What is one indication for early surgical therapy of the patient with a spinal cord injury?

Correct Answer: D

Rationale: The correct answer is D) Evidence of continued compression of the cord is apparent. Early surgical therapy in patients with spinal cord injury is crucial when there is ongoing compression of the spinal cord. This compression can lead to further damage and worsening neurological deficits if not addressed promptly. Surgical intervention aims to relieve the pressure on the spinal cord, stabilize the spine, and prevent secondary injuries. Option A) There is incomplete cord lesion involvement: While this may be a consideration in the overall management of spinal cord injury, it is not a specific indication for early surgical therapy. Option B) The ligaments that support the spine are torn: While this may indicate instability in the spine and require surgical intervention, it is not a direct indication for early surgery in the context of spinal cord injury. Option C) A high cervical injury causes loss of respiratory function: While loss of respiratory function is a serious complication of high cervical spinal cord injury, it does not necessarily indicate the need for immediate surgical intervention unless there is evidence of cord compression. Educational Context: Understanding the rationale for early surgical therapy in spinal cord injury is essential for healthcare providers caring for these patients. Prompt recognition of indications for surgery can lead to better outcomes and prevent further neurological deterioration. It is crucial to consider the specific criteria that warrant surgical intervention to provide optimal care for patients with spinal cord injuries.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Steppage gait. A steppage gait is characterized by the foot dropping down due to weakness of the dorsiflexor muscles, resulting in the toes dragging or scraping on the ground and the foot slapping down during the swing phase of the gait cycle. This is commonly seen in individuals with footdrop, a condition where they are unable to lift the front part of the foot. Option A) Ataxic gait is characterized by a wide-based, staggering, unsteady gait often seen in individuals with cerebellar dysfunction. This does not align with the symptoms described in the question. Option B) Spastic gait is characterized by stiff, jerky movements due to increased muscle tone, commonly seen in conditions like cerebral palsy or stroke. This does not fit the description given. Option C) Antalgic gait refers to a gait pattern that is altered due to pain, where the individual avoids putting weight on a specific limb. This is not the case in the scenario described. Understanding different gait patterns is vital for healthcare professionals, especially nurses, as it provides valuable information about a patient's neurological and musculoskeletal status. Recognizing specific gait abnormalities can help in identifying underlying conditions, determining appropriate interventions, and collaborating effectively with the healthcare team.

Correct Answer: A

Rationale: In the acute phase of a stroke, the body attempts to increase cerebral blood flow to the affected area to mitigate the damage caused. One way the body does this is by increasing blood pressure, which is why hypertension (Option A) is the correct answer in this scenario. Hypertension helps in maintaining perfusion to the brain by increasing the pressure within the blood vessels, thereby ensuring an adequate supply of oxygen and nutrients to the brain tissue. Regarding the incorrect options: - Fluid overload (Option B) is not a typical response to increase cerebral blood flow. In fact, fluid overload can lead to increased intracranial pressure, which is detrimental in stroke patients. - Cardiac dysrhythmias (Option C) and S3 and S4 heart sounds (Option D) are not directly related to the body's attempt to increase cerebral blood flow during a stroke. These findings may indicate underlying cardiac issues but are not specific to the situation described in the question. Educationally, understanding the physiological responses to a stroke is crucial for nurses caring for stroke patients. Recognizing signs like hypertension as the body's attempt to increase cerebral blood flow can guide appropriate interventions and help prevent further damage to the brain tissue. Regular monitoring and assessment of vital signs and neurological status are essential components of stroke care to ensure timely interventions and optimal patient outcomes.

Correct Answer: D

Rationale: In understanding the differences between generalized and focal seizures, it is crucial to grasp the underlying neurological mechanisms at play. The correct answer, D, states that generalized seizures involve bilateral synchronous epileptic discharges affecting the entire brain at the onset of the seizure. This is accurate as generalized seizures typically involve widespread electrical disturbances that affect both hemispheres simultaneously, leading to loss of consciousness and symmetric motor manifestations. Option A is incorrect as it describes focal seizures, not generalized seizures. Focal seizures originate in a specific area of the brain and may or may not spread to involve the whole brain. Option B is incorrect because some focal seizures can also result in loss of consciousness, especially if they secondarily generalize. Option C is incorrect as it describes the postictal phase, which can occur after both generalized and focal seizures. Educationally, comprehending the distinction between generalized and focal seizures is vital for healthcare professionals, especially in clinical settings. Understanding these differences aids in accurate diagnosis, appropriate management, and patient education. It also helps in differentiating between various types of epilepsy, guiding treatment decisions, and improving patient outcomes through personalized care plans.

Correct Answer: D

Rationale: In patients with Parkinson's disease, there are specific strategies that can help reduce the risk of falls due to the characteristic movement difficulties associated with the condition. The correct answer, D) Rock side to side to initiate leg movements, is based on the concept of utilizing a technique called "rocking" or "rocking back and forth" to overcome freezing episodes that commonly occur in Parkinson's disease. This technique helps initiate leg movements and can improve gait initiation, thereby reducing the risk of falls. Option A) Use an elevated toilet seat, while potentially beneficial for ease of use and safety in the bathroom, does not directly address the issue of reducing falls related to movement difficulties in Parkinson's disease. Option B) Use a walker or cane for support can be helpful for stability and balance but does not specifically address the freezing episodes and gait initiation problems seen in Parkinson's disease. Option C) Consciously lift the toes when stepping may be a general balance and gait strategy, but it does not specifically target the freezing episodes and challenges with gait initiation that are prominent in Parkinson's disease. Educational context is crucial when teaching about fall prevention strategies in patients with Parkinson's disease. Educating patients on specific techniques like rocking back and forth to initiate leg movements can empower them to better manage their symptoms and reduce the risk of falls, ultimately improving their quality of life and independence. It is essential to reinforce the rationale behind these strategies to ensure patient understanding and compliance in implementing them effectively.