Medical Surgical Nursing

(Tina Sui) #1

and bowel control (usually with urinary retention and bladder distention), loss of


sweating and vasomotor tone, & marked reduction of blood pressure.


— Complete spinal cord lesion (total loss of sensation and voluntary muscle control


below the lesion): paraplegia or tetraplegia.


— If conscious, the patient usually complains of acute pain in the back or neck


Spinal and Neurogenic Shock



  • Spinal shock

  • A sudden depression of reflex activity below the level of spinal injury

  • develops due to the loss of autonomic nervous system function below the level of the


lesion



  • Muscular flaccidity, lack of sensation and reflexes

  • Neurogenic shock

  • Due to the loss of function of the autonomic nervous system

  • Blood pressure, heart rate, and cardiac output decrease

  • Venous pooling occurs due to peripheral vasodilation

  • Paralyzed portions of the body do not perspire


Medical Management: Acute Phase



  • Goals:

  • Prevent further SCI and observe for signs of neurological deficit

  • High dose corticosteroids (controversial)

  • Research is continuing


Medical management:



  • Pharmacologic therapy

  • Respiratory therapy

  • Skeletal fracture reduction and traction

  • Surgical management

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