Author Question: A patient diagnosed with a spinal cord injury experienced spinal shock lasting 15 days. The pa-tient ... (Read 137 times)

fahad · **on:** Jun 25, 2018

A patient diagnosed with a spinal cord injury experienced spinal shock lasting 15 days. The pa-tient is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. What does the nurse suspect caused this condition?

a. Toxic accumulation of free radicals below the level of the injury
b. Pain stimulation above the level of the spinal cord lesion
c. A distended bladder or rectum
d. An abnormal vagal response

Question 2

Six weeks ago a patient suffered a T6 spinal cord injury. What complication does the nurse sus-pect when the patient develops a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia?

a. Extreme spinal shock
b. Acute anxiety
c. Autonomic hyperreflexia
d. Parasympathetic areflexia

jliusyl · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: C
The described symptoms indicate autonomic hyperreflexia and are due to a distended bladder or rectum. The described symptoms are not due to the accumulation of free radicals, pain stimula-tion, or an abnormal vagal response.

Answer to Question 2

ANS: C
The patient is experiencing autonomic hyperreflexia, which is manifested by paroxysmal hyper-tension (up to 300 mm Hg, systolic), a pounding headache, blurred vision, sweating above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection caused by pi-lomotor spasm, and bradycardia (30-40 beats/min). The patient in extreme spinal shock experi-ences paralysis and flaccidity in muscles, absence of sensation, loss of bladder and rectal control, transient drop in blood pressure, and poor venous circulation. The patient may experience acute anxiety, but the symptoms of elevated blood pressure with severe headache are due to autonomic hyperreflexia.
It is autonomic hyperreflexia, not parasympathetic areflexia, that produces paroxysmal hyperten-sion (up to 300 mm Hg, systolic), a pounding headache, blurred vision, sweating above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection caused by pilomotor spasm, and bradycardia (30-40 beats/min).