affected
are C5-C7, the 12th thoracic vertebrae, and L1.
Primary Injuries: These injuries are the result of the initial injury, or trauma and are
usually permanent.
Secondary Injuries: Include edema and hemorrhage.
Early interventions are essential to prevent partial damage from becoming total or
permanent. They result in ischemia, hypoxia, edema and hemorrhagic lesions.
These injuries are usually reversible during the first 4-6 hours after the injury. They can
result in the destruction of the myelin sheet and axons.
ASIA classifies the levels of spinal cord injuries as:
Neurological Level - The lowest level at which sensory and motor functions are intact.
Below the Neurological Level - these may be total or partial sensory and motor
paralysis. Loss of bladder and bowel control, loss of sweating and vasomotor tone, and
reduction of blood pressure from loss of peripheral vascular resistance.
Impairment Scale:
A=Complete- No motor or sensory function is preserved in the sacral segments S4-S5.
B=Incomplete- Sensory but no motor function is preseved below the neurological level
and includes the sacral segments S4-S5.
C=Incomplete- Motor function is preserved below the neurological level, and more than
half of key muscles below the neurological level have a muscle grade less than 3.
D=Incomplete- Motor function is preserved below the neurological level, and at least
half of key muscles below the neurological level have a muscle grade of 3 or more.
E=Normal Motor and sensory function are normal.
C4 injury (quadrip
Spinal Cord 2 - answerSpinal shock
Book: Can last 24 hours to 1 to 6 weeks. The Brian is unable to transmit signals to
muscles and organs, resulting in loss of sensation, movement, and other body
functions. Clinical manifestations include flaccid paralysis of all skeletal muscles,
absence of deep tendon reflexes, impaired proprioception, decreased visceral and
somatic sensations, penile reflex, urinary and fecal retention, anhidrosis, and paralytic
ileum
refers to a clinical syndrome characterized by the loss of reflex, motor and sensory
function below the level of a spinal cord injury (SCI). In some instances (possibly when
, lesion is T6 or higher), this syndrome is associated with loss of autonomic tone leading
to hypotension, hypothermia and illeus.
Autonomic dysreflexia
Levels of care (e.g. cervical, thoracic): Patients with a high cervical spinal injury require
immediate ventilatory support.
Care and management of clients with spinal cord injury
Burn Injuries - answerChemical burns - chemical burns are caused by contact with
either an acid, an alkali or an organic compound. Management of burns caused by
alkalis Many clients who present with chemical burns are unaware of the nature of the
substance that caused the burn.
The cardiovascular system - usually underpinned by circulatory disturbances. In
circumferential burns which result in eschar, severe edema may also obstruct blood
supply to the tissues; this is often managed using an escharotomy.
The renal system is usually secondary to hypovolemia, resulting in renal ischemia and
acute tubular necrosis. With severe burns, myoglobin and hemoglobin may contribute to
acute tubular necrosis.
Electrical burns are predominately internal; therefore, The client is at risk of
complications such as: Dysrhythmia, cardiac arrest, severe metabolic acidosis, and
myoglobinuria leading to acute renal failure.
Exposure to extreme cold results in cold burns, including frostbite. Frostbite occurs
when the tissues freeze. Deep frostbite - involves acute peripheral vasoconstriction, the
formation of ice crystals in the intracellular spaces of the deep tissues and the
destruction of cell membranes - resulting in tissue death, and possible amputation.
Classifications of Burns:
Superficial - First degree burn
Superficial Partial Thickness - Second degree burn. Deep Partial Thickness - Third
degree burn.
Deep full thickness
SUPERFICIAL (1ST DEGREE): EPIDERMIS Cause - sunburn, low intensity flash
Symptoms - tingling, hyperesthesia, painful, soothed with cooling
Appearance - reddened, blanches with pressure, minimal- No edema
Course - complete recovery within a week, peeling
PARTIAL THICKNESS (2ND DEGREE), EPIDERMIS & PART OF DERMIS
Cause - scalds, flash flame
Symptoms - painful, sensitive to cold
Spinal Cord Injury - answer Pathophysiology: Damage to the spinal cord injury (SCI)
include: transient concussion from which the client fully recovers, contusion, laceration
and compression of the spinal cord, and complete transection of the spinal cord which
results in paralysis below the level of the injury. The vertebrae that are often affected
are C5-C7, the 12th thoracic vertebrae, and L1.
