A nurse is caring for a client who has a spinal cord injury at the first thoracic level. Which of the following should the nurse recognize can trigger autonomic dysreflexia?
(Select All that Apply.)

Choice A Reason:

Pleural cavity decompression via needle aspiration is inappropriate. Pleural cavity decompression via needle aspiration may be indicated in cases of tension pneumothorax, a potentially life-threatening condition in which air accumulates in the pleural space and compresses the lung. While it is an intervention rather than a diagnostic tool, it may be performed emergently if tension pneumothorax is suspected based on clinical findings.

Choice B Reason:

Focused assessment with sonography in trauma (FAST) is appropriate. FAST is a bedside ultrasound examination commonly used in trauma settings to rapidly assess for the presence of free fluid in the pericardial, pleural, and peritoneal spaces. It can help identify hemopericardium, hemothorax, or intra-abdominal hemorrhage, which may be indicative of thoracic injury.

Choice C Reason:

Chest x-ray is appropriate. Chest x-ray is a commonly used imaging modality for evaluating thoracic injuries. It can help visualize abnormalities such as rib fractures, pneumothorax, hemothorax, pulmonary contusions, or other traumatic injuries to the chest.

Choice D Reason:

Thoracentesis is appropriate. Thoracentesis is a procedure used to sample fluid from the pleural space for diagnostic or therapeutic purposes. It may be indicated if there is a suspicion of pleural effusion or if fluid accumulation is seen on imaging studies such as chest x-ray or ultrasound.

Choice E Reason:

Ultrasound is appropriate. Ultrasound can be used to evaluate various aspects of thoracic injuries, including the presence of pneumothorax, hemothorax, or pleural effusion. It is often used as part of the FAST examination but can also be performed separately for more detailed assessment.

Correct answer: D

Choice A Reason:

Decreased pulmonary vascular resistance is incorrect. Inflammatory mediators released in response to a pulmonary embolism can lead to vasoconstriction and increased pulmonary vascular resistance. This is part of the body's response to redirect blood flow away from the affected area of the lung and maintain adequate perfusion to other areas.

Choice B Reason:

Hypercapnia is incorrect. Hypercapnia refers to elevated levels of carbon dioxide (CO2) in the blood.Hypocapnia usually is present with embolism; hypercapnia, on the other hand, is rare.

Choice C Reason:

Hypoventilation is incorrect. Hypoventilation occurs when there is inadequate ventilation of the lungs relative to metabolic demands. In the context of a pulmonary embolism, hypoventilation can occur due to factors such as pain, respiratory muscle fatigue, or impaired gas exchange, all of which can be influenced by the release of inflammatory mediators.

Choice D Reason:

Respiratory alkalosis is correct.In response to the blockage and the resulting inflammation, the body often increases the respiratory rate as a compensatory mechanism to maintain adequate oxygen levels and remove carbon dioxide.Due to the increased breathing rate, there is excessive exhalation of carbon dioxide, leading to a decrease in the partial pressure of CO2 in the blood. This results in an increase in blood pH, causing respiratory alkalosis.