Neurological system ‫الجهاز العصبي‬

Spinal Cord Injury:-

Nursing Diagnosis:-
1- Ineffective breathing patterns related to weakness or paralysis of
abdomen and intercostal muscles and inability to clear secretions.

2- Impaired physical mobility related to neuromuscular impairment.

3- Risk for impaired skin integrity related to immobility and sensory

loss.

Q /What are the nursing intervention of spinal cord injury?

1- Note client’s level of injury when assessing respiratory function.

2- Maintain client airway: keep head in neutral position, elevate head of

bed slightly if tolerated, and use airway adjunct as indicated.

3- Administer oxygen therapy as ordered.

4- Encourage patient to fluids (at least 2000ml/day).

5- Check serial ABGs.

6- Position arms at 90 degree at regular intervals to prevents frozen

shoulder contractures.

7- Maintain ankles at 90 degree with footboard.

8- Inspect all skin areas, noting capillary blanching/refill, redness, and

swelling.
9- Reposition frequently, whether in bed or in sitting position. Place in
prone position periodically.

10- Elevate lower extremities periodically, if tolerated to enhances

venous return and reduces edema formation.

11- Wash and dry skin, especially in high moisture areas such as
perineum.

12- Massage and lubricate skin with bland lotion/oil.

Nursing Diagnosis:-

 Impaired urinary elimination related to disruption in bladder

innervation and bladder atony as manifested by bladder distension;
incontinence, urinary tract infection (UTIs), and renal dysfunction.

Nursing intervention:-

 Assess voiding pattern (frequency and amount). Compare urine

output with fluid intake. Note specific gravity.
 Palpate for bladder distension and observe for overflow.
 Encourage intake (2–4 L per day), including acid ash juices
(cranberry).
 Cleanse perineal area and keep dry.
 Keep bladder deflated by means of indwelling catheter initially.
 Maintain good hydration to reduce the risk of UTI & Kidney
stones.
Nursing intervention for SCI:-
 Constipation related to disruption of innervation to bowel and
rectum, altered dietary and fluid intake as manifested by loss of
ability to evacuate bowel voluntarily and constipation.

Nursing intervention:-

 Auscultate bowel sounds, noting location and characteristics.

 Establish regular daily bowel program (digital stimulation, prune
juice, warm beverage, and use of stool softeners and suppositories
at set intervals. Determine usual time and routine of postinjury
evacuations.
 Assist and encourage exercise and activity within individual
ability and up in chair as tolerated.... Improves appetite and muscle
tone, enhancing GI motility.
 Observe for incontinence and help patient relate incontinence to
change in diet or routine.
 Restrict intake of grapefruit juice and caffenated beverages
(coffee, tea, cola, chocolate).
 Insert and maintain nasogastric tube and attach to suction if
appropriate.
Rehabilitation following SCI is most effectively undertaken with a
multidisciplinary, team-based approach, as follows:

1- Physical therapists typically focus on lower-extremity function and

on difficulties with mobility.

1- Occupational therapists address upper-extremity dysfunction and

difficulties in activities of daily living
2- Rehabilitation nurses are concerned with the issues of bowel and
bladder dysfunction and the management of pressure injuries
(pressure ulcers)
3- Psychologists deal with the emotional and behavioral concerns of the
newly injured patient and with any potential cognitive dysfunction
4- Speech-language pathologists address with issues of communication
and swallowing

What are the strategies to prevent stroke?

A low-fat, high fiber diet is usually recommended.
Maintain/reduce weight.
Control blood pressure.
Control Diabetes
Regular exercise
Stop smoking
Limit alcohol intake.
Managing underlying conditions
Treat Atrial fibrillation
Reduced stress
Get optimal sleep (7-9 hours).
Take medications as prescribed.