The nurse is caring for a patient immediately after a spinal cord injury between T7-T8 vertebrae. The patient displays the following symptoms: absent reflexes, flaccidity, loss of sensation below the level of injury, bradycardia, and hypotension. These are signs of which condition?
Neurogenic shock
Brain herniation
Spinal shock
Autonomic dysreflexia
The Correct Answer is A
A. Neurogenic shock occurs in spinal cord injuries above T6 and is characterized by hypotension, bradycardia, and loss of sympathetic tone below the level of injury. This condition results from disruption of autonomic pathways.
B. Brain herniation typically involves increased intracranial pressure and different neurological symptoms.
C. Spinal shock involves temporary loss of reflexes and sensation but does not specifically cause bradycardia or hypotension.
D. Autonomic dysreflexia involves sudden high blood pressure and is usually triggered by noxious stimuli, occurring after the acute phase of SCI.
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Correct Answer is A
Explanation
A. Standard precautions should be used for all patients, including those with AIDS, as they are designed to prevent the transmission of infections regardless of the patient's diagnosis. This includes the use of gloves, hand hygiene, and proper disposal of sharps.
B. Droplet precautions are specific to diseases that are spread through respiratory droplets, which is not the primary concern in AIDS management.
C. Contact precautions are used for infections that can be transmitted through direct contact with the patient or contaminated surfaces, but are not routinely required for AIDS patients unless they have co-infections.
D. Behavioral precautions are not a recognized category for infection control in clinical settings.
Correct Answer is C
Explanation
A. Penicillins are generally safe but are not specific for ototoxicity considerations.
B. Aminoglycosides are avoided in cases of tympanic membrane rupture due to their ototoxic potential, which can lead to hearing loss.
C. Fluoroquinolones, particularly those formulated for otic use, are preferred for tympanic membrane ruptures as they are not ototoxic and are safe for middle ear exposure.
D. Cephalosporins are not typically ototoxic but are less commonly used for tympanic membrane ruptures compared to fluoroquinolones.