A client has a cervical spine injury at the level of C5. Which of the following conditions would the nurse anticipate during the acute phase?A. Absent corneal reflex.
A. Absent corneal reflex.
B. Decerebrate posturing.
C. Movement of only the right or left half of the body.
D. The need for mechanical ventilation.
Correct Answer: D. The need for mechanical ventilation
The diaphragm is stimulated by nerves at the level of C4. Initially, this client may need mechanical ventilation due to cord edema. This may resolve in time. C3 to C4 contribute to breathing by controlling the muscles of the diaphragm. Patients with an injury in this area of the cervical spine can complain of difficulty breathing.
Option A: Apart from the obvious physical complaints, neuropsychiatric symptoms noticeably vary out of proportion with the severity of the correspondent TBI. The patients who experience post-concussion syndrome may have somatic complaints like a headache, dizziness, cognitive impairment, and neuropsychiatric symptoms like anxiety, irritability, depression, and sleep disorders.
Option B: Decerebrate posturing occurs with brain injuries, not spinal cord injuries. Decerebrate posturing can be seen in patients with large bilateral forebrain lesions with progression caudally into the diencephalon and midbrain. It can also be caused by a posterior fossa lesion compressing the midbrain or rostral pons.
Option C: TBI may result in a decrease in short and long-term global health (physical and behavioral) and put them at an elevated risk for disability, pain, and handicap (i.e., difficulty with a return to work, maintaining peer networks.) Rehabilitation therapies like physical therapy, occupational therapy, speech-language therapy, and assistive devices and technologies may help to strengthen patients to perform their activities of daily living.
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