Spinal Cord Injuries
What is spinal shock and how does it differ from neurogenic shock?
Spinal shock is the temporary loss of reflexes and motor/sensory function below the injury. Neurogenic shock involves hypotension and bradycardia from disrupted sympathetic pathways.
List the four cardinal symptoms of Parkinson’s Disease.
Tremor, rigidity, bradykinesia, postural instability.
Name two common risk factors for back injuries.
Poor posture, repetitive heavy lifting.
What signs during a meal would make you suspect dysphagia?
Coughing, choking, drooling, delayed swallowing.
What vital sign change is most concerning in autonomic dysreflexia?
Sudden severe hypertension.
Why does a C3 spinal cord injury require mechanical ventilation?
C3 and above injuries impair diaphragm control, necessitating mechanical ventilation.
Why should Sinemet not be taken with high-protein meals?
Protein interferes with levodopa absorption.
Describe correct body mechanics for lifting a box.
Bend at knees, keep back straight, hold object close.
What liquid modifications are typically needed for a Parkinson’s patient?
Thickened liquids to reduce aspiration risk.
Name 3 common triggers of autonomic dysreflexia.
Full bladder, constipation, tight clothing.
Describe early and late signs of autonomic dysreflexia.
Early: headache, flushing, nasal congestion. Late: hypertension, bradycardia, risk of stroke.
A patient shows involuntary movements after long-term carbidopa-levodopa. What is this and what’s your response?
Dyskinesia; notify provider to adjust dosage.
Compare conservative vs surgical treatment for herniated discs.
Conservative: rest, PT, meds. Surgical: discectomy, laminectomy, spinal fusion.
Describe 2 positioning strategies during and after meals to reduce aspiration risk.
Sit upright during meals and remain upright for 30 mins after.
What is the very first action a nurse should take?
Sit the patient up to lower blood pressure.
Your SCI patient is flushed, hypertensive, and has a headache. What’s your priority?
Sit the patient upright, check for triggers like bladder distension or tight clothing, notify provider.
What is your priority assessment during meals for a patient with Parkinson’s?
Monitor for signs of dysphagia and aspiration risk.
Your patient just had a spinal fusion. What are 3 key post-op nursing interventions?
Log rolling, neuro checks, monitor for CSF leak.
A patient refuses thickened liquids. How do you address this from a nursing perspective?
Educate on aspiration risks, collaborate with SLP, explore acceptable alternatives.
Why is hydralazine used in managing this condition?
It lowers blood pressure during a hypertensive crisis.
How does level of injury impact bowel and bladder training?
Higher injuries lead to spastic bowel/bladder; lower injuries can cause flaccid dysfunction.
Explain how to manage orthostatic hypotension in a Parkinson’s patient.
Encourage slow position changes, increase fluid/salt intake, possibly adjust medications.
What are signs of CSF leak after spinal surgery?
Clear drainage, headache when upright, nausea.
How does a speech-language pathologist help manage dysphagia in Parkinson’s?
Provides swallowing therapy, diet modification, and safety strategies.
What are the potential complications if not managed quickly?
Seizures, stroke, MI, retinal hemorrhage.