Neurological disorders.Case study# 1

Welcome to your Neurological disorders.Case study# 1

Question 1 of 6 Neuro CS1

Mr. P is a 24-year-old man. While he was water skiing, he was hit by a boat. He was rescued from the water by friends. He was immobilized and transported to the hospital by paramedics called to the scene.
Given Mr. P's clinical presentation and MRI findings, what underlying pathophysiological mechanism is most likely contributing to his hypotension and bradycardia?

Shock due to inadequate fluid volume in the circulatory system

Shock resulting from impaired pumping ability of the heart

Shock resulting from disrupted sympathetic nerve impulses due to spinal injury

Shock due to a systemic inflammatory response to an infection

Shock due to physical blockage obstructing the flow of blood

Shock induced by extreme stress or emotional trauma without physical injury

Shock resulting from a severe allergic reaction causing widespread vasodilation

Transient phase following spinal cord injury characterized by loss of reflexes

Question 2 of 6 Neuro CS1

Mr. P is a 24-year-old man. While he was water skiing, he was hit by a boat. He was rescued from the water by friends. He was immobilized and transported to the hospital by paramedics called to the scene.
In managing Mr. P’s urinary incontinence, which intervention strategy best adheres to evidence-based practice for spinal cord injury?

Question 3 of 6 Neuro CS1

Mr. P is a 24-year-old man. While he was water skiing, he was hit by a boat. He was rescued from the water by friends. He was immobilized and transported to the hospital by paramedics called to the scene.
Regarding the optimization of Mr. P’s respiratory status, which strategy is crucial to implement initially, considering his difficulty in breathing and potential spinal cord involvement?

Intubation and mechanical ventilation

Non-invasive ventilation (BiPAP)

Incentive spirometry

Administration of bronchodilators

Chest physiotherapy

Assisted cough technique

Suctioning

High-flow nasal cannula

Question 4 of 6 Neuro CS1

Mr. P is a 24-year-old man. While he was water skiing, he was hit by a boat. He was rescued from the water by friends. He was immobilized and transported to the hospital by paramedics called to the scene.
Considering the diagnostic of neurogenic shock, after management with intubation and mechanical ventilation, which pharmacologic intervention would be most suitable for the initial management of Mr. P's hemodynamic status?

Administration of dopamine as prescribed

Administration of norepinephrine as prescribed

Intravenous fluid resuscitation as prescribed

Administration of epinephrine as prescribed

Empirical antibiotic therapy as prescribed

Administration of atropine as prescribed

Administering a beta-blocker as prescribed

Initiation of anticoagulation therapy as prescribed

Question 5 of 6 Neuro CS1

Mr. P is a 24-year-old man. While he was water skiing, he was hit by a boat. He was rescued from the water by friends. He was immobilized and transported to the hospital by paramedics called to the scene.
Mr. P is diagnosed with an incomplete spinal cord transection and neurogenic shock.
When considering the psychosocial implications of Mr. P’s new diagnosis, which immediate intervention should the healthcare team prioritize?

Immediate referral to a vocational rehabilitation counselor

Discussing long-term care facilities

Initiation of sexual health counseling

Urgent consult with a neurosurgeon

Facilitation of a meeting with a peer mentor with a spinal cord injury

Commencement of intensive physical therapy

Consultation with a psychiatrist for acute stress disorder management

Encouraging participation in a spinal cord injury support group

Question 6 of 6 Neuro CS1

Mr. P is a 24-year-old man. While he was water skiing, he was hit by a boat. He was rescued from the water by friends. He was immobilized and transported to the hospital by paramedics called to the scene.
Mr. P was admitted to the emergency department with abrasions and bruising to his head and shoulders. He is having difficulty breathing and is unable to move his extremities. He complains of neck pain, and he has a cervical collar in place. He has urinary and fecal incontinence.
He does not have motor, sensory, or deep tendon reflexes from the neck to the feet. He is awake and able to talk.
Mr. P is diagnosed with an incomplete spinal cord transection and neurogenic shock.
Regarding pressure ulcer prevention for Mr. P, which nursing intervention is essential to incorporate in the initial care plan, considering his immobility and sensory deficits?

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