A client who sustained a gunshot wound has symptoms below the ...

[abarnes]

A client who sustained a gunshot wound has symptoms below the level of T-12 of ipsilateral motor paralysis, loss of proprioception and vibratory sense, and contralateral loss of pain and temperature sensation.
 
  When planning care for this client, which assumptions by the nurse are appropriate based on the provided data?
  Select all that apply.
  A) American Spinal Injury Association Impairment Scale score is A.
  B) The spinal cord injury is incomplete.
  C) These findings are consistent with Brown-Sequard syndrome.
  D) Hemisection of the spinal cord is likely.
  E) Some recovery of sensory function is higher.

Question 2

The nurse is evaluating the success of a bowel retraining program with a client recovering from a lower motor neuron spinal cord injury. Which observations indicate that this teaching has been successful?
 
  Select all that apply.
  A) One episode of bladder incontinence in 8 hours
  B) Performs self-urinary catheterization every 4 hours while awake.
  C) Transfers to use bedside commode after breakfast to evacuate bowels.
  D) Two episodes of impacted stool in 1 week
  E) Maintains a high-fluid, high-fiber diet.

[wshriver]

Answer to Question 1

Answer: B, C, D, E

Hemisection of the spinal cord, usually caused by a penetrating trauma (gunshot, knife), causes sensory and motor deficits on opposite sides of the body because the spinal cord injury is incomplete. These findings are consistent with Brown-Sequard syndrome, which has the best prognosis of all the incomplete spinal cord syndromes. American Spinal Injury Association (ASIA) Impairment Scale (AIS) score of A indicates a complete spinal cord injury where no sensory or motor function is preserved in the sacral segments S4-S5.

Answer to Question 2

Answer: B, C, E

Evidence that a bowel and bladder retraining program for a client with a spinal cord injury has been successful includes performing self-urinary catheterization every 4 hours while awake, transferring to the bedside commode to evacuate bowels after breakfast, and maintaining a high-fluid and high-fiber diet to prevent constipation. Evidence that this training has not been successful includes an episode of bladder incontinence and the need to impacted stool removed twice in 1 week.