A client with massive trauma and possible spinal cord injury is admitted to the emergency department following a dirt bike accident. Which clinical manifestation does the nurse assess to help best confirm a diagnosis of neurogenic shock?

Question

A client with massive trauma and possible spinal cord injury is admitted to the emergency department following a dirt bike accident.  Which clinical manifestation does the nurse assess to help best confirm a diagnosis of neurogenic shock?

Quizplus · Accepted Answer

11ecbb05_cafa_b0d1_b433_a5ee7e028e16_MD0009_00 Neurogenic shock belongs to the group of distributive (vasodilatory) shock. It affects the vasomotor center in the medulla and causes a disruption in the sympathetic nervous system (SNS); the parasympathetic nervous system (PNS) remains intact. The imbalance of activity between the SNS and PNS results in massive vasodilation and pooling of blood in the venous circulation, causing hypotension and bradycardia, the characteristic manifestations of neurogenic shock. (Option B) Hypotension, not hypertension, is characteristic of neurogenic shock. (Option C) Warm, dry skin is more likely to be present in neurogenic shock; cool, clammy skin is not a characteristic manifestation. (Option D) Although thermoregulation may be impaired (poikilothermia) in neurogenic shock, a low-grade temperature of 100 F (37.7 C) is not a characteristic manifestation. Educational objective: Neurogenic shock (a form of distributive shock) causes a disruption in the function of the sympathetic, but not parasympathetic, nervous system. Bradycardia, a characteristic manifestation of neurogenic shock, occurs as a result of this alteration in neural activity between the 2 systems.

A Client with Massive Trauma and Possible Spinal Cord Injury