Neuromuscular and Nervous SystemsDifficulty 3/5
A patient with a T4 spinal-cord injury develops a pounding headache, blood pressure of 180/110 and flushing above the lesion. What is the immediate action?
- AApply a cold pack to the neck and provide reassurance about the headache
- BLay the patient flat and elevate the legs to restore cerebral perfusion
- CSit the patient upright, check for bladder distension and other triggers
- DContinue the session at a lower intensity and monitor blood pressure
Show answer and rationale
Correct: C. This is autonomic dysreflexia, a medical emergency in injuries at or above T6. Sitting upright lowers blood pressure by orthostatic effect while the noxious stimulus — most often bladder distension — is identified and removed.
- B — Lying flat raises blood pressure further and worsens the crisis.
- D — Continuing any activity ignores a potentially fatal hypertensive event.
- A — Symptom comfort measures do not address the underlying trigger.