Kim Johnson is a 26-year-old female police officer

 

Disease Process:

Risk Factors

 

Potential Complications

 

PATHOPHYSIOLOGY CONCEPT MAP

Pathophysiology (definition/etiology chronicity and prognosis)

Signs & Symptoms

Medical Interventions, labs and diagnostic studies

Nursing Diagnosis

Nursing Interventions

Situation: Kim Johnson is a 26-year-old female police officer with paraplegia from a thoracic 8 (T8) spinal cord injury. She was transferred to us yesterday.

Background: The complete spinal cord injury was caused by a low-velocity gunshot wound to her back at the T8 level while she was responding to a robbery 8 days ago. The bullet penetrated the spinal column with no injury to visceral organs.

Assessment: Last bowel movement was yesterday at 1900, and the gunshot wound appears healed. Her neurological status is stable. She is awake and oriented. Bilateral upper extremity motor response is +4, and there is no movement or sensation to the lower extremities. She has been out of bed to a wheelchair. She is on a regular, high-fiber diet, and had breakfast at 0700. At 0400 she was catheterized for 300 mL of clear, yellow urine. The measured urine volume from the bladder scan 5 minutes ago was 321 mL.

Recommendation: She is due for assessment of vital signs and the 0800 intermittent urinary catheterization, which can be done after you have reviewed the chart. You should also begin the patient education on her bladder management program and the steps for a straight catheterization. The physical therapist is scheduled to see the patient at 1030.

 

aylor, C., Lynn, P., Bartlett, J. (2019). Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition.

Rehabilitation Centers, Chapter 11, p. 255

Problems Affecting the Central Nervous System, Chapter 33, p. 1139

Urinary Elimination, Chapter 37, p. 1348, Focused Assessment Guide 37-1

Characteristics of Urine, Chapter 37, p. 1350, Table 37-1

Common Diagnostic Procedures Used to Study the Urinary Tract, pp. 1354-1356, Box 37-2

Promoting Normal Urination, Chapter 37, pp. 1356-1357

Diseases and Conditions

Expert Clinical Content from Lippincott Advisor

Pharmacology

Spinal Injury

Pharmacology

Neurogenic Bladder

Pharmacology

Expert Clinical Content from Lippincott Advisor

Pharmacology

Omeprazole

Pharmacology

enoxoparin sodium

Pharmacology

oxybutynin chloride

Pharmacology

docusate calcium

Diagnostic tests

Expert Clinical Content from Lippincott Advisor

Pharmacology

Creatinine level (serum)

Procedures

Expert Clinical Content from Lippincott Procedures

Pharmacology

Intermittent (straight) urinary catheter insertion, female

Pharmacology

Bladder ultrasonography

Pharmacology

Intake and output assessment


 

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