Spinal Injury Levels
What spinal injury level causes total tetraplegia and ventilator dependence?
C1–C4
What is the most common cause of autonomic dysreflexia?
Bladder distention or bowel impaction
What steroid medication may be given in early SCI to reduce inflammation?
Methylprednisolone
What shock involves bradycardia, hypotension, and warm/dry skin from loss of sympathetic tone?
Neurogenic shock
What is the first priority assessment in a suspected spinal cord injury?
Airway and cervical spine stabilization
A patient can move their arms but has poor trunk control. Where is their likely level of injury?
T1–T6
What GI complication is associated with spinal cord injuries below T5?
Paralytic ileus
What external brace is commonly used for thoracic or lumbar spine stabilization?
TLSO brace
What shock causes flaccid paralysis, areflexia, and loss of sensation immediately after injury?
Spinal shock
What is the most important positioning principle for turning a patient with SCI?
Log rolling to maintain alignment
What spinal level is associated with bowel/bladder dysfunction but the ability to walk with assistive devices?
L1–L2 or L3–L4
What skin-related complication is common due to immobility and lack of sensation?
Pressure ulcers
What is the primary purpose of intermittent catheterization in SCI?
Prevent bladder overdistention and reduce UTI risk
How do you treat a sudden episode of autonomic dysreflexia? Name two steps.
Elevate HOB, remove cause like bladder distention, check BP, notify provider
What vital signs should be closely monitored in neurogenic shock?
Heart rate and blood pressure
At what injury level is diaphragmatic breathing preserved but intercostal muscle use reduced?
C4-C6
SCI patients are at high risk of this vascular issue due to immobility and lack of sensation.
Deep Vein Thrombosis / DVT
What device is used to stabilize cervical spine fractures externally with skull pins?
Halo traction device
What is the most reliable early indicator that spinal shock is resolving?
Return of reflexes like bulbocavernosus reflex
What education should be provided to a patient learning self-catheterization?
Sterile technique, frequency, signs of UTI
A patient with this injury level can move the neck and shrug shoulders but cannot breathe without assistance.
C2–C3
Name two signs of autonomic dysreflexia besides hypertension.
Pounding headache, bradycardia, flushing, sweating
Name three non-pharmacological nursing interventions to prevent respiratory complications in SCI.
Incentive spirometry, chest physiotherapy, assisted coughing, positioning
This injury above a certain level is most likely to cause neurogenic shock.
T6
What are three nursing actions to prevent pressure ulcers in a SCI patient?
Reposition q2h, use pressure-relief surfaces, inspect skin daily