A nurse is caring for a client who has an acute spinal cord injury. Which of the following findings should the nurse recognize as autonomic dysreflexia?

Choice A reason: A decrease in blood pressure is not characteristic of autonomic dysreflexia. Instead, autonomic dysreflexia typically causes a sudden and severe increase in blood pressure due to sympathetic nervous system overactivity triggered by stimuli below the level of injury. This option is incorrect. Choice B reason: An increase in heart rate is not typical of autonomic dysreflexia. In fact, bradycardia (decreased heart rate) often occurs due to parasympathetic compensation in response to hypertension. Therefore, this option is incorrect. Choice C reason: Eye twitching is not a recognized symptom of autonomic dysreflexia. The hallmark symptoms include severe hypertension, pounding headache, flushing, sweating above the level of injury, and nasal congestion. This option is incorrect. Choice D reason: A sudden, severe headache is a hallmark symptom of autonomic dysreflexia. It results from acute hypertension caused by noxious stimuli such as bladder distention, fecal impaction, or skin irritation below the level of injury. This makes option D the correct answer.