What manifestation is expected when a person with a spinal cord injury develops autonomic dysreflexia?

Choice A reason: A vesicle is a small, elevated, thin-walled lesion filled with clear fluid, typically less than 1 cm, seen in conditions like herpes or contact dermatitis. This matches the description perfectly, making it the correct choice for the lesion.

Choice B reason: A pustule is an elevated lesion filled with pus, not clear fluid, indicating infection or inflammation. The description specifies clear fluid, not purulent content, making pustule incorrect for the described skin lesion.

Choice C reason: A macule is a flat, non-elevated skin lesion with color change, like a freckle, not containing fluid. The description of an elevated, fluid-filled lesion does not match, making macule incorrect for this scenario.

Choice D reason: A nodule is a solid, elevated lesion deeper in the skin, not thin-walled or fluid-filled. The description of a clear fluid-filled, elevated lesion does not fit a nodule’s characteristics, making this choice incorrect.

Choice A reason: Prolonged nasogastric suctioning removes gastric acid (HCl), reducing hydrogen ions in the blood, leading to metabolic alkalosis. This is reflected by elevated pH (7.50) and increased HCO3 (28 mEq/L), with normal PaCO2 as the lungs have not yet compensated. This matches the expected acid-base imbalance, making it correct.

Choice B reason: This result shows a slightly acidic pH (7.34) with normal PaCO2 and low HCO3, suggesting metabolic acidosis. Nasogastric suctioning causes loss of acid, not base, so it does not lead to acidosis. This imbalance is inconsistent with the alkalosis expected from gastric acid loss, making it incorrect.

Choice C reason: This result indicates a low pH (7.32) and elevated PaCO2, suggesting respiratory acidosis with partial compensation (normal HCO3). Nasogastric suctioning affects gastric acid, causing metabolic, not respiratory, alkalosis. The respiratory parameters here do not align with the condition’s pathophysiology, making this choice incorrect.

Choice D reason: This result shows an elevated pH (7.46) and low PaCO2, indicating respiratory alkalosis, likely from hyperventilation, with normal HCO3. Nasogastric suctioning causes metabolic alkalosis due to acid loss, not respiratory changes. The low PaCO2 does not fit the expected metabolic profile, making this choice incorrect.