American Association of Critical-Care Nurses (AACN) Certification Practice Test

In neurogenic shock, what is the immediate treatment that should be conducted?

1. Volume replacement

2. Immediate surgical intervention

3. Use of antihistamines

4. Administration of glucocorticoids

The correct answer is: Volume replacement

In the context of neurogenic shock, volume replacement is a critical and immediate treatment. Neurogenic shock occurs when there is a loss of sympathetic tone, often due to spinal cord injury, leading to peripheral vasodilation and impaired venous return. This results in decreased blood pressure and inadequate perfusion to vital organs. Volume replacement is essential because it helps to restore circulating blood volume and improve venous return to the heart, thereby enhancing cardiac output and blood pressure. Administering intravenous fluids is a first-line response to counteract the hypotension and ensure sufficient blood flow to maintain organ function. While other treatments might be appropriate in specific contexts, they do not address the acute hemodynamic instability that characterizes neurogenic shock as effectively as volume replacement does. For instance, while glucocorticoids can be used in the management of spinal cord injury to reduce inflammation, they are not an immediate response to hypotension. Immediate surgical intervention is only necessary in cases where there is a compressive lesion needing emergency surgery, and antihistamines do not play a role in this type of shock.