Question

I. Read Chapters 48 and 49 from your Textbook

II. NCLEX REview Questions Chapters 48 and 49 from Evolve Resources

III. Spinal Cord Injury

Adam is a 6-year-old boy who dove head first in the shallow end of a swimming pool. Unable to move, he sank to the bottom of the pool and was rescued by his mother. His father called the emergency medical services (EMS) while the mother provided mouth-to-mouth resuscitation. The EMS arrived and continued the resuscitation and placed him in a cervical collar. Adam was placed on a backboard and began to breathe on his own while en route to a trauma center. Neurologic assessment revealed paralysis of the upper and lower extremities, and cervical spine x-ray images and a magnetic resonance image (MRI) confirmed a C6-C7 complete transection injury. The patient was intubated before going into surgery for decompression of the injury.

Into what types of shock could the patient go? What symptoms did the patient exhibit?

For which complications of a spinal cord injury will the nurse assess?

What procedures would you anticipate for long-term rehabilitative management?

Answer 1

1. Patient may go into neurogenic shock

Emergency symptoms

Extreme back pain

Incoordination or paralysis of body parts

Numbness

Loss of bladder or bowl control

Impaired breathing

Other symptoms - nausea , vomiting , dizziness

Severe cases -

Difficulty in breathing ,chest pain , faint pulse , sexual dysfunction , automatic dysreflexia

2 nurse access to respiratory problems , reflexs , muscle test and rsmge of Motion

3. Airway , disability , breathing , circulation ,expose

High dose corticosteroid

Orthopedic management - reduction , fixation , fusion

Reduction - with reduction spine is realigned

Fixation involves stabilization of fractured parts

Fusion involves attachment of fractured with non fractured one

physiotherapy Goals

Relieve pain

maintain optimal level of wellness

maintain optimal functioning

Learn new skills

Self care

Integrate back to community