Primary Injuries: These injuries are the result of the initial injury, or trauma and are
usually permanent.
Secondary Injuries: Include edema and hemorrhage.
Early interventions are essential to prevent partial damage from becoming total or
permanent. They result in ischemia, hypoxia, edema and hemorrhagic lesions.
These injuries are usually reversible during the first 4-6 hours after the injury. They can
result in the destruction of the myelin sheet and axons.
ASIA classifies the levels of spinal cord injuries as:
Neurological Level - The lowest level at which sensory and motor functions are intact.
Below the Neurological Level - these may be total or partial sensory and motor
paralysis. Loss of bladder and bowel control, loss of sweating and vasomotor tone, and
reduction of blood pressure from loss of peripheral vascular resistance.
Impairment Scale:
A=Complete- No motor or sensory function is preserved in the sacral segments S4-S5.
B=Incomplete- Sensory but no motor function is preseved below the neurological level
and includes the sacral segments S4-S5.
C=Incomplete- Motor function is preserved below the neurological level, and more than
half of key muscles below the neurological level have a muscle grade less than 3.
D=Incomplete- Motor function is preserved below the neurological level, and at least
half of key muscles below the neurological level have a muscle grade of 3 or more.
E=Normal Motor and sensory function are normal.
C4 injury (quadrip
Spinal Cord 2 - answerSpinal shock
Book: Can last 24 hours to 1 to 6 weeks. The Brian is unable to transmit signals to
muscles and organs, resulting in loss of sensation, movement, and other body
functions. Clinical manifestations include flaccid paralysis of all skeletal muscles,
absence of deep tendon reflexes, impaired proprioception, decreased visceral and
somatic sensations, penile reflex, urinary and fecal retention, anhidrosis, and paralytic
ileum
refers to a clinical syndrome characterized by the loss of reflex, motor and sensory
function below the level of a spinal cord injury (SCI). In some instances (possibly when
, lesion is T6 or higher), this syndrome is associated with loss of autonomic tone leading
to hypotension, hypothermia and illeus.
Autonomic dysreflexia
Levels of care (e.g. cervical, thoracic): Patients with a high cervical spinal injury require
immediate ventilatory support.
Care and management of clients with spinal cord injury
Burn Injuries - answerChemical burns - chemical burns are caused by contact with
either an acid, an alkali or an organic compound. Management of burns caused by
alkalis Many clients who present with chemical burns are unaware of the nature of the
substance that caused the burn.
The cardiovascular system - usually underpinned by circulatory disturbances. In
circumferential burns which result in eschar, severe edema may also obstruct blood
supply to the tissues; this is often managed using an escharotomy.
The renal system is usually secondary to hypovolemia, resulting in renal ischemia and
acute tubular necrosis. With severe burns, myoglobin and hemoglobin may contribute to
acute tubular necrosis.
Electrical burns are predominately internal; therefore, The client is at risk of
complications such as: Dysrhythmia, cardiac arrest, severe metabolic acidosis, and
myoglobinuria leading to acute renal failure.
Exposure to extreme cold results in cold burns, including frostbite. Frostbite occurs
when the tissues freeze. Deep frostbite - involves acute peripheral vasoconstriction, the
formation of ice crystals in the intracellular spaces of the deep tissues and the
destruction of cell membranes - resulting in tissue death, and possible amputation.
Classifications of Burns:
Superficial - First degree burn
Superficial Partial Thickness - Second degree burn. Deep Partial Thickness - Third
degree burn.
Deep full thickness
SUPERFICIAL (1ST DEGREE): EPIDERMIS Cause - sunburn, low intensity flash
Symptoms - tingling, hyperesthesia, painful, soothed with cooling
Appearance - reddened, blanches with pressure, minimal- No edema
Course - complete recovery within a week, peeling
PARTIAL THICKNESS (2ND DEGREE), EPIDERMIS & PART OF DERMIS
Cause - scalds, flash flame
Symptoms - painful, sensitive to cold
