Neuro

Name:___________________ Date:_____________

Instructions: all questions apply to this case study. Your responses should be brief and to the point. Adequate space has been provided for answers. When asked to provide several answers, they should be listed in order of priority or significance. Do not assume information that is not provided.

Scenario

T.W. is a 22-year-old man who fell 50 feet from a chairlift while skiing and landed on hard-packed snow. He was found to have T10-11 fracture with paraplegia. He was initially admitted to the SICU and placed on high-dose steroids for 24 hours. He was taken to surgery 48 hours postaccident for spinal stabilization. He spent 2 additional days in the SICU, 5 days on the neuro unit, and now is ready to be transferred to your rehab unit. He continues to have no movement of his lower extremities.

1. The goal of treatment in the acute phase of spinal cord injury (SCI) is to help T.W. survive the injury and maintain physiologic stability through the period of spinal shock. Once the acute phase is over. T.W. moves into the postacute and early rehab phases. What are the treatment goals for T.W. in these phases?

2. Considering a hierarchy of rehabilitative needs for patients like T.W., number the following from highest (1) to lowest (5) priority.

____ Community integration and employment

____ Accomplishment of self-care and ADLs

____ Self-actualization

____ Stabilization of the physiologic systems

____ Adjustment to living at home

3. T.W. receives high-dose steroid therapy every 24 hours; then he is placed on a smaller maintenance dose. What effect will steroids have on T.W.?

4. List three critical potential infections that T.W. should be monitored for through-out his hospitalization.

A person with an SCI at the T2-12 level should be independent in a wheelchair and able to manage ADL’s, including bowel and bladder care.

5. T.W. is taking vitamin C250mg PO bid. What is the purpose of this?

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