Autonomic Dysreflexia

Definition: Life-threatening, uninhibited sympathetic response of the nervous system to a noxious stimulus after a spinal cord injury (SCI) at T7 or above [has been demonstrated in clients with injuries at T8 and occasionally lower]


RELATED FACTORS

  • Bladder or bowel distention; [catheter insertion, obstruction, irrigation]
  • Skin irritation
  • Lack of client and caregiver knowledge
  • [Sexual excitation]
  • [Environmental temperature extremes]


Subjective

  • Headache (a diffuse pain in different portions of the head and not confined to any nerve distribution area)
  • Paresthesia, chilling, blurred vision, chest pain, metallic taste in mouth, nasal congestion.

Objective

  • Paroxysmal hypertension (sudden periodic elevated blood pressure in which systolic pressure 140 mm Hg and diastolic 90 mm Hg)
  • Bradycardia or tachycardia (heart rate 60 or 100 beats per minute, respectively)
  • Diaphoresis (above the injury), red splotches on skin (above the injury), pallor (below the injury)
  • Horner’s syndrome
  • ..other on the book...

DESIRED OUTCOMES/EVALUATION CRITERIA

Sample NOC linkages:

  • Neurologic Status: Autonomic: Extent to which the autonomic nervous system coordinates visceral function
  • Knowledge: Disease Process: Extent of understanding conveyed about a specific disease process
  • other on the book...


ACTIONS/INTERVENTIONS

Sample NIC linkages:

  • Dysreflexia Management: Prevention and elimination of stimuli that cause hyperactive reflexes and inappropriate autonomic responses in a patient with a cervical or high thoracic cord lesion
  • Urinary Elimination/Bowel Management: Maintenance of an optimum urinary elimination pattern/establishment and maintenance of a regular pattern of bowel elimination
  • other on the book..

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