Spinal Cord Injury — NCLEX Cheat Sheet
C3-C5 keeps diaphragm aliveAlso known as: SCI · spinal injury · broken neck · paralysis injury
Use this quick-reference guide to spot, treat, and prevent Spinal Cord Injury on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
📌 Mechanism
- Higher injury = more deficit
- C4 above → vent dependent
- C3-5 = phrenic/diaphragm
🩺 Signs
- Spinal shock: flaccid, areflexia
- Neurogenic shock: ↓ BP, bradycardia
- Loss motor/sensory below level
✅ Do
- Immobilize spine, log roll
- Maintain airway, monitor resp
- DVT/skin/bowel-bladder program
🚩 Report
- Resp distress in cervical injury
- Autonomic dysreflexia = emergency
📚 Spinal Cord Injury — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Function is lost below the level of injury; cervical (C3-C5) injuries threaten the diaphragm and breathing.
- Spinal shock is a temporary loss of all reflexes, motor, sensory, and autonomic function below the injury, with flaccid paralysis.
- Neurogenic shock (often with high thoracic/cervical injury) causes hypotension, bradycardia, and warm, dry skin from loss of sympathetic tone.
- Paraplegia involves the lower body (thoracic/lumbar injury); tetraplegia/quadriplegia involves all four limbs (cervical injury).
- Autonomic dysreflexia is a later life-threatening complication in injuries at or above T6.
Nursing priorities
What to do, in order- Maintain a patent airway and adequate ventilation first; high cervical injuries may require mechanical ventilation.
- Immobilize the spine and maintain proper alignment to prevent further cord damage; logroll and keep the neck stabilized.
- Monitor for neurogenic shock: assess blood pressure and heart rate, and support circulation as ordered.
- Prevent complications of immobility: DVT prophylaxis, skin care/repositioning, and bowel and bladder programs.
- Perform serial neuro assessments to detect any change in motor or sensory level.
Red flags — report now
Escalate immediately- Any compromise of breathing in a cervical injury is a life-threatening emergency requiring immediate airway support.
- Hypotension with bradycardia (neurogenic shock) needs urgent intervention.
- Improper movement or removal of immobilization can cause permanent additional cord damage.
- Sudden severe hypertension with pounding headache in a T6-or-higher injury signals autonomic dysreflexia, an emergency.
Patient teaching
What patients must know- Learn skin inspection and pressure-relief techniques to prevent pressure injuries in insensate areas.
- Follow the prescribed bowel and bladder program and recognize early signs of autonomic dysreflexia.
- Participate in rehabilitation and use assistive devices to maximize independence.
❓ Spinal Cord Injury: NCLEX FAQs
What are the priority nursing interventions for Spinal Cord Injury?
Maintain a patent airway and adequate ventilation first; high cervical injuries may require mechanical ventilation. Immobilize the spine and maintain proper alignment to prevent further cord damage; logroll and keep the neck stabilized. Monitor for neurogenic shock: assess blood pressure and heart rate, and support circulation as ordered. Prevent complications of immobility: DVT prophylaxis, skin care/repositioning, and bowel and bladder programs.
What are the warning signs of Spinal Cord Injury a nurse must report?
Any compromise of breathing in a cervical injury is a life-threatening emergency requiring immediate airway support. Hypotension with bradycardia (neurogenic shock) needs urgent intervention. Improper movement or removal of immobilization can cause permanent additional cord damage. Sudden severe hypertension with pounding headache in a T6-or-higher injury signals autonomic dysreflexia, an emergency.
What do I need to know about Spinal Cord Injury for the NCLEX?
Function is lost below the level of injury; cervical (C3-C5) injuries threaten the diaphragm and breathing. Spinal shock is a temporary loss of all reflexes, motor, sensory, and autonomic function below the injury, with flaccid paralysis. Neurogenic shock (often with high thoracic/cervical injury) causes hypotension, bradycardia, and warm, dry skin from loss of sympathetic tone. Paraplegia involves the lower body (thoracic/lumbar injury); tetraplegia/quadriplegia involves all four limbs (cervical injury).
What patient teaching is important for Spinal Cord Injury?
Learn skin inspection and pressure-relief techniques to prevent pressure injuries in insensate areas. Follow the prescribed bowel and bladder program and recognize early signs of autonomic dysreflexia. Participate in rehabilitation and use assistive devices to maximize independence.
Quick Tip
Function is lost below the level of injury; cervical (C3-C5) injuries threaten the diaphragm and breathing.
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