. A patient is diagnosed with Brown-Sequard syndrome after a spinal cord injury. Which of the following symptoms should the nurse expect?
Loss of pain temperature, and light touch sensation on the same side as the injury
Loss of motor function and deep pressure sensation on the opposite side of the injury
Loss of motor function and position sense on the same side as the injury
Loss of motor function with preserved pain and temperature sensation in the lower extremities
The Correct Answer is C
A. Loss of pain, temperature, and light touch sensation on the same side as the injury. In Brown-Sequard syndrome, pain, temperature, and light touch are typically lost on the opposite (contralateral) side of the injury.
B. Loss of motor function and deep pressure sensation on the opposite side of the injury. Motor function and deep pressure sensation loss occur on the same side (ipsilateral) as the injury.
C. Loss of motor function and position sense on the same side as the injury. Brown-Sequard syndrome is a spinal cord hemisection injury leading to loss of motor function and proprioception on the same side as the injury.
D. Loss of motor function with preserved pain and temperature sensation in the lower extremities. Pain and temperature sensations are lost on the opposite side of the injury in Brown-Sequard syndrome, not preserved.
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Correct Answer is D
Explanation
A. I need to monitor the puncture site for signs of infection such as redness or swelling. Monitoring the puncture site is crucial for detecting any signs of infection or complications, which the patient should be aware of.
B. I should follow a heart-healthy diet to support my recovery. A heart-healthy diet is recommended to manage cholesterol levels and prevent further coronary artery disease progression.
C. I will take my prescribed medications as directed by my doctor. Following the medication regimen is important for preventing complications and supporting recovery, especially for blood thinners or other cardiac medications.
D. I can resume my regular physical activities immediately after I get home. This statement indicates a need for further teaching, as patients should gradually resume physical activities and avoid strenuous activities immediately after PTCA to prevent complications, such as bleeding at the catheter insertion site.
Correct Answer is ["A","C","D","E"]
Explanation
A. Ensure that the client's urine output is at least 1 ml/kg/hr. Adequate urine output is essential before administering IV potassium to ensure the kidneys are functioning properly and can handle the increased potassium load, preventing hyperkalemia.
B. Ensure potassium infusion is prepared with 5% dextrose solution. While IV potassium can be mixed with normal saline or dextrose solutions, the specific diluent will depend on the clinical scenario. This isn't necessarily a standard requirement, so it may not be appropriate for all situations.
C. Educate the client regarding high-potassium foods. Education on high-potassium foods helps the client maintain potassium levels after treatment, reducing the need for future supplementation.
D. Repeat blood serum potassium levels. Rechecking potassium levels ensures the patient reaches a safe and therapeutic range and helps monitor for signs of overcorrection or continued hypokalemia.
E. Cardiac monitoring during infusion. Cardiac monitoring is critical, as hypokalemia and potassium replacement can affect heart rhythm and lead to arrhythmias.