Nursing Care for a patient with Cervical Spinal Cord Injury complicated by Neurogenic Shock and Respiratory Failure : Case Study.

Abstract

     This study was case study. The objective was to study nursing care for a patient with Cervical Spinal Cord Injury complicated by Neurogenic Shock, and Respiratory Failure. The study was conducted on a 64-year-old male patient who was referred to a community hospital for further treatment. He had a history of illness and an accident which he fell and hit the occipital region of his head. Following that, both arms and legs became weak. Seven hours before coming to the hospital, the doctor diagnosed him with a cervical spinal cord injury at levels 3 and 4. Preoperatively, he developed neurological shock and a urinary tract infection. Within 24 hours, he developed pneumonia, bradycardia, atelectasis, left hemifacial spasm, difficulty breathing, and hypoproteinemia. Treatment include Intravenous fluids, vasopressor, anticholinergic, steroids, antibiotics, and albumin Infusion. The operation performed was Anterior Cervical Discectomy and Fusion (ACDF) with metallic cage anterior plating, intubation and ventilator, and tracheostomy. Nursing interventions included assessing vital signs, assessing neurological signs, assessing fluid adequacy, administering vasopressor, steroids, antibiotics, and anticholinergic drug, providing a blenderized diet, using the ventilator effectively, weaning the ventilator upon signs of improvement in the condition, and preventing postoperative complications related to cervical spine surgery and immobility. After receiving treatment, the patient's condition resolved completely. He remained unable to self-care, with weakness in both arms and legs, The muscle strength was grade 0, requiring continuous rehabilitation of muscle strength and nerve function, which takes a long time. The doctor subsequently referred him back to a community hospital for continued care. The total length of stay was 46 days.