Terms in this set (20)
Injury resulting from sharp hyperextension and flexion of the cervical spine that damage muscles, ligaments, disks, and nerve tissue
Excellent prognosis, symptoms usually subsiding with symptomatic treatment
Also called whiplash
Unexpected force causes the head to jerk back and then forward.
The neck bones snap out of position, causing injury.
Irritated nerves can interfere with blood flow and transmission of nerve impulses.
Microvascular bleeding and local release of inflammatory mediators may lead to acute symptoms.
Pinched nerves can affect certain body part functions.
Motor vehicle accidents
Driving under the influence of alcohol or drugs
Lack of or improper use of seat belts
One million cases occur each year in the United States, with patients typically ages 40 to 49.
Trauma and sports injuries are most common in young adults.
Chronic pain syndrome
Mechanism of injury
Pain initially minimal but increases 12 to 72 hours after the accident
Neck pain, stiffness, tenderness
Neck muscle asymmetry
Reduced neck mobility
Rigidity or numbness in the arms
Tenderness at the exact location of the injury
Decreased active and passive range of motion
Diagnostic Test Results-Imaging
Full cervical spine X-rays rule out cervical fracture.
Soft cervical collar (see Applying a cervical collar) for periods of increased pain
Ice packs or ice massage
Transcutaneous electrical nerve stimulation (TENS)
Limited activity during the first 24-72 hours after the injury
Limited neck movement
Limited strenuous activities, such as lifting and contact sports, until full recovery has been established (which may take more than 2 years)
Oral analgesics, such as acetaminophen and hydrocodone-acetaminophen
Cyclooxygenase-2 (COX-2) inhibitors, such as celecoxib, or nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen sodium for inflammation
Muscle relaxants, such as tizanidine, carisoprodol, cyclobenzaprine hydrochloride, oxazepam, or methocarbamol
Low-dose tricyclic antidepressants to promote rest and sleep, such as amitriptyline for sleep if analgesics and muscle relaxants provide no relief
Possible surgical stabilization in severe cervical acceleration-deceleration injuries
Nursing Considerations-Nursing Diagnoses
Impaired physical mobility
Risk for posttrauma syndrome
Nursing Considerations-Expected Outcomes
express feelings of increased comfort and decreased pain
express feelings of decreased anxiety
attain the highest degree of mobility possible
state feelings and fears about the injury.
Nursing Considerations-Nursing Interventions
Protect the patient's spine during all care.
Give prescribed drugs, such as, acetaminophen and nonsteroidal anti-inflammatory drugs for mild to moderate pain; administer muscle relaxants if prescribed, usually at night.
Apply a soft cervical collar.
Apply ice packs as ordered, usually every 1 to 2 hours for 15 to 20 minutes.
Assist with beginning range-of-motion exercises and isometric strengthening exercises, as prescribed. Anticipate starting with painless, active, assistive range-of-motion exercises.
Tell the patient to use the soft cervical collar for short periods of time.
Range of motion
Response to medications
Nursing Considerations-Associated Nursing Procedures
Cervical collar application
Oral drug administration
activity restrictions, including type and duration; prescribed exercise routine
proper application of soft cervical collar and the duration of use; that the collar should only be worn for short periods of time (less than 3 hours at a time) and for no more than 1 to 2 weeks
medication administration, dosage, and possible adverse effects, such as drowsiness with muscle relaxants
instructions about driving and the use of alcohol when muscle relaxants are prescribed
resolution of symptoms (with mild symptoms typically resolving within 6 months and injuries involving degenerative changes within 30 months)
planned physical therapy regimen, including frequency and duration, as appropriate
preventive measures, such as proper head and neck positioning when playing sports; proper stretching measures; stress reduction; and proper posture
importance of follow-up evaluation.
Patient Teaching-Discharge Planning
Refer the patient to a neurologist, as indicated.