Reference no: EM133854153

Assignment:

Jason is a 21-year-old senior at the University of Delaware, majoring in economics. While on spring break in Florida, Jason was involved in a one-vehicle motorcycle accident. In the accident, Jason was thrown from his bike to the pavement, landing on his back. A police officer witnessed the accident and immediately called for medical assistance. Emergency personnel arrived within minutes, and upon recognizing the seriousness of Jason's back injury, immobilized his neck and secured him to a rigid board prior to transporting him to the emergency room of the nearest hospital. When he arrived at the hospital, Jason was conscious and complained of pain in his lower back. Upon examination by the emergency room personnel, Jason was found to have numerous abrasions and contusions, and loss of both sensation and motor control of his legs. After he was stabilized, a complete neurological exam was performed to assess and localize Jason's injury.

The neurological exam revealed the following: Jason demonstrated normal or near normal strength in ?exing and extending his elbows, extending his wrists, and when ?exing his middle ?nger and abducting his little ?nger on both hands. However, he exhibited no movement when medical personnel tested his ability to ?ex his hips, extend his knees, and dorsi?ex his ankles. Stretch re?exes involving the biceps, brachioradialis, and triceps muscles were found to be normal, while those involving the patella and ankle were absent. In addition, Jason was found to have normal sensitivity to pin prick and light touch in areas of his body above the level of his inguinal (groin) region, but not below that region of the body.

1. What is autonomic dysreflexia (AD)? Describe the symptoms that a patient would present with this syndrome. What level of injury is AD seen as?

2. What is the most common trigger of autonomic dysreflexia? List the other triggers. Is this considered an emergency? What would occur if this is not caught early?

3. What measures can be done by nursing to prevent and treat AD?

4. If this patient had a spinal cord injury that affected the cervical vertebrae, how would you expect this to impact the patient's blood gases, acid-base balance pH, etc.? Given this acid-base imbalance, what would be the treatment options to correct the imbalance?

5. What would be some important nursing diagnoses for patients with spinal cord injury?

6. What would be some expected patient outcomes in this case?

7. Describe the Glasgow coma scale. What does it mean if the patient scores a 15 as opposed to a patient who scores an eight? If a patient scores a 3 out of 15, what is their level of consciousness? Would a score of 3 require intervention, and if so, what?

8. What potential complications can put the spinal cord injury patient at risk in regards to immobility?