Delegation
The nurse has a patient assigned with a C-4 spinal injury. Can the nurse delegate assisting the patient with meals to the UAP?
Yes
If you see someone unconscious after falling off of a ladder, what is the first thing you should do to the patient?
Immobilize them
What is the first diagnostic that should be done?
CT scan
Where did Mr. M have his spinal cord injury?
C4-C5
Respiratory therapist, anesthesiologist/CRNA
The patient is reporting a mild headache. To which member of the healthcare team can be delegated the task of administering an oral pain medication?
LPN/LVN
The patient is on a bowel retraining regimen. How often should you offer the bed pan?
Every two hours
What lab would you want to check if the patient's oxygen saturation drops below 92% with shallow respirations, like in the case of Mr. M?
An injury at what vertebrae will affect breathing ability?
Injuries at C3 and above
dysphagia
Which nursing task would be most appropriate for the nurse to delegate to the unlicensed nursing personnel?
A) teach Crede's maneuver to client needing to void
B)Administer tube feeding to client who is a quadriplegic
C) Assist with bowel training by placing client on commode
D) Observe the client demonstrating self catheterization technique
C)Assist with bowel training by placing client on commode
What are the priorities of care in an acute phase of an SCI?
Preserve life function
Maintain alignment
prevent complications
support the client's and family's ability to cope
Which diagnostic test is the most accurate in locating a spinal cord injury without bone fractures?
MRI
A patient is admitted to the ED with a SCI at the level of T2. Which finding is of most concern to the nurse?
A. SpO2 of 92%
B. HR of 42 bpm
C. BP of 88/60 mmHg
D. Loss of motor and sensory function in arms and legs
B. Neurogenic shock associated with SCI above the level of T6 generally decreases the effect of the SNS and bradycardia and hypotension occur. A HR of 42 bpm is not adequate to meet the oxygen of the body
A patient experiences depression of reflexes below the level of an SCI, losing bowel and bladder control. What is the patient experiencing?
Spinal shock
You are the charge nurse on the neuro floor getting a new admission of an acute SCI also exhibiting signs of neurogenic shock. Which member of the team would you assign this patient
A) An LPN who has been on floor for 5 years
B) Travel Nurse
C) A float nurse from L&D
D) An experienced nurse who has been on this floor for 3 years
D) An experienced nurse who has been on this floor for 3 years
What medication/treatment would be started on a patient with a spinal cord injury that is immobilized in the hospital?
Lovenox
SCDs
What type of X-ray would be ordered for Mr. M (injury at C4-C5)?
lateral cervical spinal x-ray
Which area of the spinal cord falls within the sympathetic nervous system? (Fight or flight)
the T1-L2-L3 segment
The patient develops hypotension, bradycardia, and venous pooling in the extremities. What is the patient experiencing?
neurogenic shock!
What pretreatment medication can be given to prevent complications while intubating a tetraplegic?
Atropine
IV fluid bolus to prevent hypotension
What labs would you draw to evaluate the level of shock?
ABG --> specifically if there is a base deficit
Lactate
Which area of the spinal cord falls within the parasympathetic nervous system? (Rest and digest)
Brainstem and the S2-S4 segment
What complications can you anticipate during the intubation of a tetraplegic?
Bradycardia, hypotension