Question

1. Identify the rehabilitation potential of the patient with T6 spinal cord injury

2. Describe the mourning process and nursing interventions for patients with spinal cord injury.

Answer 1

1, Rehabilitation goal for independent mobilization for paraplegic patients during the chronic period is ambulation and exercise to prevent joint contracture, loss of muscle strength, bone density and promote normal function of the respiratory and digestive system. Rehabilitation program involve patient family, occupational therapist, physiotherapist, psychologist, dietician, social worker, speech therapist, etc. T6 spinal cord injury involves abdominal and back muscle results paraplegia. patients develop with autonomic dysreflexia. ROM exercise can maintain functional capacity. exercise with stretching of the upper extremity as a goal to make patient for sitting up in the bed or a wheelchair, dressing, and transfer, it means only bed movement as an initial stage. wheelchair makes optimal mobility prevent bed sore and make normal anatomical position. A battery wheelchair will be an appropriate goal to prevent spasticity to prevent DVT, bowel and bladder movement and osteoporosis. walkers, crutches, and orthoses in chronic stage ambulation will be helpful for walk independently at home. C8 -T12 injury ambulation achieved by parawalker hip guidance, it will be lightweight and easy to move. robotic training improves functional outcome with subacute spinal cord injury patients. The occupational therapist can assess patient limitations and activity plans.
2, Psychological outcomes for patient with spinal cord injury to handle their disability. the process of confrontation with disability in spinal cord injury patients at risk for dependency, side effects of medicine, drug addiction, lack of support from society and family..patients with spinal cord injury live with the disability for long period. disability diagnosed as the main psychosocial problem difficult to perform daily activity...support level includes spiritual and religious beliefs, self-esteem and self-confidence by physicians, nurse and social workers, a family can help them to achieve their dependency. support the concept and improve psychosocial aspects help personal promotion and family situation. The grief process supports their emotional ability. kubler-ross stages can help the patient to overcome their feelings.
Nursing intervention:
- monitor cardiovascular and respiratory function
- avoid infection and further complication
- Maintain patient headend least at 30-degree elevation
- Avoid pressure sore, DVT, spasticity by mobilization, ROM, and exercises with the help of physiotherapist.
-monitor patient intake and output
- once the patient medically stable prepare the patient for social and rehabilitation support
- help the patient with ADLs
- provide health education regarding nutrition, mobility, oral care, and skin care, etc.
-explain the drug regimen to patients for the followup