Medical Surgical Spinal Cord Injury #1
The nurse is caring for a client who is recovering from a T1 spinal cord injury. Which is the best explanation by the nurse to the client and family on the ability for motor function in relation to spinal cord injury?
- There will be complete loss of mobility with paralysis from the neck down.
This answer is not correct because C5 and above indicates complete loss of mobility with paralysis from the neck down. The client will experience paralysis in the hands, arms, trunk, and legs.
- There will be risks of respiratory depression because of the location of the injury.
This answer is not correct because respiratory depression will occur for cervical injuries, especially in those above C-5. Spinal injuries above C-5 are the most severe, with the client at risk for respiratory depression due to the location of the injury.
- The shoulders may be mobile and shrug, but the arms below the shoulders will be paralyzed.
This answer is not correct because C-5 and the shoulder are associated only with paralysis downward for C-5. The client with this injury may be able to breathe on their own, but respiratory effort will be weakened.
- The arms will retain their full function.
This answer is correct because T1 injuries are expected to retain full function of arms. T1 spinal cord injuries usually affect muscles of the upper chest, mid back, and abdominals, with clients most likely using a manual wheelchair. The most common cause of T1 spinal cord injuries is motor vehicle accidents or trauma.
The first thoracic vertebrae is T1. Injuries in this region affect the chest and legs, therefore arms will retain full function.
T1-T5 injuries affect the trunk and legs, known as paraplegia but will be able to use their arms. Nursing interventions involve assessing the client’s motor function and assisting with range of motion exercises. Also important is to provide a means to summon help with activities due to impaired physical mobility. Encouraging deep breathing and coughing is advised to prevent pulmonary infection. Daily assessment of skin integrity is recommended to avoid skin breakdown and prompt peripheral circulation.
Test Taking Tip
Knowing the spinal nerves and their function will assist the student with this question.