Neurological System – Nursing Interventions for Acute Spinal Cord Injury

by Rhonda Lawes, PhD, RN

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    00:01 Okay. Now let's look at what you'll be seeing in your patient.

    00:04 The clinical manifestations of a spinal cord injury, system by system. Okay? We're gonna start with neurological and work our way through all of these systems you see on the slide.

    00:16 Okay. So neurological, I want you to think, motor and sensory.

    00:22 Remember, those are the neuron's we have that we're playing with, that we're dealing with; motor and sensory.

    00:27 So the American Spinal Injury Association, they have an impairment scale.

    00:32 That's something that can help us assess that and document it.

    00:36 See, this scale takes assessment of motor and sensory function to kinda look at the neurological level and the completeness of the injury.

    00:43 So it's very helpful when we record changes and identify exactly where the patient is and what rehab goes we're gonna have for them.

    00:52 Okay. Their scale goes from A to E.

    00:55 I know, it's another alphabetical skill, but it seems pretty popular in medicine, doesn't it? 'A' means there's no motor or sensory functions preserved in the sacral segments S4-S5.

    01:06 'B' you have sensory but no motor function is preserved below the neurological level and includes sacral segments S4 and S5.

    01:15 Now 'C' motor function is preserved below the neurological level and more than half of the key muscles below the neurological level have a muscle grade less than three.

    01:25 The difference in 'D' is they have a muscle grade of three or more.

    01:30 Now finally in E, motor and sensory function are normal.

    01:34 So hopefully that's like you or I.

    01:37 The only thing I will remember that in this case, A is a no-bueno.

    01:42 That's no good. E is the most normal and you've got B, C and D in between.

    01:48 So the most important take away from this slide is knowing that there's a standardized scale that we use and it's to look at motor and sensory.

    01:56 'A' being the worse severe impact, 'E' being normal.

    02:01 Now let's talk about the dermatome, it helps us with sensory regions.

    02:05 Each spinal cord segment innervates at a particular area of the skin that's why you hear this called a dermatome.

    02:13 You can see how there's a lot of complicated looks like in there, but it's very simple.

    02:17 Just to show you that there's a very specific regions that each spinal cord segment innervates.

    02:23 Now we can use these regions for testing.

    02:26 You can see we've got the dermatome on the front side and the backside just for your review.

    02:32 But this will help us tie the injury and the symptoms help us with better diagnosis and planning for the patient's care.

    02:39 So, let's look at neurological motor and sensory and see what do we do as a nurse.

    02:45 Well, you're gonna have to be really thorough on your neuro assessments.

    02:49 You'll do a very thorough and regular neuro assessments on patient who've had a spinal cord injury.

    02:54 You're gonna watch and document changes, look for trends and make sure that you notify the healthcare provider when something significant happens because our role as a nurse is to be the eyes at the bedside.

    03:07 So, thorough neuro assessments and done regularly.

    03:11 And make sure you document changes and trends in clear, concise and objective language.

    About the Lecture

    The lecture Neurological System – Nursing Interventions for Acute Spinal Cord Injury by Rhonda Lawes, PhD, RN is from the course Spinal Cord Injuries and Syndromes (Nursing) .

    Included Quiz Questions

    1. E
    2. A
    3. B
    4. C
    1. Completing thorough neuro assessments regularly
    2. Performing rehabilitation exercises
    3. Ensuring that the client receives the proper nutrition to support healing
    4. Allowing the client to rest throughout the day

    Author of lecture Neurological System – Nursing Interventions for Acute Spinal Cord Injury

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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