Question

Trauma patients are often in shock. Hypotension is common to all types of shock. Which of the following assessments is important in helping distinguish between neurogenic shock and other types of shock?

A) Pulse rate
B) Skin color and temperature
C) Urinary output
D) Pupillary response

Answer 1

Option A. A normal or slow pulse rate, in the setting of hypotension, can help distinguish neurogenic shock from other forms of shock, which typically present with a rapid heart rate.

Step-by-step explanation:

The assessment that is important in helping distinguish between neurogenic shock and other types of shock is A) Pulse rate. Neurogenic shock is a form of vascular shock that occurs due to damage to the nervous system, specifically the cardiovascular centers in the medulla oblongata or the nerve fibers from this region. Typically, in neurogenic shock, because of the loss of sympathetic tone, patients may present with hypotension but without the compensatory tachycardia (rapid heart rate) that is seen in other forms of shock such as hypovolemic shock.

In contrast, in cases of hypovolemic shock, patients often present with a rapid heart rate, cool and clammy skin, and other symptoms like rapid, shallow breathing and hypothermia. Therefore, a normal or slow pulse rate in the setting of hypotension is a key indicator of neurogenic shock.