A patient with a history of spinal cord injury presents with severe headache, hypertension, bradycardia, and flushed face. Which intervention should be performed first?

A patient with a history of spinal cord injury presents with severe headache, hypertension, bradycardia, and flushed face. Which intervention should be performed first?

• A. Apply compression stockings
• B. Lower the head of the bed
• C. Empty the client's bladder
• D. Increase the IV flow rate

Answer: (C)

In autonomic dysreflexia, a noxious stimulus below the level of spinal injury triggers a dangerous sympathetic surge, causing severe hypertension with bradycardia, headache, and flushed face. The first priority is to remove the triggering stimulus. Bladder distension is a very common trigger, so emptying the bladder promptly often halts the reflex and reduces blood pressure quickly. After drainage, reassess vitals and address remaining triggers if needed. Other actions don’t tackle the underlying cause: lowering the head of the bed would worsen hypertension, compression stockings don’t remove the trigger, and increasing IV flow rate could raise blood pressure further.

In autonomic dysreflexia, a noxious stimulus below the level of spinal injury triggers a dangerous sympathetic surge, causing severe hypertension with bradycardia, headache, and flushed face. The first priority is to remove the triggering stimulus. Bladder distension is a very common trigger, so emptying the bladder promptly often halts the reflex and reduces blood pressure quickly. After drainage, reassess vitals and address remaining triggers if needed. Other actions don’t tackle the underlying cause: lowering the head of the bed would worsen hypertension, compression stockings don’t remove the trigger, and increasing IV flow rate could raise blood pressure further.