A client diagnosed with a spinal cord injury has been ...

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A client diagnosed with a spinal cord injury has been experiencing spinal shock. Which of the following assessment findings would indicate that this shock is resolving?
 
  1. Blood pressure 80/55 mmHg
  2. Heart rate 48 beats per minute
  3. Reflexive emptying of the bladder
  4. Body temperature 97F

Question 2

The nurse is caring for a client with a spinal cord injury located at T5. Which of the following should be included in this client's plan of care?
 
  1. Use mechanical ventilation.
  2. Assess blood glucose level for onset of diabetes.
  3. Assist with removal of pulmonary secretions.
  4. Provide assistive devices for ambulation.

[sarah_brady415]

Answer to Question 1

3
Resolution of spinal shock is indicated by return of reflexes, replacement of flaccidity with hyperreflexes, and reflexive emptying of the bladder. Low blood pressure, low heart rate, and low body temperature are all indications of neurogenic shock, which is an aspect of spinal shock.

Answer to Question 2

3
Because of the interruption in chest muscle innervation with spinal cord injuries located at level T7 and above, patients often need assistance with removal of secretions and have difficulty with inspiration and expiration. Mechanical ventilation is not needed for a spinal cord injury at level T5. A spinal cord injury does not precipitate the onset of diabetes. A client with a spinal cord injury at level T5 will not be able to use an assistive device to ambulate.

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Excellent

[cdmart10]

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