Nursing Diagnosis y y y y y y y Ineffective breathing patterns related to weakness or paralysis of abdominal and intercostals muscles.

Ineffective airway clearance related to weakness of intercostals muscles. Impaired physical mobility related to motor and sensory impairment. Disturbed sensory perception related to motor and sensory impairment Risk for impaired skin integrity related to immobility and sensory loss Urinary retention related to inability to void spontaneously Acute pain and discomfort related to treatment and prolonged immobility

Treatment y Immediate immobilization on a rigid board to stabilize the spine and prevent further cord damage(primary treatment); use of head blocks on both sides of the patient¶s head, a hard cervical collar, or skeletal traction with skull tongs or a halo device for cervical injuries. Methylprednisolone(Solu-Medrol) to reduce inflammation with evidence of cord injury Bed rest on firm support (such as bed board) Laminectomy and spinal fusion for severe or unstable lumbar fracture. Exercises to strengthen the back muscles and back brace or corset to provide support while walking.

y y y y

Management of Spinal Cord Injury Emergency Management y Initial care must include a rapid assessment, immobilization, stabilization or control of life-threatening injuries, and transportation to the most appropriate medical facility. At the scene of the injury, the patient must be immobilized on a spinal (back) board, with head and neck in a neutral position, to prevent an incomplete injury from becoming complete.

y

Surgical Management (indicated in the following instances) y y y y y Compression of the cord is evident The injury results in a fragmented or unstable vertebral body The injury involves a wound that penetrates the cord There are bony fragments in the spinal canal The patient¶s neurologic status is deteriorating

Often, surgery is necessary to remove fragments of bones, foreign objects, herniated disks or fractured vertebrae that appear to be compressing the spine. Surgery may also be needed to stabilize the spine to prevent future pain or deformity.

or specially trained carers give supportive care. Turning not only assists in the prevention of pressure ulcers but also prevents the pooling of blood and tissue fluid in the dependent areas. Maintaining urinary elimination Improving bowel function Providing comfort measures y y y y y y Rehabilitation Once the patient is stabilised. Improving mobility Patient is turned every 2 hours. and counselling for emotional support. and other assistance. Rehabilitation often includes physical therapy. Specific breathing exercises are supervied by nurse to increase strength and endurance of the inspiratory muscles. Assisted coughing promotes clearing of secretions from upper respiratory tract. Promoting adaption to sensory and perceptual alterations Teaching the patient strategies to compensate for or cope with these deficits. This care might include helping the patient bathe. occupational therapy. Provide emotional support. Maintain skin integrity The patient¶s position is changed at least every 2 hours. but caution must be used during suctioning because this procedure can stimulate vagus nerve. Each program is designed to meet the patient's unique needs.Nursing Intervention y Promoting adequate breathing and airway clearance Suctioning may be indicated. Family members. rinsed well. change positions to prevent bedsores. and blotted dry. nurses. . care and treatment focuses on supportive care and rehabilitation. The patient¶s skin should be kept clean by washing with a mild soap. dress.

FAR EASTERN UNIVERSITY Institute of Nursing SPINAL CORD INJURY (Philippine Orthopedic Center) Submitted to: Submitted by: BSN 207 ± Group 25 Cadsawan. Cahucom. Romina Anna J. Mei Jellyn R. .

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