哪項評估發現對於頸椎脊髓損傷病人而言，需要立即介入？
Which assessment finding in a client with a cervical spinal cord injury warrants immediate intervention?
- ADifficulty with fine motor skills in the hands手部精細動作困難
- BAbsence of deep tendon reflexes in the lower extremities下肢深層肌腱反射消失
- CFlaccid paralysis below the level of injury損傷平面以下軟癱
- DBlood pressure of 180/100 mmHg and bradycardia✓ 正解血壓 180/100 mmHg 伴隨心搏過緩
頸椎脊髓損傷（T6以上）病人的高血壓伴隨心搏過緩（自主神經反射異常，AD）是醫療急症。若未及時處理，可能引發腦溢血或心律不整。這是因為受到有害刺激（如尿滯留、便秘）導致交感神經異常放電。其他選項多為脊髓休克後的常見表現，雖需關注，但緊急程度不及 AD。
In a client with a cervical (above T6) spinal cord injury, the combination of severe hypertension and bradycardia is the hallmark of autonomic dysreflexia, a medical emergency caused by an exaggerated sympathetic response to a noxious stimulus (e.g., bladder distension, fecal impaction). Without prompt intervention it can cause stroke, seizure, or death. Absent reflexes, flaccid paralysis, and loss of fine motor control are expected findings after the injury and not immediate emergencies.
自主神經反射異常在美國教導為必須掌握的 NCLEX 核心考點，台灣臨床對此現象的警覺性同樣很高。