Elimination concerns with acute spinal cord trauma. Assessment and nursing interventions

Elimination for the spinal cord-injured patient presents a challenge to nurses in both the acute and rehabilitation phases. The most frequent GI and urinary complications associated with spinal shock are gastric dilatation and paralytic ileus, stress ulcers, metabolic disturbances, and neurogenic bowel and bladder. Associated clinical findings are often altered or absent from the lack of sensory, motor, and reflex functions. Nonspecific signs and symptoms such as anorexia, nausea, and vomiting, create the need for complex differential diagnosis. Critical care nurses have a vital role in this diagnostic process by monitoring and reporting significant changes in assessment and laboratory findings. In addition, care measures are directed at preventing complications or supporting the patient's current condition. These interventions include gastric decompression, gastric pH monitoring, administration of antacids, nutritional support, and early bowel and bladder management.