Reference no: EM133241817

Compare and contrast spinal cord injury and Parkinson's disease

Spinal Cord Injury 

Patient Profile

M.P., a 19-year-old African American male, has a spinal cord injury following a gunshot wound 2 weeks ago. The gunshot injury occurred during a hunting accident when his best friend's gun was accidentally discharged. His injury is at the T5 level. The goal is to prepare him for transfer to a rehabilitation unit in the next few days. 

Subjective Data

• Has just completed his first year of college as an engineering student
• States he is depressed and "he cannot get used to the idea of not walking again" 

Objective Data

Physical Examination

• Supine blood pressure 120/68, sitting blood pressure 114/62, pulse 68, temperature 99.8° F, respirations 16
• Slight edema bilateral lower extremities - ace wraps wrapped around lower extremities
• Abdominal binder in place
• Urinary catheter intact and draining dark yellow urine
• Last bowel movement 2 days ago; it was hard, small and brown
• Full head, neck, shoulder and upper extremity movement with normal muscle strength and sensation
• Complete paralysis of lower body and legs with no sensation present
• Full passive range of motion without crepitation in the bilateral lower extremities

Diagnostic Studies

• Spinal series x-rays: Complete transsection at T5
• MRI: Confirmed transection and revealed no clots or masses present
• Laboratory results:
  • White blood cells: 9500/µL
  • Hemoglobin: 16 g/dL
  • Hematocrit: 45%

 Discussion Questions

1. Name the level of injuries and what clinical manifestations present based on the level of injury.
2. Name the five syndromes associated with incomplete injuries.
3. Based on the assessment data, what are the nursing priorities for M.P.at this time?
4. What is the rationale for the lower extremity elastic compression stockings and abdominal binder?

Case Study Progress

M.P. did not have any signs of autonomic dysreflexia. He had a large bowel movement after receiving a PRN suppository. Antibiotic therapy was initiated after results of a urinalysis with culture and sensitivity indicated a urinary tract infection. After 3 days of medication and fluid therapy, he is being transferred to the rehabilitation unit.

5. Because of the complexity of M.P.'s care, you are coordinating care among many members of the health care team. Who might be participating in M.P.'s rehabilitation?

6. What are priority interventions for autonomic dysreflexia?

7. Rehabilitation care includes initiating a bowel retraining program. Outline the components of a program for M.P.