19-Year-Old Hispanic Male, George Mayes, arrives to the emer

19-Year-Old Hispanic Male, George Mayes, arrives to the emergency… 19-Year-Old Hispanic Male, George Mayes, arrives to the emergency department via ambulance after being injured in a skate boarding accident. VS               BP 124/80               HR 86               RR 24               Temp: 37George arrives in a C-Collar, but the paramedics report he can move his full neck. He has partial movement of his shoulders and back. He has some use of his arms and can extend his elbow. You are unable to assess if he can roll over.He has use of his hands.He can breathe on his own but appears short of breath.You suspect what level of spinal cord injury?  George is accompanied to the ED by his sister. What are your first interventions? (Emergency Interventions)   What would you take into consideration when starting George’s IV? Why?    What IVF’s do you anticipate being ordered?   How will Oxygen be delivered?   PATIENT UPDATE:You ask a colleague to speak with George’s sister while the trauma team works to stabilize him. What s do you anticipate the RN will ask?    PATIENT UPDATE:You receive the following information from George’s sisterNo known drug allergiesPreviously healthy college student home for fall breakHistory of depressionCurrently takes Sertraline 50 mg/dailyNo other significant medical historyYou are being your assessment of GeorgeWhat is included in your immediate assessment?       PATIENT UPDATE:Assessment findingsAirway.Neurological status.Pain, tenderness, deformities, muscles spasms adjacent to vertebral column.Numbness, paresthesia.Alterations in sensation: temperature, light, touch, deep pressure, proprioception.Weakness or heaviness in limbs.Weakness, paralysis, or flaccidity of muscles, spinal shock, cuts, bruises, open wounds over head, face, neck or back.Neurogenic shock:Hypotension, bradycardia; dry, flushed skin.Bowel and bladder incontinence.Urinary retention.Difficulty breathing.Considering the suspicion that George has a C5-C7 fracture, what neurological findings might be present?             What is paresthesia?What is proprioception? PATIENT UPDATE:ASSESSMENT FINDINGSGeorge is groggy but responsive and able to answer some s. He knows his name and that he is in the hospital.He has a laceration to his right scalp and cuts and bruises to his arms legs and torso.He has no protruding bones.He is receiving 10L O2 via a non-rebreather and is no longer short of breath. Poor capillary refill.His blood pressure is now 90/50 and his heart rate is 52 BPM. Respiratory rate 20. Temperature 36What do you suspect?     What are the causes?    What level of spinal cord injury is associated with neurogenic shock?    What are your nursing priorities?    How is Spinal Shock different than Neurogenic Shock?     What the characteristics of Spinal Shock and ow long does it last?    What medications do you anticipate being ordered during the acute care phase?    What are the therapeutic effects of these medications?    What diagnostic studies and labs do you anticipate?  PATIENT UPDATEThe physician has ordered a CT scan of the head and spinal cord. George remains groggy from the pain medication he has received. His family has arrived. They are concerned about the CT scan.How will you explain the CT scan to George and his family? Practice with a partner.  CT scan confirms C7 fracture.After several weeks in the Trauma ICU, George is moved to a medical surgical unit and transferred to your care. You receive the following report.Pulse 80, RR 20, BP 124/68, Temp 37.2Healing laceration to right scalp, no remaining stiches, healing abrasions and bruises to abdomen. Has full movement of neck.Senses tingling and numbness in the hands and fingers.Able to move arms at the elbow.Lack of control of bowel and bladder.Becomes short of breath but does not require ventilation. History of depression exacerbated since accident. The CT scan shows a fracture at the C7 level with partial laceration of the spinal cord. Based on this injury what long-term complications are you anticipating?What do you anticipate George’s rehabilitation potential is?   What are your priority nursing concerns?   PATIENT UPDATEGeorge is being transferred to a rehabilitation facility.What information will you included in your report.Practice SBAR with a partner!     What resources would you suggest in the Peterborough Community? Are there resources for his support system? What are they?      Health Science Science Nursing NURS 3560H

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