online solution: S.W., an 18-yr-old white woman, is admitted to the emergency

S.W., an 18-yr-old white woman, is admitted to the emergency… S.W., an 18-yr-old white woman, is admitted to the emergency department with the diagnosis of a cervical SCI. S.W. was swimming at a neighbor’s backyard pool. She dove into the shallow end, striking her head on the bottom of the pool. Her friends noticed she did not resurface. They rescued her and brought her to the side of the pool. They maintained neck immobilization until rescue crews arrived.Subjective DataAwake and alertComplaining of neck painAnxious and asking why she cannot move her legsAsking to see her familyObjective DataWeak biceps movement bilaterallyNo triceps movement bilaterallyGross elbow movement present bilaterallyNo movement in bilateral lower extremitiesDecreased sensation from the shoulders downNo bladder or bowel controlBP 85/50 mm Hg; pulse 56 beats/min; respirations 32 breaths/min and laboredDiagnostic StudiesCT C-spine shows C5 subluxation and compression fractureMRI C-spine shows severe spinal cord compression at C5-6Interprofessional CareIntubated in the emergency departmentStarted on mechanical ventilationPlaced in tongs and traction on arrival to the ICU  Questions to Answer (Acute Phase):Priority Decision: What nursing activities would be a priority on S.W.’s arrival in the ICU?What physiologic problems are causing S.W. to have hypotension and bradycardia?What would be the initial treatment for S.W.’s hypotension and bradycardia?Safety: What signs and symptoms would indicate respiratory distress? What physiologic problem would cause respiratory distress in S.W.’s injury state?Teamwork and Collaboration: What can the interprofessional team do to decrease S.W.’s anxiety?Priority Decision: Based on the assessment data provided, what are the priority nursing diagnoses? What are the collaborative problems?Teamwork and Collaboration: Identify activities that can be delegated to unlicensed assistive personnel (UAP). Scenario Continued (Rehabilitation Phase)S.W. is now 1 month post injury and has been admitted to a local inpatient SCI rehabilitation facility. She has been extubated and uses a wheelchair to mobilize. She eats three meals a day with assistance and is on a strict bowel and bladder program.Subjective DataAwake and alert but anxiousComplaining of severe headache, blurred vision, and nauseaObjective DataFlushed and diaphoretic above the level of injuryNo bowel movement for 2 daysBP 235/106 mm Hg, pulse 32 beats/min, respirations 30 breaths/min and labored Questions to Answer (Rehabilitation Phase):Priority Decision: What initial priority nursing interventions would be appropriate?What physiological problem is causing S.W.’s hypertension and bradycardia?Once the HCP has been notified, what other interventions would be appropriate?11. Quality Improvement: What outcomes would indicate that nursing interventions were successful?Priority Decision: Based on the assessment data provided, what are the priority nursing diagnoses?Patient-Centered Care: Patient and family involvement in the rehabilitation process is vital. What teaching will you provide about bowel management?Evidence-Based Practice: S.W. and her family are concerned about the risk of autonomic hyperreflexia. What effective strategies to prevent autonomic hyperreflexia would you discuss with the patient and family? Health Science Science NursingNSG 401

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