A nurse is evaluating a patient who presents to the emergency department for episodes of confusion and lethargy. Which of the following neurological complications are associated with endocrine emergencies? Select all that apply

Rationale for Correct Choices Diabetic ketoacidosis (DKA): The patient presents with hyperglycemia (glucose >400 mg/dL), positive urine ketones, metabolic acidosis (low HCO3), dehydration, and altered mental status. DKA can cause confusion, lethargy, and in severe cases, cerebral edema leading to neurological complications. Cerebral vascular accident (CVA): Endocrine emergencies like severe hyperglycemia increase the risk of thrombotic events or stroke due to vascular endothelial damage and hypercoagulability, which can manifest as neurological deficits. Increased cranial pressure (ICP): Cerebral edema from DKA or other metabolic derangements can increase ICP, resulting in confusion, lethargy, or altered consciousness. Rationale for Incorrect Choices Pheochromocytoma: Primarily causes episodic hypertension, headaches, palpitations, and diaphoresis; neurological deficits are indirect and not a hallmark of acute presentation. Hyperparathyroidism: Usually causes fatigue, bone pain, kidney stones, and mild cognitive changes but does not acutely cause severe neurological compromise in endocrine emergencies. Spinal cord injury: Not related to endocrine emergencies; presents with motor and sensory deficits below the injury level rather than systemic metabolic derangements.