SCI
Name some causes of SCI
vehicle crashes, falling, violence, sports, diving into shallow water
For a c1-c2 injury patients will be need to be on a ___________
ventilator
slide 14
loosening up tight clothes, having a bowel program, and using pillow to keep off pressure points are all useful ways to prevent :
autonomic dysreflexia
PTSD causes low levels of what 2 neurotransmitters?
norepinephrine malfunctions and cortisol remains normal
SSRIs like sertraline and and paroxetine are most often used in conjunction with psychotherapy for PTSD. what is a side effect nurses must educate patients about?
a) muscle pain
b) itching
c) fry skin
d) insomnia
D
common side effects of SSRIs are insominia, dizziness, drowsiness, anxiety, N/V/D and sexual dysfunction
select all the secondary injuries which are caused by a primary impact injury!
a) cord compression
b)ischemia
c)swelling
d)hemorrhage
e) interruption of blood supply
b, c, d
mendel ppt slide 7
c3-c4
so c1-c4
distended. lack of signal to empty bladder
T/F
PTSD involves exposure to a traumatic event and a person develops symptoms from any 2 out of the 4 categores: intruding thoughts, avoidance, arousal, negative thoughts
False
kallams slide says symptoms will fall into these 4 categories and will be present longer than a month to be diagnosed.
a client has been taking amitriptyline for 2 months and returns to the clinic for follow up. What serious side effect is important to observe for?
suicidal thoughts
tricyclic antidepressants
this type of injury leads to some loss of sensory and motor function below the injury
incomplete
may be able to still detect sensation and have function
what does compression of the cord and extension of edema increase?
swelling, damage, edema decrease blood supply and nutrients
pearson pg 966
this is a dangerous complication of patients with SCI due to immobility and decreased venous return
DVT and PE
A nurse observes a client who was a victim of a home invasion stand up startled when hearing a door shut loudly across the hall. The client could be experiencing what hallmark sign of PTSD?
the client was experiencing a flashback and associated the sound with the home invasion event.
flashbacks are intrusive thoughts one of the 4 signs
they can be images, sounds, smells, or feelings that are triggered by daily events
important to teach clients that take lithium to increase intakes of _______
fluids
prevent dehydration that increases toxicity
teaching: 2000-3000 ml a day
SATA: symptoms seen in a patient with autonomic dysreflexia
a) congested
b) flushed skin
c) restless
d) blurry vision
e) tachycardia
a b c d
e- its bradycardia and HTN says multiple sources
the __higher/lower____ the injury, greater loss of function
higher
This is the way to move a patient suspected of SCI
log roll
A client witnessed his brother be murdered. What signs could the client exhibit that point to PTSD? SATA
a) recurring nightmares
b) excessive sleep
c) aggressive behavior
d) associating everyday sounds with gunshots
e) excessive pulling out hair
a, c , d
a client taking an SSRI fluoxetine is experiencing fever, sweating, and anxiety. the client could be experiencing what serious side effect?
serotonin syndrome :hypertension, confusion, anxiety, high temperature
Edema in SCI is caused by an _________ response that worsens the primary injury
inflammatory.
some function may be improved when edema decreases
in terms of circulation: we would like for what complications due to a SCI
a) chest pain and MI
b) asp PNA and UTI
c) hemorrhage and neurogenic shock
d) pressure ulcers and bladder injury
c!
b and d are also complications but not because of circulation
drug given within 8 hours to prevent inflammation and improve blood flow
methylprednisolone
a) ask the client to explore their history of PTSD
b) assure the client they are safe
c) remove objects, cords, that could harm the client and others
d) tell the client that everything will be okay if they just get some rest
e) turn off the lights and close the door to provide a quiet and calm environment
b, c, e
a is not appropriate. clients with PTSD usually do not wish to talk about the event and the client is in a crisis
d clients with PTSD are usually unable to sleep and suffer from insomnia
A client asks the doctor if there is a medication she can take to reduce her fast heart beat when she has flashbacks. The provider might prescribe what medication for PTSD?
a new medication off label use for treating somatic s/s of PTSD anxiety like tachycardia and sweating