A client who has been immobile from a neurological deficit is moved to another bed in the nursing home and, following the move, complains of pain in his leg. Which complication is possible?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Fractures. When a client with a neurological deficit is immobile and is moved to another bed, they may experience pain in their leg due to the potential development of fractures. Prolonged immobility can lead to bone demineralization and weakness, making the bones more susceptible to fractures, especially during movements or transfers. Option A) TIA's (Transient Ischemic Attacks) are not directly related to the scenario described. TIAs are brief episodes of neurological dysfunction caused by a temporary disruption of blood flow to the brain, often manifesting as stroke-like symptoms. Option B) Paralysis refers to the loss of muscle function in part of your body. While paralysis can be a complication of some neurological conditions, it is not the most likely immediate complication in this case scenario. Option D) Bruising is not the most likely complication in this case. While bruising can occur due to physical trauma, such as bumping into objects during movement, the potential for fractures is higher in this context due to the combination of immobility and relocation of the client. Educationally, understanding the risks associated with immobility in clients with neurological deficits is crucial for healthcare providers. Proper techniques for transferring immobile clients and the importance of preventive measures, such as repositioning and monitoring for signs of discomfort or injury, are essential components of care to prevent complications like fractures.

Correct Answer: B

Rationale: The correct answer is B) Protects against harmful blood-borne agents. The blood-brain barrier is a crucial physiological mechanism that protects the central nervous system (CNS) from potentially harmful substances circulating in the blood, such as toxins, pathogens, and large molecules. This selective barrier is formed by specialized endothelial cells in the capillaries of the brain, which tightly regulate the passage of substances into the brain tissue. Option A) Protects the brain from external trauma is incorrect because the blood-brain barrier primarily functions to protect the brain from internal threats, not external physical trauma. Option C) Provides for flexibility while protecting the spinal cord is incorrect because the blood-brain barrier specifically refers to the protective mechanism for the brain, not the spinal cord. The spinal cord has its own protective mechanisms. Option D) Forms the outer layer of protective membranes around the brain and spinal cord is incorrect because the blood-brain barrier is not a physical membrane but rather a physiological barrier formed by specialized cells in the brain capillaries. Understanding the role of the blood-brain barrier is essential for healthcare providers as it impacts the treatment of neurological conditions and the delivery of medications to the brain. Educating patients about the blood-brain barrier helps them comprehend the importance of protecting the brain from harmful substances circulating in the bloodstream and the limitations it poses on certain treatments for CNS disorders.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A: Paraplegia with a flaccid paralysis. The presence of spinal shock after a spinal cord injury at the C7 level is characterized by a temporary loss of reflexes and muscle tone below the level of injury. This results in flaccid paralysis, where the affected limbs are limp and lack muscle tone. Option B, tetraplegia with total sensory loss, is incorrect because spinal shock typically presents with flaccid paralysis rather than spastic paralysis and is more localized to the area of injury rather than affecting all limbs. Option C, total hemiplegia with sensory and motor loss, is incorrect as hemiplegia refers to paralysis affecting one side of the body, not both sides as seen in this case. Option D, spastic tetraplegia with loss of pressure sensation, is incorrect because spinal shock is characterized by flaccid paralysis, not spastic paralysis. Educationally, understanding the manifestations of spinal shock is crucial for healthcare providers caring for patients with spinal cord injuries. Recognizing the signs of spinal shock helps in providing appropriate interventions and predicting potential outcomes for the patient's recovery and rehabilitation process.

Correct Answer: B

Rationale: The correct answer is B) Spinal cord damage resulting in ipsilateral motor paralysis and contralateral loss of pain and sensation below the level of the lesion. This accurately describes Brown-Séquard syndrome, which is typically caused by a hemisection (half-section) of the spinal cord, often due to trauma like a knife wound. This syndrome results in a characteristic pattern of symptoms where there is paralysis and loss of sensation on the same side as the injury (ipsilateral) due to damage to the corticospinal tract, and loss of pain and temperature sensation on the opposite side (contralateral) due to damage to the spinothalamic tract. Option A is incorrect as it describes a lower motor neuron lesion, not consistent with Brown-Séquard syndrome. Option C is incorrect as it describes a different syndrome called anterior cord syndrome. Option D is incorrect as it describes a different condition, acute spinal cord injury resulting in complete motor paralysis and sensory loss below the injury level. Understanding neurological syndromes like Brown-Séquard syndrome is crucial for healthcare professionals, especially those working in emergency medicine or neurology, to accurately diagnose and manage patients with spinal cord injuries. This knowledge helps in predicting patient outcomes and guiding rehabilitation strategies.

Correct Answer: A

Rationale: In a patient with a T2 spinal cord injury developing paralytic ileus, the nurse should anticipate that the patient will need IV fluids. Paralytic ileus is a condition where there is a loss of normal bowel function due to disruption of nerve impulses in the intestines, which can lead to abdominal distention, pain, and nausea. IV fluids are crucial to maintain hydration and electrolyte balance in these patients, as oral intake may not be possible due to the ileus. Option B, tube feedings, is incorrect because feeding the patient orally or through a tube may worsen the condition by adding more content to the already paralyzed bowel. Option C, parenteral nutrition, is not the first-line treatment for paralytic ileus and is typically reserved for patients who cannot tolerate enteral feeding for an extended period. Option D, nasogastric suctioning, may be used to decompress the stomach and relieve distention but does not address the need for hydration and electrolyte balance. Educationally, understanding the pathophysiology of paralytic ileus following a spinal cord injury is crucial for nurses to provide appropriate care. Recognizing the signs and symptoms of ileus and knowing the appropriate interventions, such as IV fluid administration, is essential for optimizing patient outcomes in such cases.