Author Question: A patient recovering from a spinal cord injury (SCI) is experiencing gastric distress. Which ... (Read 43 times)

fnuegbu · **on:** Jun 25, 2018

A patient recovering from a spinal cord injury (SCI) is experiencing gastric distress. Which medication should the nurse expect to be prescribed for this patient?

1. omeprazole (Prilosec)
2. dopamine (Intropin)
3. baclofen (Lioresal)
4. dantrolene (Dantrium)

Question 2

A patient is placed in ventilator support with the diagnosis of botulism and failure to thrive. Which nursing actions would be most appropriate for this patient?

Select all that apply.
1. maintaining intravenous fluids at KVO (keep vein open)
2. assessing bowel sounds once a shift
3. referring the patient for a physical therapy consult
4. monitoring total parenteral nutrition infusion
5. assessing urinary output every hour

CharlieArnold · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1
Proton pump inhibitors such as omeprazole (Prilosec) are often administered to prevent stress-related gastric ulcers, a common complication in SCI. Vasopressors are used in the immediate acute care phase to treat bradycardia or hypotension due to spinal and neurogenic shock. Dopamine (Intropin) is used to treat hypotension in neurogenic shock. Antispasmodics such as baclofen (Lioresal) and dantrolene (Dantrium) may be used to treat spasticity in patients with spinal cord injury.

Answer to Question 2

Correct Answer: 3, 4, 5
Maintaining fluids at KVO is inappropriate because this patient will be placed on NPO (nothing by mouth) status while ventilated. It is important that the patient receive adequate fluids for hydration and nutrition as nothing will be consumed by mouth. The patient is at risk for a paralytic ileus, and bowel sounds need to be assessed more often than once a shift (every one to two hours while in the ICU). Physical therapy will be beneficial for maintaining ROM (range of motion) because of paralysis caused by the botulism toxin. Nutritional support is provided with total parenteral nutrition in the treatment of botulism. The patient is at risk for dehydration and renal failure. Monitoring hourly urine output totals is essential.