Your client is at home in northern Texas during the month of August. The average daytime temperature is 103 degrees F. What advice should you give your client with a T4 spinal cord injury in this situation?

Dress lightly during the day and stay in an air conditioned environment

Drink at least 3000 mL of cold liquids daily in hot weather

Dress lightly during the heat of the day and stay on the screened parch

Sit outside for a limited time (one hour) in the morning only

Answer and Explanation

The Correct Answer is A

A. Dress lightly during the day and stay in an air conditioned environment: Clients with T4 spinal cord injuries have impaired thermoregulation and are at high risk for heat-related illness. Light clothing and air conditioning help prevent hyperthermia and heat stroke. Staying in a cool environment is the safest strategy during extreme heat.

B. Drink at least 3000 mL of cold liquids daily in hot weather: While hydration is important, drinking excessive cold liquids does not fully prevent heat-related complications in clients with impaired thermoregulation. Cooling the environment is more effective in controlling core temperature.

C. Dress lightly during the heat of the day and stay on the screened porch: Even with light clothing, exposure to outdoor heat, such as on a porch, can lead to dangerous hyperthermia in someone with a high spinal cord injury. Indoor cooling is safer.

D. Sit outside for a limited time (one hour) in the morning only: Morning temperatures may still be high, and direct sun exposure poses a risk for hyperthermia. Limiting outdoor activity alone does not adequately protect thermoregulation. Air conditioning and minimal heat exposure are preferred.

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Correct Answer is A

Explanation

A. Neurogenic shock: Neurogenic shock results from disruption of sympathetic nervous system pathways, often due to spinal cord injury. It leads to unopposed parasympathetic activity, causing bradycardia, vasodilation, and hypotension. Unlike other shock types, the loss of vascular tone is a hallmark.

B. Cardiogenic shock: Cardiogenic shock stems from pump failure, typically after myocardial infarction, causing hypotension and poor perfusion. Tachycardia is common as a compensatory response, rather than bradycardia. Vasodilation is usually not a primary feature.

C. Septic shock: Septic shock is characterized by systemic vasodilation, hypotension, and often tachycardia due to infection and inflammatory mediator release. Bradycardia is uncommon. Warm, flushed skin may be present initially. Rapid identification and antibiotics are priorities.

D. Hypovolemic shock: Hypovolemic shock is caused by fluid or blood loss, leading to hypotension and tachycardia as compensation. Vasoconstriction occurs to maintain perfusion, not vasodilation. Bradycardia is rare unless decompensation occurs.

A. Aspirate from the catheter using a 60 ml syringe B. Flush the catheter with 50 mL of additional dialysate C. Advance the catheter 2 to 4 cm further into the peritoneal cavity D. Reposition the client to facilitate drainage

Correct Answer is D

Explanation

A. Aspirate from the catheter using a 60 ml syringe: Aspiration can introduce infection or damage the catheter if done routinely. It is not the first-line action for slow drainage during peritoneal dialysis. Safer interventions should be attempted first.

B. Flush the catheter with 50 mL of additional dialysate: Flushing may force fluid and increase intra-abdominal pressure, potentially causing discomfort or complications. It is not recommended as an initial step to improve drainage.

C. Advance the catheter 2 to 4 cm further into the peritoneal cavity: Manipulating the catheter manually can increase the risk of trauma or infection. Catheter position is generally fixed, and adjustments should be made only under provider guidance.

D. Reposition the client to facilitate drainage: Changing the client’s position, such as turning from side to side or elevating the head of the bed, often helps the dialysate flow freely. This is a safe and effective first action to relieve slow drainage and prevent complications like fluid retention or abdominal distention.

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Your client is at home in northern Texas during the month of August. The average daytime temperature is 103 degrees F. What advice should you give your client with a T4 spinal cord injury in this situation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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