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VSIM FOR NURSING|FUNDAMENTALS-Kim Johnson 2021

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DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) Spinal Cord Injury is damage to the spinal cord caused by fracture, contusion, dislocation, subluxation or compression of the nerv ...

DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) Spinal Cord Injury is damage to the spinal cord caused by fracture, contusion, dislocation, subluxation or compression of the nerves. Most common sites can be C5, C6, C7, T12, L1, L4-L5, and L5-S1 vertebrae. The classification of spinal cord injury could be Paraplegia: spinal cord injury that occurs in the thoracic, lumbar, or sacral segments and involves paralysis in the lower half of the body. Pathophysiology: Injury causes compression, pulling, twisting, or tearing of the cord, resulting in microscopic hemorrhages. Edema causes spinal cord compression, further decreasing the blood supply. Spinal nerves are blocked or tangled; ischemia continues due to damage or impingement. DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS) PATIENT INFORMATION ANTICIPATED PHYSICAL FINDINGS ANTICIPATED NURSING INTERVENTIONS  Wash hands, introduce self, and identify patient  Obtain vital signs, including asking about allergies and pain level every 8 hours  Auscultate lung sounds  Check the provider’s orders in the electronic health record (EHR)  Provide patient education about intake and output  Provide patient education about the bladder management program  Provide patient education about Antiemobolism stockings  Call for secondary nurse to help to change patient position  Perform Bladder scan before catheterization  Arterial blood gas analysis may identify respiratory impairment.  Creatinine level (serum), monitor the renal function  Level of injury and any spinal cord damage located by neurologic assessment  Limited range of motion (ROM)  Bladder incontinence  Bowel incontinence Kim Johnson is a 26-yearold female police officer with paraplegia from a thoracic 8 (T8) spinal cord injury. The complete spinal cord injury was caused by a low- velocity gunshot wound to her back  Perform intermittent catheterization  Perform active and passive range of motion exercise to the extremities  Provide clear explanations and emotional support; encourage the use of positive coping strategies  Turn and reposition the patient regularly and frequently...........................continued

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