NURS 3290 Lecture Notes - Lecture 26: Neurogenic Bladder Dysfunction, Neurogenic Shock, Flaccid Paralysis
13 Apr 2016
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Assessments must be frequent, bilateral (compare side to side), compare to previous assessment. Motor vehicle accidents, violence, falls, sports, alcohol, drugs, risk takers. Decreased sns > bradycardia, vasodilaion causes hypotension, hypovolemia because of increased venous capacity. Iv luids to manage bp and spinal cord perfusion. Paralysis of abdominal muscles/intercostals (cannot cough efecively, risk for atelectasis and pneumonia) A complete: no sensory or motor funcion in s4-s5. B sensory incomplete: sill have sensory funcion below level of injury. C motor incomplete: sill have motor funcion below level, muscle grade <3. D motor incomplete: same, with a muscle grade more than 3. E normal: sensory and motor funcion are normal. Secondary: ongoing damage prevented by immobilizaion & methylprednisone. Loss of vasomotor tone due to t5 or higher injury. Loss of sns> peripheral vasodilaion, venous pooling, decreased cardiac output. Compression of anterior spinal cord due to lexion injury. Motor paralysis, loss of pain and temperature below injury.
