What Should the Nurse Do?
John, a thirty-five-year-old male, was involved in a motorcycle accident and sustained a spinal cord injury at the T4 level. Upon arrival at the emergency department, he presents with bradycardia, hypotension, and warm, dry skin below the level of injury. The health-care provider orders a series of diagnostics, including blood tests and imaging, to evaluate John’s condition further. John’s condition is confirmed as neurogenic shock. The health-care team initiates treatment protocols, and you are responsible for implementing the nursing care plan. After several hours of treatment, John’s blood pressure has stabilized, and his heart rate has improved. However, he still exhibits signs of impaired perfusion. The physician orders norepinephrine and atropine to manage John’s neurogenic shock.
1
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What verbal and nonverbal cues should the nurse recognize that indicate John may be experiencing neurogenic shock?
2
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What diagnostic tests and laboratory values should the nurse monitor to confirm the diagnosis of neurogenic shock, and how do these findings guide the next steps in care?
3
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What specific nursing interventions should be prioritized for John to manage neurogenic shock, and how would these interventions be tailored to his injury?
4
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How should the nurse evaluate the effectiveness of the interventions provided for John, and what indicators would suggest a need to adjust the care plan?
5
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What should the nurse consider when administering norepinephrine and atropine, and how would the nurse explain the purpose and potential side effects of these therapies to John?