Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

What is a primary goal of care in the first 48 hours for an individual with a spinal cord injury?

1. Prevent postural hypotension

2. Manage dependent edema

3. Maintain neurologic and orthopedic stability

4. Prevent complications from immobility

The correct answer is: Maintain neurologic and orthopedic stability

The primary goal of care in the first 48 hours for an individual with a spinal cord injury is to maintain neurologic and orthopedic stability. This critical period following a spinal cord injury is essential for preventing further damage to the spinal cord and surrounding structures. Ensuring stability helps to mitigate any potential secondary injury that may arise due to the physiological responses to the injury, such as swelling or impaired blood flow. Maintaining neurologic stability involves careful monitoring of the patient’s neurological status, which includes assessing motor and sensory function. This allows healthcare providers to detect any changes that may indicate deterioration of the injury or the need for surgical intervention. Orthopedic stability focuses on ensuring that the spine remains aligned and stable, which may involve the use of braces or traction, and supports the healing process. Immediate concerns such as preventing postural hypotension, managing dependent edema, and preventing complications from immobility are certainly important considerations in spinal cord injury care. However, they are typically secondary to the urgent need to stabilize the patient's neurological and orthopedic status in the initial hours following the injury. Addressing these secondary goals often follows after ensuring that the primary stability objectives are successfully met.