Questions: A nurse is caring for a client with a spinal cord injury. What are possible causes of autonomic dysreflexia that the nurse should monitor for?

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Autonomic dysreflexia (AD) is a potentially life-threatening condition that can affect individuals with spinal cord injuries, particularly those at or above the T6 level. It's a sudden overreaction of the autonomic nervous system (which controls things like blood pressure, heart rate, and bladder function) to a stimulus below the level of injury.

The most frequent cause of AD is bladder irritation, often due to a distended bladder or urinary tract infection. Bowel issues, such as constipation or fecal impaction, are another common trigger. Skin-related problems, including pressure sores, ingrown toenails, and even tight clothing, can also cause AD.

Less common but still important triggers include sexual activity, menstrual cramps, labor and delivery, and skeletal fractures. Even strong smells or sudden temperature changes can sometimes provoke AD.

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