Traumatic Brain Injury and Spinal Cord Injury Flashcards

A patient with a C5 spinal cord injury develops sudden severe headache, sweating above the level of injury, hypertension, and bradycardia. The nurse immediately suspects:

Answer: Autonomic dysreflexia

Autonomic dysreflexia is a life-threatening syndrome in patients with SCI at T6 or above, triggered by noxious stimuli below the injury level causing uncontrolled hypertension.

The nurse's FIRST action when autonomic dysreflexia is suspected is to:

Answer: Sit the patient upright and search for the precipitating stimulus

Sitting the patient upright to lower BP and immediately identifying and removing the precipitating noxious stimulus (e.g., full bladder, fecal impaction) is the first priority in autonomic dysreflexia.

Which spinal cord injury level results in a patient who is ventilator-dependent due to loss of diaphragm function?

Answer: C3 and above

The phrenic nerve (C3, C4, C5 — 'keeps the diaphragm alive') originates at C3–C5; injury at C3 or above disrupts diaphragmatic function, requiring ventilatory support.

The ASIA Impairment Scale (AIS) Grade A for spinal cord injury means:

Answer: Complete injury with no motor or sensory function below the neurological level

ASIA Impairment Scale Grade A indicates a complete spinal cord injury with no preserved motor or sensory function in the sacral segments S4–S5.

Which complication of spinal cord injury is the LEADING cause of death in the chronic phase?

Answer: Urinary tract infections and urosepsis

Urinary tract infections progressing to urosepsis are the leading cause of death in the chronic phase of spinal cord injury due to neurogenic bladder dysfunction.

A patient with acute cervical SCI is maintained in cervical traction using Gardner-Wells tongs. The nurse's priority assessment is:

Answer: Pin site inspection for loosening or infection

Monitoring pin sites for signs of infection, loosening, or skin breakdown is the priority nursing assessment for patients in cervical traction devices.