A patient sustained an injury to the cervical area of the spinal cord approximately 3 hours prior to being admitted through the emergency department
The nurse realizes that which of the following can be indicated for this patient? 1. insert an indwelling urinary catheter
2. measure pulse oximetry
3. infusion of methylprednisolone
4. monitor blood pressure
3
Rationale: Studies have shown that patients who receive methylprednisolone after a spinal cord injury have a reduction in secondary injury to the spinal cord and that methylprednisolone has a profound effect on functional level. National Acute Spinal Cord Injury studies suggest that secondary injury may be diminished if methylprednisolone is initiated within 8 hours of injury with an initial bolus of 30 mg/kg, followed by a continuous infusion of 5.4 mg/kg/hr over 23 to 48 hours. The insertion of an indwelling urinary catheter may or may not be indicated for the patient. Measuring the patient's pulse oximetry will evaluate the patient's oxygenation status but will not help prevent a secondary injury. Monitoring blood pressure is also important but will not help prevent a secondary injury.
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