Medical Surgical Critical Care Shock #3

Question

A client is brought to the emergency department with a T5 spinal cord injury from a car wreck. Which of these vital signs should the nurse expect to see the client exhibiting?

Answers

  1. HR 120, RR 20, BP 100/68.
    • Rationale:

      This answer is not correct because the heart rate is high (tachycardia), respiratory rate is normal at 20, and the BP is normal at 100/68. Symptoms associated with neurogenic shock and commonly seen are hypotension, bradycardia, and difficulty breathing.

  2. HR 100, RR 16, BP 120/72.
    • Rationale:

      This answer is not correct because the heart rate is normal at 100; respiratory rate is normal at 16, and blood pressure is normal at 120/72. Symptoms associated with neurogenic shock and commonly seen are hypotension, bradycardia, and difficulty breathing.

  3. HR 62, RR 18, BP 110/50.
    • Rationale:

      This answer is not correct because the heart rate is normal at 62; respiratory rate is normal at 18, and blood pressure is normal systolic, and a bit low diastolic 110/50, but not shock low.

  4. HR 50, RR 32, BP 78/45.
    • Rationale:

      This answer is correct because symptoms associated with neurogenic shock and commonly seen are hypotension, bradycardia, and difficulty breathing, thus HR 50, RR 32, BP 78/45.

Overview

The client with a spinal cord injury T6 or higher is at great risk for neurogenic shock. Neurogenic shock refers to a spinal cord injury associated with autonomic dysfunction.

Explanation

Learning Outcomes

Neurogenic shock refers to a spinal cord injury associated with autonomic dysregulation. Neurogenic shock is caused by a lack of blood flow throughout the client’s body. The sympathetic nervous system usually maintains expected muscle tone in the body, but suddenly the signal is lost causing relaxed dilated blood vessels resulting in blood pooling in our venous system creating a decreased blood pressure and bradycardia. Symptoms associated with neurogenic shock and commonly seen are hypotension, bradycardia, and difficulty breathing. Blood pressure is normally systolic below 80.

Test Taking Tip

Know the symptoms of neurogenic shock: hypotension, bradycardia, and difficulty breathing.

Video Rationale