The trauma intensive care nurse suspects a client with a C6 fracture has developed neurogenic shock. Which findings support the nurse's suspicion?

Evaluating a cervical spine injury for neurogenic shock requires knowledge of autonomic nervous system disruption. Specifically, loss of sympathetic tone below the level of injury must be identified. Differentiating neurogenic shock from spinal shock involves assessing hemodynamic parameters and thermoregulation. Choice A rationale Neurogenic shock involves loss of sympathetic vascular tone, causing massive vasodilation and hypotension. Unchecked parasympathetic activity leads to bradycardia. Normal heart rate is 60 to 100. Warm, pink skin results from peripheral blood pooling due to vasodilation. Choice B rationale Hyperactive reflexes are characteristic of the later stages of spinal cord injury after spinal shock resolves. They do not indicate the acute hemodynamic collapse seen in neurogenic shock, which specifically targets the cardiovascular regulatory systems. Choice C rationale Loss of sensation and movement defines spinal shock or the initial cord injury itself. While present in neurogenic shock, these findings are not specific to the autonomic failure that characterizes the life-threatening hemodynamic instability of shock. Choice D rationale Spasticity occurs due to upper motor neuron damage after the initial period of areflexia. This is a chronic or subacute finding and is not associated with the acute cardiovascular distributive failure seen in neurogenic shock.