spinal cord injury

SoldierNurse22, BSN, RN · Jan 5, 2014

What complications does he have? How do YOU think they should be handled? What are your ideas?

rahulsharma · Jan 6, 2014

the common complications are pressure sores, DVT, orthostatic hypotension, neuropathic pain, spasticity, pulmonary complications. and they also have problem with coping the injury status.

SoldierNurse22, BSN, RN · Jan 6, 2014

Correct, those are common complications. So how would you handle them? Can this patient walk? Is he paralyzed? Does he move around with the assistance of a walker or wheelchair? Is there an accompanying brain injury that prevents him from caring for himself?

How would you treat those individual complications on their own? For instance, how do you prevent pressure sores and DVTs in a patient that can walk? What about in a patient that can't?

While we're happy to help at AN, we do expect to see effort put forth on your part in answering your own questions. How would you proceed in this patient's care?

nurseprnRN, BSN, RN · Jan 6, 2014

Understand that a good part of your faculty's reason for making this assignment is not to pin you down on THE perfect answers in order, but to see how well you research it on your own, make your decisions on priorities, and defend them with evidence from your search.

There are many excellent books that have good info on SCI. Two I use often are:

Blackwell et al., Spinal Cord Injury Desk Reference, focuses largely (but not exclusively) on medical diagnoses and physician-prescribed interventions but also looks at PT/OT, psych, and nursing

AANLCP Core Curriculum for Nurse Life Care Planning, chapter on SCI, based on nursing diagnoses found in SCI with a good summary of medical problems too

I have no financial interest in either work, and both are available in paperback at Amazon.

There should also be a good amount of information in your med/surg textbook, so before we do your homework for you (we don't do that), what are your ideas on priorities, and why?

PS. They aren't called "pressure sores" anymore, they're pressure ulcers.

SL2014 · Jan 6, 2014

Agree with this guy but also don't forget to address the ability of the patient to take care of themselves. Basic ADLs like brushing teeth and putting on deodorant but also how will they get around their home? Dive? What will their spouse do? Home safety teaching? (this is if this is a NEW dx for the most part).

Be sure to give more background when asking questions like this... How old is the patient? Is the a new injury or an old injury? What area of care? Inpatient? Skilled Nursing? Home care?

SoldierNurse22, BSN, RN · Jan 7, 2014

Agree with this guy

I'm actually a lady! :)

RunBabyRN · Jan 7, 2014

You really have to look at each patient and what's going on with THEM. Just because he has a spinal cord injury doesn't mean he has X, Y and Z going on. Does he have chronic pain? Does he have mobility? What is HIS situation?

nurseprnRN, BSN, RN · Jan 7, 2014

If this homework question is not connected to an actual live patient to assess, revert to my original post: Do your reading, come to some conclusions, and defend them.

OP, are you still there?

rahulsharma · Jan 8, 2014

The complications can be managed medically as well a proper education would be require for the patient to prevent himself from the complications.

As we all know spinal cord injury has 5 level in which AIS-A, AIS-B, AIS-C, AIS-D, AIS-E. Its means AIS-A is complete injury whereas all other are incomplete injury. The complete injury patients has only 2-3 percent chance to recover whereas other has 50 percent chance. So, complete injury require more attention.

uRNmyway, ASN, RN · Jan 8, 2014

The complications can be managed medically as well a proper education would be require for the patient to prevent himself from the complications.
As we all know spinal cord injury has 5 level in which AIS-A, AIS-B, AIS-C, AIS-D, AIS-E. Its means AIS-A is complete injury whereas all other are incomplete injury. The complete injury patients has only 2-3 percent chance to recover whereas other has 50 percent chance. So, complete injury require more attention.

Well this kinda sounds like you just copy-pasted something you saw in a book...can you give us something from you? Your interpretation, what YOU think would be issues? Think of what those different levels of injury would create? We tend to think of physical behaviors we can see. What about on the inside? What happens to someone's bladder, bowels, lungs, diaphragm, etc when you have an injury at the cervical level for instance? Try to tie in your A&P on this one.

RunBabyRN · Jan 8, 2014

Honestly, it sounds like you need some work on the critical thinking aspect of nursing, and looking at the patient holistically. If this is an actual patient, you need to look at THIS patient, not just categorize them and come up with some textbook answer. Your instructors shouldn't accept textbook answers, either. You're giving very broad, general information, and nothing about one specific patient, if that's the goal.

If you're asking how to care for spinal cord injury patients in general, it still varies. You need to consider the stuff you've posted, the textbook stuff, but you also need to consider what's going on with THAT patient, including psychosocial issues.