A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be go-ing into shock. The most likely mechanism of his shock is:
a. hypovolemia caused by blood loss.
b. hypovolemia caused by evaporative fluid losses.
c. vasodilation caused by gram-negative bacterial infection.
d. vasodilation caused by a decrease in sym-pathetic stimulation.
ANS: D
The patient is experiencing neurogenic shock in which blood volume has not changed, but SVR decreases drastically so that the amount of space containing the blood has increased, leading to hypotension. In this type of shock, blood loss has not occurred. In this type of shock, fluid loss has not occurred. Vasodilation due to infection would be septic shock; the type of shock de-scribed in the patient is due to loss of sympathetic stimulation.
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