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Traumatic Brain Injury and Spinal Cord Injury Flashcards

6 cards from real CNRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which herniation syndrome occurs when the cerebellar tonsils herniate through the foramen magnum, compressing the medulla?

    Answer: Tonsillar herniation

    Tonsillar herniation (downward herniation) occurs when cerebellar tonsils are pushed through the foramen magnum, causing rapid medullary compression and cardiorespiratory arrest.

  2. A patient with TBI is receiving mannitol for ICP reduction. The nurse monitors serum osmolality, knowing the maximum safe osmolality is:

    Answer: 320 mOsm/kg

    Serum osmolality should not exceed 320 mOsm/kg during mannitol therapy to avoid renal toxicity and rebound cerebral edema.

  3. Which type of TBI is characterized by diffuse white matter damage from rotational acceleration-deceleration forces, often with prolonged unconsciousness despite minimal CT findings?

    Answer: Diffuse axonal injury (DAI)

    Diffuse axonal injury (DAI) results from shear-strain forces disrupting axons throughout the white matter; CT may appear near-normal despite severe neurological dysfunction.

  4. The nurse is preparing a patient for lumbar puncture to assess for meningitis after TBI. Before performing the LP, the priority is to:

    Answer: Administer empiric antibiotics and obtain CT head to rule out elevated ICP

    CT head must be obtained first to rule out elevated ICP before LP; antibiotics should be started empirically without delaying treatment pending imaging.

  5. Which pharmacological agent is recommended to reduce spasticity in patients with chronic spinal cord injury, delivered intrathecally for severe cases?

    Answer: Baclofen

    Intrathecal baclofen (ITB) therapy via an implanted pump is used for severe spasticity in SCI when oral medications are insufficient.

  6. A patient with acute SCI is at high risk for deep vein thrombosis. Pharmacological prophylaxis should be initiated:

    Answer: After 24 hours if no active bleeding

    DVT prophylaxis with low-molecular-weight heparin should be initiated within 24 hours in SCI patients if there is no contraindication such as active bleeding.

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