A 35-year-old patient is admitted to the emergency department after a severe spinal cord injury. The nurse assesses the patient and notes hypotension, bradycardia, and hypothermia. Which of the following interventions is the priority in managing neurogenic shock?
a) Administering a bolus of hypertonic saline
b) Elevating the patient’s legs
c) Administering atropine
d) Maintaining a warm environment
e) Initiating mechanical ventilation
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Rationale:
Neurogenic shock is characterized by vasodilation and loss of sympathetic tone, leading to hypotension and bradycardia. Maintaining a warm environment is crucial as vasodilation can result in hypothermia. The priority is to prevent further complications related to hypothermia, such as coagulopathy and cardiac arrhythmias.
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Understanding the Neurogenic Shock: NCLEX Priority Questions
A patient with a spinal cord injury is at risk for neurogenic shock. The nurse is educating the patient on preventive measures. Which instruction should the nurse include in the teaching plan?
a) Encourage the patient to perform isometric exercises regularly
b) Maintain a low-sodium diet
c) Instruct the patient to increase fluid intake
d) Avoid raising the head of the bed more than 30 degrees
e) Administer antihypertensive medications as prescribed
Rationale:
Isometric exercises help maintain muscle tone and prevent venous pooling, which can contribute to preventing neurogenic shock. Regular isometric exercises enhance venous return and counteract the effects of sympathetic dysfunction seen in neurogenic shock.
Understanding Neurogenic Shock: NCLEX Delegation Questions
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A patient with a spinal cord injury develops neurogenic shock. The nurse is preparing to administer medications. Which medication is commonly used to manage neurogenic shock?
a) Epinephrine
b) Dopamine
c) Atropine
d) Norepinephrine
e) Vasopressin
Rationale:
Norepinephrine is commonly used in the management of neurogenic shock to improve blood pressure and perfusion. It acts as a vasoconstrictor, counteracting the vasodilation seen in neurogenic shock. The goal is to restore vascular tone and maintain adequate perfusion to vital organs.
Understanding Neurogenic Shock: Causes and Symptoms
A patient with a recent spinal cord injury is at risk for developing neurogenic shock. The nurse is monitoring the patient closely. Which early sign may indicate the onset of neurogenic shock?
a) Increased heart rate
b) Elevated blood pressure
c) Flushed and warm skin
d) Profuse sweating
e) Bradycardia
Rationale:
One of the early signs of neurogenic shock is bradycardia due to the loss of sympathetic tone. The unopposed vagal (parasympathetic) activity leads to a decrease in heart rate. Recognizing this early sign is crucial for prompt intervention to prevent further complications associated with neurogenic shock.
NCLEX Practice Questions: Understanding Neurogenic Shock Causes and Symptoms
A patient with a spinal cord injury is admitted to the intensive care unit. The nurse is assessing for manifestations of neurogenic shock. Which finding is characteristic of neurogenic shock?
a) Hyperthermia
b) Hypertension
c) Hyperreflexia
d) Increased respiratory rate
e) Warm and dry skin
Rationale:
Neurogenic shock is characterized by vasodilation, leading to hypotension and bradycardia. The peripheral vasodilation can result in warm and dry skin. This is in contrast to other types of shock where cold and clammy skin is more common. Understanding these characteristic findings aids in the early identification and management of neurogenic shock.
NCLEX Questions: Focus on Medications for Neurogenic Shock
A patient with a spinal cord injury is admitted to the emergency department. The nurse observes signs of neurogenic shock. Which nursing intervention is essential for managing neurogenic shock?
a) Administering a diuretic to reduce fluid overload
b) Elevating the lower extremities to improve venous return
c) Administering an antipyretic to reduce fever
d) Monitoring for signs of fluid volume excess
e) Administering medications to induce vasodilation
Rationale:
Elevating the lower extremities helps enhance venous return and counteracts the venous pooling associated with neurogenic shock. This intervention assists in maintaining adequate preload and cardiac output, contributing to the overall management of hypotension in neurogenic shock.
NCLEX Focus Exploring Neurogenic Shock: Causes and Diagnosis
A patient with a spinal cord injury is receiving treatment for neurogenic shock. The nurse monitors for potential complications. Which complication is associated with neurogenic shock?
a) Hyperglycemia
b) Hypovolemia
c) Hypokalemia
d) Bradypnea
e) Disseminated intravascular coagulation (DIC)
Rationale:
Neurogenic shock can lead to complications such as disseminated intravascular coagulation (DIC). The loss of sympathetic tone may result in inadequate tissue perfusion, leading to the activation of clotting factors and the development of DIC. Monitoring for signs of DIC is essential for timely intervention and prevention of further complications.
NCLEX Review: Neurogenic Shock Treatments
A patient with a spinal cord injury is admitted to the critical care unit. The nurse is preparing to administer medications for neurogenic shock. Which medication is often used to treat bradycardia associated with neurogenic shock?
a) Furosemide
b) Metoprolol
c) Atropine
d) Nitroglycerin
e) Heparin
Rationale:
Atropine is commonly used to treat bradycardia in neurogenic shock. It acts by blocking the parasympathetic stimulation, thereby increasing heart rate. The administration of atropine helps counteract the bradycardic effects of unopposed vagal activity, addressing one of the key manifestations of neurogenic shock.
NCLEX Questions Critical Thinking: Neurogenic Shock Symptoms
A patient with a spinal cord injury is being assessed for potential neurogenic shock. The nurse notes a sudden drop in blood pressure and bradycardia. Which position is recommended for this patient?
a) Supine with legs elevated
b) High-Fowler’s position
c) Trendelenburg position
d) Left lateral position
e) Prone position
Rationale:
The Trendelenburg position, with the patient lying flat on their back with the lower body elevated higher than the head, can help improve venous return and increase preload. This position assists in addressing the hypotension and bradycardia seen in neurogenic shock, promoting better perfusion to vital organs.
A patient with a spinal cord injury is receiving care for neurogenic shock. The nurse is assessing for potential complications. Which assessment finding indicates a complication related to neurogenic shock?
a) Cool and pale extremities
b) Hyperactive bowel sounds
c) Hypertension
d) Rapid capillary refill
e) Decreased urinary output
Rationale:
Cool and pale extremities suggest decreased peripheral perfusion, which can be a complication of neurogenic shock. The vasodilation seen in neurogenic shock leads to inadequate blood supply to the extremities, resulting in a cool and pale appearance. Monitoring for such complications is crucial for prompt intervention and preventing further deterioration.
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