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.
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) .
When assessing clients using the American Spinal Injury Association Impairment Scale, the nurse knows that a client without neurological deficits will be classified as what level on the scale?
In caring for a client with a spinal cord injury, which of the following is the primary nursing intervention?
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