©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
NRSG 421 Final Exam Questions With
Verified Answers
Spinal cord components - answer✔7 cervical
12 thoracic
5 lumbar
5 sacral
4 coccygeal
Spinal cord injury risks - answer✔Ages, 16/18, male, high risk activity, driving and drinking, car
accidents
*C4,C5,C6,T12=most common
Spinal injury - answer✔Damage to the spinal cord, resulting in functional loss and
mobility/sensation
Results from = concussion, contusion, compression, tearing, laceration, transection, ischemia
Spinal cord - answer✔18 inches, nerves within cord carry messages from brain> Spinal nerves>
Upper motor neuron> And back
spinal nerve - answer✔Lower motor neuron, branch from the spinal cord to specific areas of
body
Sensory: body to brain
Motor: back to body part to initiate action
, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
Classification of SCI - answer✔1. mechanism of injury
2. level of injury
3. degree of injury
Mechanism of injury - answer✔Flexion: ruptures posterior ligaments
Hyper extension: ruptures anterior ligaments
Compression fracture: crushed vertebrae, spinal cord compression
Flexion - rotation: tearing of ligament structures that stabilizes spine *most severe
level of injury of SCI - answer✔cervical (7) thoracic (12) lumbar (5) sacral
* cervical/lumbar most common due to greatest flexibility/movement
degree of injury - answer✔Complete: total loss of sensory and motor function below level of
injury
Incomplete/partial: mix, loss of voluntary motor activity and sensation, some tracts intact
SCI diagnostic studies - answer✔CT scan, cervical x-rays (C7 and T1 hard to see), MRI (soft
tissue) neurologic exam, CT angiogram
SCI immediate goals - answer✔-Patent airway
-Adequate ventilation/breathing
-Adequate circulating blood volume
-immobilize spine
-Medical sedation/restraints
-keep MAP >85
, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
SCI NRSG Interventions - answer✔Respiratory: determine how well they breathe,
oxygen/suction, abdominal pressure, when coughing, incentive spirometer, monitor breath
sounds
*Quad coughing
Skin care, VTE, prophylaxis, bladder/bowel management, temp control, stress, ulcers,
fear/anxiety, impaired mobility
*log rolling
Neurogenic Shock - answer✔Hemodynamic phenomenon, within 30 minutes of injury at T5 or
above, last up to 6 weeks, blood flow to low, lose SNS
-Trouble keeping heart rate, BP, temp stable
Results in: massive vasodilation> Pooling of blood vessels> Tissue hypoperfusion> Impaired
cellular metabolism
Poikilothermic - answer✔inability to regulate core body temperature is sweating/adding layers
tx: fluids (careful of overload), vasopressors( bradycardia, hypotension) dopamine, epi/no epi,
atropine
Spinal shock - answer✔Spinal cords response to inflammation caused by injury
*Not hemodynamic
S/S: flaccid paralysis, loss of reflexes, paralytic, absence of deep tendon reflexes, impaired
proprioception, decreased visceral and somatic sensations, urinary and fecal retention, anhidrosis
(absence of sweating)
Keep MAP> 85, corticosteroids
