A client who suffered a spinal cord injury is experiencing an exaggerated autonomic response. What aspect of the client’s current health status is most likely to have precipitated this event?

Reasoning:

Choice A reason: Limiting bed rest to 4 weeks to prevent contractures and atrophy is not the primary principle. While prolonged immobility causes these issues, early mobilization post-stroke improves recovery and prevents complications like thromboembolism, making immediate mobilization the key focus rather than a time limit.

Choice B reason: Mobilizing as soon as physically able is critical post-ischemic stroke to enhance recovery. Early mobilization improves circulation, prevents thromboembolism, maintains muscle strength, and promotes neuroplasticity, reducing disability. This principle counters the family’s insistence on bed rest, which increases complication risks and hinders recovery.

Choice C reason: Waiting for the client to express a desire to mobilize delays recovery. Stroke patients may lack initiative due to neurological deficits or depression. Early mobilization, guided by physical ability, prevents complications like deep vein thrombosis and supports rehabilitation, making patient desire a poor criterion.

Choice D reason: Lack of mobility does not directly increase stroke recurrence risk, which is more tied to vascular risk factors like hypertension or diabetes. However, immobility increases complications like thromboembolism, which could indirectly contribute to stroke. Early mobilization is the priority to enhance overall recovery.

Reasoning:

Choice A reason: DIC is not primarily an autoimmune disease complication. While autoimmune conditions may trigger inflammation, DIC results from widespread activation of coagulation pathways due to conditions like sepsis or trauma, leading to microthrombi and factor consumption, not direct autoimmune attack on body cells.

Choice B reason: Hemolytic processes destroying erythrocytes cause hemolytic anemia, not DIC. While hemolysis may contribute to inflammation, DIC is driven by systemic activation of coagulation, forming microthrombi that consume platelets and clotting factors, leading to bleeding, not primarily erythrocyte destruction.

Choice C reason: Immune-mediated platelet destruction occurs in conditions like immune thrombocytopenia, not DIC. DIC involves systemic clotting activation, consuming platelets and factors, causing both thrombosis and bleeding. The immune system does not directly target platelets in DIC’s pathophysiology, making this explanation inaccurate.

Choice D reason: DIC is caused by abnormal activation of the clotting pathway, triggered by conditions like sepsis or trauma, leading to excessive microthrombi formation in organs. This consumes platelets and clotting factors, causing bleeding tendencies.