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1. Question
The nurse is evaluating the neurological signs of a client in spinal shock following spinal cord injury. Which observation indicates that spinal shock persists?
Correct
Option C is the correct answer:
Rationale: Resolution of spinal shock is occurring when there is return of reflexes (especially flexors to noxious cutaneous stimuli), a state of hyper-reflexia rather than flaccidity, and reflex emptying of the bladder.
Test-Taking Strategy: Recall that spinal shock is characterized by the loss of movement of skeletal muscles, loss of bowel or bladder wall function, and depressed reflex action. Return of any of these indicates that spinal shock is beginning to resolve. Note that options 1, 2, and 4 are comparable or alike, indicating the presence of reflexes.
Incorrect
Option C is the correct answer:
Rationale: Resolution of spinal shock is occurring when there is return of reflexes (especially flexors to noxious cutaneous stimuli), a state of hyper-reflexia rather than flaccidity, and reflex emptying of the bladder.
Test-Taking Strategy: Recall that spinal shock is characterized by the loss of movement of skeletal muscles, loss of bowel or bladder wall function, and depressed reflex action. Return of any of these indicates that spinal shock is beginning to resolve. Note that options 1, 2, and 4 are comparable or alike, indicating the presence of reflexes.
The spinal shock associated with SCI represents a sudden depression of reflex activity in the spinal cord (areflexia) below the level of injury. The muscles innervated by the part of the spinal cord segment below the level of the lesion are without sensation, paralyzed, and flaccid, and the reflexes are absent. In particular, the reflexes that initiate bladder and bowel function are affected.
Bowel distention and paralytic ileus can be caused by depression of the reflexes and are treated with intestinal decompression by insertion of a nasogastric tube.
