Goals of rehabilitation for the patient with an injury at the C6 level include: Select all that apply
stand erect with leg brace
feed self with hand devices
assist with transfer activities
drive adapted van from wheelchair
push a wheelchair on a flat surface
Correct Answer : B,C,D,E
A C6 spinal cord injury allows partial use of the shoulders and upper arms as well as wrist extension. With adaptive devices and rehabilitation, patients can achieve independence in many activities of daily living (ADLs) but cannot ambulate independently because leg function is absent.
Rationale for correct answers:
2. Feed self with hand devices. Patients at C6 can use adaptive hand devices to feed themselves because they retain shoulder movement and partial wrist control.
3. Assist with transfer activities. With training, patients can participate in transfers using sliding boards or mechanical lifts.
4. Drive adapted van from wheelchair. Adaptive driving controls make this possible with upper extremity strength and wrist function.
5. Push a wheelchair on a flat surface. C6 patients have enough arm and wrist strength to propel a manual wheelchair on level ground.
Rationale for incorrect answer:
1. Stand erect with leg brace. This requires lower extremity motor function, which is absent at the C6 injury level. Standing with braces is possible only with lower thoracic or lumbar injuries, not cervical.
Take-home points:
- C6 injury patients have functional use of shoulders, arms, and wrists but no voluntary leg function.
- They can achieve independence in feeding, transfers, mobility, and some driving with adaptive equipment.
- Walking or standing independently is not realistic at this level of injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A condom catheter is an appropriate bladder management method for a male patient with a cervical spinal cord injury who has some voluntary voiding or reflex bladder emptying. This method is noninvasive, reduces the risk of urethral trauma, and allows for continuous urinary drainage without the complications of an indwelling catheter. Proper placement and hygiene are essential to prevent skin breakdown and infection.
Rationale for correct answer:
1. Condom catheter. This method provides a safe and convenient option for male patients with SCI who can void reflexively or partially, reducing the risk of urinary tract infections compared with indwelling catheters. It is less invasive and allows the patient to maintain some independence in urinary management.
Rationale for incorrect answers:
2. Intermittent urinary catheterization. While generally preferred for long-term bladder management, it may not be needed if the patient can void adequately with a condom catheter.
3. Crede’s method. Manual compression of the bladder is less safe and can increase the risk of urethral trauma or reflux, particularly in high-level injuries.
4. Indwelling urinary catheter. Continuous catheterization carries a higher risk of infection and urethral injury, making it less desirable for long-term use.
Take-home points:
- A condom catheter is suitable for male SCI patients with reflex or partial voiding.
- Proper placement and hygiene are essential to prevent skin breakdown and infection.
- More invasive methods like indwelling catheters or Crede’s method are reserved for patients who cannot void adequately.
Correct Answer is C
Explanation
For patients with a cervical spinal cord injury who have not undergone surgical stabilization, skeletal traction with skull tongs is commonly used to maintain spinal alignment. This method provides continuous immobilization and realigns vertebrae while allowing for gradual reduction of fractures. Proper nursing care includes monitoring for traction-related complications and maintaining pin site integrity.
Rationale for correct answer:
3. Skeletal traction with skull tongs. Traction provides immobilization and stabilization of the cervical spine while preventing further injury. It allows for controlled alignment of cervical vertebrae and reduces pressure on the spinal cord. Nurses must ensure proper positioning, weight management, and regular neurovascular assessments.
Rationale for incorrect answers:
1. Kinetic beds. These beds are used mainly for spinal precautions in thoracic and lumbar injuries, not for cervical stabilization.
2. Hard cervical collar. This provides immobilization for minor or stable injuries but is insufficient for unstable cervical fractures.
4. Sternal-occipital-mandibular immobilizer brace. This brace is rarely used and does not provide the precise alignment achieved with skeletal traction in acute unstable cervical injuries.
Take-home points:
- Skeletal traction with skull tongs is standard for unstable cervical SCI without surgery.
- Continuous monitoring and pin care are essential to prevent complications.
- Traction maintains spinal alignment and minimizes further neurologic damage.
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