Quadriplegia

Definition

Quadriplegia (tetraplegia) is paralysis affecting all four extremities and often the trunk, resulting from spinal cord injury at the cervical level (C1-C8). Injury at C4 and above affects diaphragm and requires mechanical ventilation.

Key Complications

• Respiratory: impaired ventilation, atelectasis, pneumonia
• Cardiovascular: orthostatic hypotension, autonomic dysreflexia (T6 and above)
• Bladder/bowel dysfunction
• Pressure injuries
• DVT
• Spasticity/contractures

Autonomic Dysreflexia (Emergency)

Severe hypertension, pounding headache, bradycardia, flushing/sweating above lesion, usually triggered by distended bladder (most common), impacted stool, or pressure injury. INTERVENTIONS: Sit patient UP (lower BP), find and remove trigger (check catheter, disimpact), monitor BP every 5 min, give antihypertensives if needed.

Nursing Interventions

Ventilation support, C-spine precautions, bowel/bladder program, skin care, ROM, DVT prophylaxis, psychosocial support.

NCLEX Relevance

Autonomic dysreflexia: sit UP first, find trigger.