Which action is among the initial steps in treating autonomic dysreflexia?

• A. Sit the patient up to lower blood pressure
• B. Lay the patient flat and give analgesics
• C. Immediately administer a vasopressor
• D. Ignore mild symptoms

Answer: (A)

The action tested here is the immediate management of autonomic dysreflexia, which centers on rapidly lowering the dangerous blood pressure by repositioning the patient and addressing the trigger. Sitting the patient up takes advantage of gravity to decrease venous return and reduce systemic blood pressure quickly while you look for and relieve the stimulus below the level of injury (most often a full bladder, catheter obstruction, or bowel impaction). Lying flat would not help and can worsen the high blood pressure, while analgesics or a vasopressor would not resolve the underlying trigger and could be harmful. Ignoring symptoms is dangerous. After positioning, promptly check for and relieve triggers, ensure the bladder is draining, remove any constrictive clothing, and monitor blood pressure as you proceed with further treatment if needed.