A client with a C-7 spinal cord injury (SCI) is experiencing autonomic dysreflexia. The nurse should first assess the client for which precipitating factor?

Rationale: A. Skeletal traction misalignment: While misalignment can cause discomfort and complications in spinal cord injury clients, it is not the most common or immediate trigger of autonomic dysreflexia. Assessment of alignment is secondary to more urgent causes of sympathetic overactivity. B. Profuse forehead diaphoresis: Sweating is a symptom of autonomic dysreflexia but is a manifestation rather than a precipitating factor. Identifying the cause of the dysreflexia takes priority over treating symptoms alone. C. An acutely distended bladder: Bladder distension is the most common precipitating factor for autonomic dysreflexia in clients with lesions at T6 or above. Immediate assessment and relief of urinary retention are critical to prevent severe hypertension, stroke, or other life-threatening complications. D. A severe pounding headache: Headache is a classic symptom of autonomic dysreflexia, reflecting elevated blood pressure. While important to recognize, it indicates the presence of the condition rather than identifying the cause that must be addressed first.