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Help With A Trauma Patient Case



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  #1  
Old Nov 14, 2006, 02:47 AM
Registered User
Join Date: Sep 2006
Help With A Trauma Patient Case

Hi, i need help with this case my instructor gave use. A patient who has spinal cord injury has not voided for 6-8 hours, it is a medical injury, what do you call that medical injury and what would you do? When doing my research i came across spinal shock and AUTONOMIC DYSREFLEXIA. Could the patient be having AD? i am not so sure with my answer if it is right , please someone help me if i am on the right track. Unfortunately that is the only info my teacher gave and no specifics. THank you in advance

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  #2  
Old Nov 14, 2006, 06:56 AM
JentheRN05's Avatar
Just Jen 2 U
Join Date: Aug 2005
Re: Help With A Trauma Patient Case

sounds like AD but there's other symptoms to watch for as well. good luck

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  #3  
Old Nov 14, 2006, 09:21 AM
AuntieRN's Avatar
AuntieRN (Female)
Finally..an RN!
Join Date: May 2005
Re: Help With A Trauma Patient Case

I agree with JentheRN05. Sounds like AD.

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  #4  
Old Nov 19, 2006, 06:45 PM
Dinith88 (Male)
Registered User
Join Date: Jul 2003
Re: Help With A Trauma Patient Case

Originally Posted by Leng27 View Post
Hi, i need help with this case my instructor gave use. A patient who has spinal cord injury has not voided for 6-8 hours, it is a medical injury, what do you call that medical injury and what would you do? When doing my research i came across spinal shock and AUTONOMIC DYSREFLEXIA. Could the patient be having AD? i am not so sure with my answer if it is right , please someone help me if i am on the right track. Unfortunately that is the only info my teacher gave and no specifics. THank you in advance

NO. Not Autonomic Dysreflexia

The answer is probably neurogenic bladder. Neurogenic bladder is an inability to void d/t nerve damage (in this case it's trauma).

Autonomic Dysreflexia is more of a systemic response (seen in spinal cord injury) ...which can be triggered by various stuff...and can be an emergency
because of hypertensive crisis.

just google 'neurogenic bladder' and 'autonomic dysreflexia'.

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  #5  
Old Nov 19, 2006, 06:51 PM
Dinith88 (Male)
Registered User
Join Date: Jul 2003
Re: Help With A Trauma Patient Case

Originally Posted by Dinith88 View Post
NO. Not Autonomic Dysreflexia

The answer is probably neurogenic bladder. Neurogenic bladder is an inability to void d/t nerve damage (in this case it's trauma).

Autonomic Dysreflexia is more of a systemic response (seen in spinal cord injury) ...which can be triggered by various stuff...and can be an emergency
because of hypertensive crisis.

just google 'neurogenic bladder' and 'autonomic dysreflexia'.

just a clarification in case you mean something different... autonomic dysreflexia can be CAUSED by an over-full bladder in spinal-cord injured patients.... but to say a spinal-cord injured patient is having AD because
he hasnt voided is wrong...

(The only symptom you give is innability to void)

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  #6  
Old Nov 19, 2006, 06:54 PM
Tweety's Avatar
Tweety (Male)
Admin Team
Join Date: Oct 2002
Re: Help With A Trauma Patient Case

Originally Posted by Dinith88 View Post
just a clarification in case you mean something different... autonomic dysreflexia can be CAUSED by an over-full bladder in spinal-cord injured patients.... but to say a spinal-cord injured patient is having AD because
he hasnt voided is wrong...

(The only symptom you give is innability to void)

Agree. The inability to void is probably neurogenic.

A full bladder can lead to AD, but the OP hasn't listed any of the symptoms of AD.

The OP can focus on the fact that the bladder needs to be emptied to prevent this complication.

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  #7  
Old Jan 30, 2007, 12:59 PM
SEOBowhntr (Male)
Registered User
Join Date: Aug 2005
Re: Help With A Trauma Patient Case

Originally Posted by Tweety View Post
Agree. The inability to void is probably neurogenic.

A full bladder can lead to AD, but the OP hasn't listed any of the symptoms of AD.

The OP can focus on the fact that the bladder needs to be emptied to prevent this complication.
Agreed, but I've also seen patients who had pretty severe vasovagal responses after an inability to void and having very full bladders. One case the patient was scanned for 1500cc's of Urine!!!!! Bad thing about him was that we had to have a urologist do numerous dilitations to even place a catheter, which made him all that much more miserable!!!

With the vague information, there are more questions than answers. Was the patient hyper- or hypotensive????


Last edited by SEOBowhntr : Jan 30, 2007 at 01:20 PM.
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  #8  
Old Jan 30, 2007, 02:28 PM
BBFRN's Avatar
PhD student
Join Date: May 2002
Re: Help With A Trauma Patient Case

I agree that it's neurogenic bladder. The pt has only gone 6-8 hrs without voiding. I do that every day at work...lol.

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  #9  
Old Jan 31, 2007, 09:54 AM
Registered User
Join Date: Jan 2007
Re: Help With A Trauma Patient Case

I agree...neurogenic bladder

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