Author Question: When caring for a patient who experienced a T2 spinal cord transection 24 hours ago, which ... (Read 109 times)

maegan_martin · **on:** Jun 25, 2018

When caring for a patient who experienced a T2 spinal cord transection 24 hours ago, which collaborative and nursing actions will the nurse include in the plan of care (select all that apply)?

a. Urinary catheter care
b. Nasogastric (NG) tube feeding
c. Continuous cardiac monitoring
d. Maintain a warm room temperature
e. Administration of H2 receptor blockers

Question 2

Which finding in a patient with a spinal cord tumor is most important for the nurse to report to the health care provider?

a. Back pain that increases with coughing
b. Depression about the diagnosis of a tumor
c. Decreasing sensation and ability to move the legs
d. Anxiety about scheduled surgery to remove the tumor

shewald78 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A, C, D, E
The patient is at risk for bradycardia and poikilothermia caused by sympathetic nervous system dysfunction and should have continuous cardiac monitoring and maintenance of a relatively warm room temperature. Gastrointestinal (GI) motility is decreased initially and NG suctioning is indicated. To avoid bladder distention, a urinary retention catheter is used during this acute phase. Stress ulcers are a common complication, but can be avoided through the use of the H2 receptor blockers such as famotidine.

Answer to Question 2

ANS: C
Decreasing sensation and leg movement indicates spinal cord compression, an emergency that will require rapid action (such as surgery) to prevent paralysis. The other findings will also require nursing action but are not emergencies.