A patient with a spinal cord injury at T1 complains of stuffiness of the nose and a headache.The nurse notes a flushing of the neck and "goose flesh." What should be the primary nursing intervention based on these assessments?
A) Place patient in flat position and check temperature.
B) Administer oxygen and check oxygen saturation.
C) Place on side and check for leg swelling.
D) Sit upright and check blood pressure.

Question

Quizplus · Accepted Answer

The symptoms described are indicative of autonomic dysreflexia, a condition that can occur in individuals with spinal cord injuries above T6. It is characterized by a sudden and severe increase in blood pressure due to an irritant below the level of injury. The primary nursing intervention is to sit the patient upright to help lower blood pressure and then check the blood pressure to assess the severity of the situation.

A Patient with a Spinal Cord Injury at T1 Complains