tetraplegia /tet·ra·ple·gia/ (-ple´jah) quadriplegia.
tetraplegia,
quadriplegia [kwod″rĭ-ple´jah]
tet·ra·ple·gia (t t r -pl  j)n. See quadriplegia. |
tetraplegia,
paralysis of the arms, legs, and trunk of the body below the level of an associated injury to the spinal cord. This disorder is usually caused by spinal cord injury, especially in the area of the fifth to the seventh vertebrae. Automobile accidents and sporting mishaps are common causes. This condition affects about 150,000 Americans, the majority of whom are men between 20 and 40 years of age. Signs and symptoms commonly include flaccidity of the arms and the legs and the loss of power and sensation below the level of the injury. Cardiovascular complications also may develop from any injury that damages the spinal cord above the fifth cervical vertebra because of an associated block of the sympathetic nervous system. A major cause of death from such injury is respiratory failure. Other symptoms may include low body temperature, bradycardia, impaired peristalsis, and autonomic dysreflexia. Diagnosis is based on a complete physical and neurologic examination with radiographic pictures of the head, chest, and abdomen to rule out underlying injuries. Spinal x-ray examinations and CT scores and MRI are usually done to evaluate the extent of the injury. Also called quadriplegia. Compare hemiplegia, paraplegia.
interventions Treatment starts at the accident scene, where the patient's neck and spine are immobilized. Additional immobilization at the hospital commonly includes the use of halo traction. Steroids may be administered to decrease spinal cord edema. Surgery is commonly performed to fuse unstable spinal sections and remove bone fragments.
nursing considerations Nursing care includes maintaining adequate respiration and blood pressure according to the Guidelines for Management of Spinal Cord Injury, maintaining the integrity of the GI system, preventing complications such as hypothermia, bradycardia, catheter obstruction, and fecal impaction. A quadriplegic patient who suffers hypothermia is wrapped in blankets instead of being warmed with hot water bottles or electromechanic devices because such devices can burn the skin of the patient experiencing severe sensory loss. Abdominal binders and antiembolism hose are used when the patient is placed in an upright position. Patients who develop bradycardia are commonly connected to a cardiac monitor and intravenously administered an antimuscarinic drug, such as atropine. Fecal impaction may cause hypertension and is always a possible complication.
quadriplegia [kwod″rĭ-ple´jah]
paralysis of all four limbs; motor and/or sensory function in the cervical spinal segments is impaired or lost due to damage to that part of the spinal cord, resulting in impaired function in the upper limbs, lower limbs, trunk, and pelvic organs. This term does not include conditions due to brachial plexus lesions or to injuries of peripheral nerves outside the spinal canal. Called also tetraplegia. adj., adj quadriple´gic.
Patient Care. The quadriplegic patient has major sensory and motor deficits and is therefore subject to the many problems associated with immobility and loss of sensation. (See hazards of immobility.) The immediate goal of care is the prevention of complications that can affect all body systems, and maintenance of the integrity of the body systems so that optimum rehabilitation can be achieved. The extent to which the patient may eventually achieve mobility in a wheelchair and some degree of independence is greatly affected by the caliber of care received and the motivation and drive of the individual patient.
Mechanical devices such as braces are helpful in compensating for the loss of muscular function. physical therapy procedures and techniques and occupational therapy are essential aspects of patient care and are vital to the attainment of the goals of rehabilitation. (See also paraplegia.)
Patient education is especially important to the long-range goal of prevention of serious complications. Patients and their families should be aware of the early signs and symptoms of breakdown of the skin (pressure ulcer), fecal impaction, a developing infection, and urinary difficulties. As with any type of long-term care, these patients should be medically evaluated periodically and their care should be under the supervision of a visiting nurse. In spite of the many difficulties that may be encountered by paralyzed patients, it is possible for them to lead useful and personally rewarding lives.
Mechanical devices such as braces are helpful in compensating for the loss of muscular function. physical therapy procedures and techniques and occupational therapy are essential aspects of patient care and are vital to the attainment of the goals of rehabilitation. (See also paraplegia.)
Patient education is especially important to the long-range goal of prevention of serious complications. Patients and their families should be aware of the early signs and symptoms of breakdown of the skin (pressure ulcer), fecal impaction, a developing infection, and urinary difficulties. As with any type of long-term care, these patients should be medically evaluated periodically and their care should be under the supervision of a visiting nurse. In spite of the many difficulties that may be encountered by paralyzed patients, it is possible for them to lead useful and personally rewarding lives.
Quadriplegia.
tetraplegia
paralysis of all four extremities; quadriplegia.
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