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When speaking to a group of high school students, the rehabilitation nurse states that spinal cord injuries resulting in paralysis occur mainly as the result of traumatic accidents in which group of individuals?
- A. Middle-aged men
- B. Older adult females
- C. Young males
- D. Young females
Correct Answer: C
Rationale: Individuals paralyzed by spinal cord injuries are primarily young males.
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What should the nurse do to reduce the incidence of postural hypotension in a patient with a spinal cord injury?
- A. Monitor diastolic blood pressure closely.
- B. Encourage the patient to remain in the bed.
- C. Raise the head of the bed for 15 to 20 minutes before transfer to a wheelchair.
- D. Encourage adequate intake of fluids to expand fluid volume.
Correct Answer: C
Rationale: Raising the head of the bed before transfer allows for gradual vessel accommodation from the supine position to the upright position. It is important to check the patient's blood pressure, but it will not reduce the incidence of postural hypotension. It is important to encourage the patient to get out of bed. Postural hypotension is related to a pooling of blood in the lower extremities and is not related to a fluid volume deficit.
The nurse who assesses for cultural influences, values cultural diversity, and incorporates cultural knowledge in practice is said to be culturally
Correct Answer: competent
Rationale: A culturally competent nurse includes knowledge of cultural values and influences in their nursing practice.
The rehabilitation nurse can use basic rehabilitation skills regardless of the origin of the disability. What intervention would be effective for a person with arthritis, a person with a brain injury, or a person with a spinal cord injury?
- A. Encouraging large fluid intake
- B. Seeking spiritual support from a higher being
- C. Using the spouse as a support system
- D. Positioning to maintain alignment
Correct Answer: D
Rationale: Alignment preservation is an implementation that is appropriate for a variety of rehabilitation patients, regardless of the origin of their disability.
When the nurse observes a patient experiencing a severe episode of autonomic dysreflexia, what should be the initial intervention?
- A. Locate the cause of irritation.
- B. Assess the blood pressure.
- C. Cover the patient with several blankets.
- D. Raise the head of the bed to a high Fowler's position.
Correct Answer: D
Rationale: The head of the bed should be raised immediately. Raising the head of the bed will reduce the blood pressure. Finding the cause of the episode is secondary to preventing the possibility of a stroke from the hypertension.
When changing the position of a patient with a spinal cord injury at T4, the nurse should recognize that what symptom is an indication of an episode of autonomic dysreflexia?
- A. Nausea
- B. Pallor
- C. Goose bumps
- D. Dizziness
Correct Answer: C
Rationale: Patients with spinal cord lesions above T5 may experience sudden and extreme elevations in blood pressure caused by a reflex action of the autonomic nervous system. It is produced by stimulation of the body below the level of the injury, usually by a distended bladder from a blocked catheter. Any stimulation can produce the syndrome, including constipation, diarrhea, sexual activity, pressure injuries, position changes (from lying to sitting), and even wrinkles in clothing or bed sheets. Other symptoms may include diaphoresis, shivering, goose bumps, flushing of the skin, and a severe pounding headache.