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Exam (elaborations)

NU410 Exam 3 Guide With Complete Solution

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NU410 Exam 3 Guide With Complete Solution...

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  • September 17, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • nu410 exam 3 guide
  • NU410
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NU410 Exam 3 Guide With
Complete Solution

Incomplete SCI - ANSWER - Some function remaining below primary site of
injury

- Motor and sensory are partially interrupted with vlibre franklinble loss of
function below level of injury

- Degree of sensory and motor loss varies on level and reflects specific nerve
tracts damaged and those spared

- May demonstrate a mixture of symptoms

Assessment and Diagnostic Findings of Spinal Cord Injury (SCI) - ANSWER -
Detailed Neuro Assessment

- X-Rays

- CT scan

- MRI (myelogram if contraindicated)

- Continuous Cardiac Monitoring

Emergency Management of Spinal Cord Injury (SCI) - ANSWER - Rapid
Assessment

- Immobilization

- Extrication

- Stabilization

,- Transport

Medical Management (Acute Phase) of Spinal Cord Injury (SCI) - ANSWER -
Respiratory Therapy

- Diaphragmatic pacing

- Skeletal Fracture Reduction and Traction

- Surgical Management

- Pharmacologic Therapy

Care of client with Halo Device for Spinal Injury - ANSWER - Ensure that
wrench to release rods is attached to vest when using halo traction in the
event CPR is necessary

- Maintain body alignment and ensure cervical tong weights hang freely

- Monitor skin integrity by providing pin care and assessing skin under halo
fixation vest as appropriate

- Don't use halo device to turn or move a client

- If client goes home with a halo fixation device on, provide instruction on
pin and vest care

- Teach client signs of infection and skin breakdown

Halo Device Nursing Considerations - ANSWER - Ensure pulley is free of
knots, fraying and loosening every 8-12 hours

- Notify provider if patient experiences severe pain from muscle spasms
(unrelieved by meds or positioning)

- Assess neurovascular every hour for 24 hours

,- Provide pin care once a shift, 1-2 times a day

A nurse is preparing to discharge a client who has halo device and is
reviewing new prescriptions from the provider. The nurse should clarify
which of the following prescriptions with the provider?

a. Increase intake of fiber-rich foods

b. May place a small pillow under head when sleeping

c. May operate a motor vehicle when no longer taking analgesics

d. Take a tub bath instead of showers - ANSWER c. May operate a motor
vehicle when no longer taking analgesics

Complications of Spinal Cord Injury (SCI) - ANSWER - Spinal Shock

- Neurogenic Shock

- Autonomic Dysreflexia

Spinal Shock - ANSWER - Spinal cord's response to inflammation caused by
the SCI (secondary injury)

- A sudden loss of reflex activity below level of spinal injury

- Muscular flaccidity, lack of sensation and reflexes

- Client can have hypotension and bradycardia

- Reflexes that initial bowel and bladder function affected, bowel distension
and paralytic ileus occur

Spinal Shock Care - ANSWER - Keeping mean arterial pressure at least 85 mm
Hg can prevent further damage to spinal cord

, - NG tube

- Control of hypotension & bradycardia w/meds

Neurogenic Shock - ANSWER - Caused by loss of function of autonomic
nervous system

- Loss of communication with sympathetic nervous system cause
bradycardia, hypotension, dependent edema, loss of temperature regulation

- Massive venous pooling occurs because of peripheral vasodilation
(distributive shock)

- Paralyzed portions of body do not perspire

Neurogenic Shock Nursing Actions - ANSWER Treat adverse findings with
appropriate medications (vasopressors or atropine) and IV fluids

Autonomic Dysreflexia - ANSWER - Life-threatening HTN emergency

- Excessive uncontrolled sympathetic output caused by a stimulus

- Typically SCI above T6

- Seizures, cerebral hemorrhage, stroke, heart attack can result if not treated

Autonomic Dysreflexia S/S - ANSWER - Bradycardia, hypertension

- Anxiety, restlessness severe pounding H/A

- Nasal stuffiness/congestion

- Red blotches on skin

- Muscle spasms

- Flushed warm skin with profuse sweating above lesion and pale, cold, and

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