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Concept Table Spinal Cord Injury

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14 views2 pages

Concept Table Spinal Cord Injury

Uploaded by

minklesarah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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NURS 258 Concept Table

Disease Process/ Patient Problem: Spinal Cord Injury

What do I already know about this disease New Concepts/ Key considerations for this disease process:
process?
Basic  Typically caused by trauma to the  Caused by trauma or damage to the spinal cord
Pathophysiology: head/neck/back  Temporary or permanent alteration in spinal cord function
 Can be crush, whiplash,  Caused by MVAs, falls, violence, and sports injuries most
penetrating, or due to edema commonly
 May result in varying degrees of  May lead to secondary conditions such as neurogenic shock
disability  Flexion, hyperextension, compression, and flexion rotation injuries

Risk Factors:  High risk behaviors  Risk factors include those populations that may typically engage in
 Osteoporosis high risk behaviors such as adolescents, young adults, or males
 Previous spinal cord injury  People with osteoporosis or other previous spinal injuries are at
 Head trauma risk as they have less protection for their spinal cord in the event
 Significant mechanism of injury of an injury

Health  Avoid risky behaviors  Identify high risk people and provide education on injury
Promotion/  Seek medical attention prevention
Education: immediately after an injury to the  Use seatbelts, car seats, and avoid distracted or impaired driving
head/neck/back or with significant
mechanism
 Use equipment with spinal
protection when playing sports
such as football
Signs and  Difficulty breathing  Motor and sensory impairments
Symptoms  No gag reflex  Impaired respiration and cough
(Assessment cues  Paralysis  Bradycardia
the problem/  Pain below level of injury  Hypotension
disease process is  Sensory changes  Vasodilation
occurring):  Autonomic Dysreflexia  Neurogenic bladder
 Decreased GI motility and paralytic ileus
 Neurogenic bowel
 Impaired thermoregulation

Pertinent Labs/  MRI  CT


Diagnostics:  CT  Cervical x ray
 X ray  MRI for soft tissue damage
 CT angiogram to rule out additional injuries

Initial Treatment  Protect the airway  Maintaining and supporting the airway
(Nursing  Prevent movement or additional  Prevent secondary damage
interventions and injury to the spine  Sedation
Collaborative  Place a cervical collar and splint  Stabilization and decompression of the spine
Care to include spine while supine on bed  Surgical treatment to stabilize spine
medications):  Steroids to reduce/prevent swelling  Methylprednisolone
 Antibiotics for open injuries  Heparin

Special Nursing  May require long periods of PT/OT  May require extensive external splinting for long periods of time
Considerations/ to regain some function  Patients will likely need assistance with ADLs
Patient advocacy:  Permanent disability is common  All SNS functions will be impaired with a high thoracic or cervical
spine injury

What do I want to learn more about?

 I want to learn more about emergency use of steroids for spinal cord injuries. Currently, the results are mixed on the use of
methylprednisolone to reduce spinal swelling. I wonder if a different steroid or another anti-inflammatory agent would prevent
further harm.

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