The nurse is assessing a pediatric patient with a spinal cord injury. Which cue should the nurse recognize as a potential indication of spinal cord injury in this patient?

A. Increased muscle tone: Hypertonia may occur later in recovery, but acute spinal cord injury often initially presents with flaccid paralysis rather than increased muscle tone. B. Heightened reflex activity: Reflexes are typically diminished or absent below the level of injury in the acute phase, so heightened reflexes are not an early indicator of spinal cord injury. C. Loss of function and reflexes below the affected area of the spine: Acute spinal cord injury commonly results in loss of motor and sensory function as well as absent reflexes below the level of injury, making this a primary clinical cue for assessment. D. Normal bowel function: Bowel function is often impaired in spinal cord injury due to disruption of autonomic control. Normal function would not indicate the presence of spinal cord injury.