Rehab Nursing
The Rehab Nursing program helps individuals affected by chronic illness or physical
disability achieve their greatest potential, adapt to their disabilities and work
toward productive, independent lives.
At Sister Kenny Rehabilitation Institute, there are many components of the Rehab
Nursing program for people with spinal cord injury:
Spinal cord injury education
A program is in place to ensure that all areas of spinal cord injury are covered. A series of videos are shown and a comprehensive manual is given to each patient.
Bladder management
The purpose of the program is to eliminate urine from the body with the eventual goal of restoring continence, which gives the patient control of his or her bladder.
Physicians in the Rehab Nursing program are skilled in the application of various
medications used to regulate the bladder. A bladder management program is designed based on each patient’s needs and specific injury.
In addition to restoring continence, care team members will teach the patient
about:
- the anatomy and physiology of the urinary system
- preventing complications like bladder
infections, kidney
stones and uretral reflux
- fluid guidelines in order to prevent overdistention (expansion) of the bladder.
Nurses, in collaboration with the physicians, will also establish a catheterization program to fit each patient’s individual bladder needs.
Bowel management
A custom bowel management program can be designed based on a patient’s individual
needs. Various techniques used to achieve continence and regularity include:
- digital stimulation
- oral medications
- suppositories
- mini-enemas.
Program participants also learn about the importance of good nutrition and a high
fiber diet in maintaining bowel continence and regularity.
Skin management
The best way to treat skin breakdown is to prevent it. We work with patients to
establish good skin care to help them prevent hospital stays for pressure
ulcer treatment and surgery.
Guidelines established by our program require the patient to:
- do pressure relief at least every 20-30 minutes
- eat foods that feed the skin, including maintaining a good diet full of
protein (necessary for when a patient is sick or losing weight as the skin
becomes more sensitive), vitamins and minerals. Drink plenty of fluids within
the limit of a bladder program.
- keep the skin clean and dry
- build up skin tolerance
- check your skin inch by inch twice a day: once before you get out of bed
and again before you get back into bed
- be kind to your feet; circulation is slower and they take longer to heal
- stop
smoking
Care team members also work with each patient to:
- educate patients regarding their level of spinal cord injury and ways to maintain independence through promotion of self care.
- establish proper wheelchair positioning
- ensure that a proper mattress is used
- avoid extreme changes in temperature
- maintain ideal
body weight
- wear clothing and shoes that are neither too loose nor too tight
- find ways to avoid stress
Autonomic dysreflexia
Autonomic dysreflexia is a life threatening emergency and must be treated immediately.
Autonomic dysreflexia is an overreaction of the nervous system caused by an irritation
or other stimulus. The most common cause is a full bladder. Other causes are bowel
fullness, irritation to the skin, sexual activity and infection. Physicians teach
the patient and caregivers how to recognize signs and symptoms of autonomic dysreflexia
and treatment options.
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