Page 2483 - Saunders Comprehensive Review For NCLEX-RN

level, the bladder will contract but not empty
(neurogenic bladder).
3. Injury above S2 in males allows them to have an
erection, but they are unable to ejaculate because of
sympathetic nerve damage.
4. Injury between S2 and S4 damages the sympathetic
and parasympathetic response, preventing erection or
ejaculation.

M. Emergency interventions

Always suspect spinal cord injury when trauma occurs until this injury is ruled

out. Immobilize the client on a spinal backboard with the head in a neutral position to
prevent an incomplete injury from becoming complete.
1. Emergency management is critical, because improper
movement can cause further damage and loss of
neurological function.
2. Assess the respiratory pattern and maintain a patent
airway.

3. Prevent head flexion, rotation, or extension.

4. During immobilization, maintain traction and
alignment on the head by placing hands on both sides
of the head by the ears.
5. Maintain an extended position.
6. Logroll the client.
7. No part of the body should be twisted or turned, and
the client is not allowed to assume a sitting position.
8. In the emergency department, a client who has
sustained a cervical fracture should be placed
immediately in skeletal traction via skull tongs or
halo traction to immobilize the cervical spine and
reduce the fracture and dislocation.

N. Interventions during hospitalization

1. Respiratory system
a. Assess respiratory status, because
paralysis of the intercostal and
abdominal muscles occurs with C4
injuries.
b. Monitor arterial blood gas levels and
maintain mechanical ventilation if
prescribed to prevent respiratory
arrest, especially with cervical injuries.
c. Encourage deep breathing and the use
of an incentive spirometer.

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