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A. High Fowler's with legs loweredB. Low Fowler's with legs loweredC. Semi-Fowler's with legs at heart levelD. ProneThe answer is A. The patient should be in highFowler's (90 degrees) with the legs lowered.This will allow gravity to cause blood to pool inthe lower extremities and help decrease bloodpressure.9. In autonomic dysreflexia, the nurse wouldexpect what finding below the site of the spinalcord injury?A. Flushed lower bodyB. Pale and cool lower extremitiesC. Low blood pressureD. Absent reflexesThe answer is B. The lower extremities wouldbe cool and pale due to vasconstriction causedby the exaggerated reflex response of the
sympathetic nervous system from an irritatingstimulus. The sympathetic reflex can NOT beunopposed by the parasympathetic nervoussystem due to the spinal injury, which isblocking the nerve impulse. The areas foundABOVE the site of injury would be flushed dueto vasodilation from parasympatheticstimulation.10. Which statements are TRUE aboutautonomic dysreflexia? Select all that apply:A. "Autonomic dysreflexia is an exaggeratedreflex response by the parasympathetic nervoussystem that results in severe hypertension due toa spinal cord injury."B. "Autonomic dysreflexia causes a slow heartrate and severe hypertension."C. "Autonomic dysreflexia is less likely to occurin a patient who has experienced a lumbarinjury."D. "The first-line of treatment for autonomicdysreflexia is an antihypertensive medication."The answers are B and C. Option A is false, itshould say: Autonomic dysreflexia is anexaggerated reflex response by theSYMPATHETIC (NOT parasympathetic)nervous system that results in severehypertension due to a spinal cord injury. OptionD is false because medications are used only ifthe blood pressure is not decreasing or the causecannot be determined.11. The nurse is about to assess for bowelimpaction in a patient who has developedautonomic dysreflexia. The nurse makes itpriority to?A. Avoid using lubricantsB. Stimulate the bowel with rectal manipulationC. Slowly administer a saline solution prior toassessmentD. Instill an anesthetic jelly prior to assessmentThe answer is D. To avoid increasing autonomicdysreflexia symptoms by increasing thesympathetic reflex due to an irritating stimulus,the nurse should instill an anesthetic jelly beforeassessing the rectum for hardened stool. This isalso important prior to catheterization to checkthe bladder for urine.1. A nurse explains that the spinal cord extendsfrom the brainstem to the level of whichvertebra?a. Last thoracicb. Second lumbarc. First sacrald. CoccygealANS: BThe cord starts at the brainstem and extends tothe second lumbar vertebra.2. On admission to the emergency department, apatient with a C5 compression fracture can moveonly his head and has flaccid paralysis of allextremities. The distraught family asks if theparalysis is permanent. Whatis the best response by the nurse?

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Term
Winter
Professor
NoProfessor
Tags
Nephrology, Chronic kidney disease, AKI

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