A nurse is reviewing the electronic medical record of a middle-aged client who was admitted following a stroke. Which of the following findings should the nurse identify as a modifiable risk factor for stroke?

Complete spinal cord injury causes total disruption of motor pathways, ascending sensory transmission, spinal reflex activity, and voluntary neurologic function below the lesion level. Injury at T6 commonly produces paraplegia, autonomic dysfunction, loss of sensation, bowel and bladder impairment, and absent voluntary movement distally.

Rationale:

A. Full neurologic recovery is not expected with a complete spinal cord injury because total interruption of spinal cord conduction pathways has occurred. Permanent deficits commonly persist below the lesion level despite rehabilitation and supportive care. Complete injury causes irreversible neuronal damage and profound functional impairment affecting mobility and sensation.

B. Partial movement below the injury level is characteristic of incomplete spinal cord injuries where some neural pathways remain intact. Complete injuries involve total absence of voluntary motor and sensory conduction distal to the lesion. Loss of descending motor control and absent neurologic transmission prevent preserved movement below T6.

C. Complete spinal cord injury results in absence of both motor and sensory function below the affected spinal level. Clients lose voluntary movement, tactile sensation, pain perception, and autonomic control distal to the lesion. Total disruption of spinal cord conduction produces profound neurologic deficits and paraplegia below the injury site.

D. Isolated sensory loss without motor impairment does not occur in complete spinal cord injury because both ascending sensory and descending motor pathways are fully interrupted. Clients experience combined paralysis and sensory absence below the lesion. Severe motor dysfunction accompanies extensive sensory impairment in complete spinal cord injuries.

Heterotopic ossification is abnormal bone formation within soft tissues following neurologic injury, causing progressive joint inflammation, restricted range of motion, and periarticular pain. Spinal cord injury commonly predisposes clients to ectopic calcification around major joints due to inflammatory and neurovascular alterations.

Rationale:

A. Arthralgia commonly occurs with heterotopic ossification because abnormal bone deposition around joints produces inflammation, swelling, and restricted movement. Clients frequently experience localized pain and decreased mobility during active ossification phases. Progressive periarticular calcification causes impaired joint mobility and discomfort in affected extremities.

B. Hypertension is more closely associated with autonomic dysreflexia rather than heterotopic ossification after spinal cord injury. Although both complications may occur in neurologically impaired clients, elevated blood pressure is not a characteristic manifestation of ectopic bone formation. Heterotopic ossification primarily affects musculoskeletal function and surrounding soft tissues.

C. Fecal impaction is a gastrointestinal complication associated with neurogenic bowel dysfunction following spinal cord injury rather than heterotopic ossification. Ectopic bone growth specifically affects joints and connective tissues surrounding skeletal structures. Resulting complications mainly involve mobility limitation and impaired musculoskeletal movement rather than bowel elimination problems.

D. Bradycardia commonly develops from autonomic nervous system disruption in high spinal cord injuries but is not directly linked to heterotopic ossification. Abnormal ectopic bone growth primarily produces local inflammatory musculoskeletal manifestations. The condition mainly causes joint stiffness and progressive painful mobility restriction in affected areas.