高位脊髓損傷（T2）病人有神經源性休克的風險。護理師應監測哪些臨床表現？（選所有適合的）
A client with a high-level spinal cord injury (T2) is at risk for neurogenic shock. Which clinical manifestations should the nurse monitor for? (Select all that apply.)
- AHypotension✓ 正解低血壓
- BTachycardia心搏過速
- CBradycardia✓ 正解心搏過緩
- DWarm, dry skin✓ 正解溫暖且乾燥的皮膚
- EDiaphoresis盜汗
神經源性休克（Neurogenic shock）是一種特殊的休克類型，通常發生在 T6 或更高部位的脊髓損傷後。與其他類型的休克（如低血容性休克或心因性休克）不同，神經源性休克是由於交感神經系統（sympathetic nervous system）的傳導路徑受損，導致交感神經張力（sympathetic tone）喪失，進而引起血管擴張、血液淤積和心搏過緩。由於交感神經對血管的收縮控制消失，血管會擴張，導致血壓驟降。同時，心臟的交感神經加速作用也受損，使得副交感神經（vagus nerve）的影響佔主導地位，導致心搏過緩。 此外，體溫調節也受到影響，因為皮膚血管無法收縮以保留熱量，導致受傷平面以下的皮膚呈現溫暖乾燥。這些獨特的臨床表現是護理師區分神經源性休克與其他休克類型的關鍵，對於早期識別和正確管理至關重要，以避免危及生命的併發症。
Neurogenic shock is a special type of shock that typically occurs after spinal cord injury at T6 or higher. Unlike other types of shock (such as hypovolemic or cardiogenic shock), neurogenic shock results from disruption of the sympathetic nervous system pathways, leading to loss of sympathetic tone, which then causes vasodilation, blood pooling, and bradycardia. Because sympathetic vasoconstriction is lost, blood vessels dilate and blood pressure falls sharply. At the same time, sympathetic acceleration of the heart is also impaired, and parasympathetic (vagal) influences predominate, producing bradycardia. In addition, thermoregulation is affected, because cutaneous vessels cannot constrict to retain heat; the skin below the level of injury becomes warm and dry. These distinctive clinical findings are key for the nurse in differentiating neurogenic shock from other shock states, and are essential for early recognition and proper management to avoid life-threatening complications.
神經源性休克的病理生理學和臨床表現，以及其與其他休克類型的區別，在台灣與美國的醫學和護理教育中是核心知識。兩地護理師都需熟悉其獨特徵兆（低血壓、心搏過緩、溫暖乾燥的皮膚），以便早期診斷和管理。治療方面，補充液體、升壓藥物（如 norepinephrine）和保持體溫的原則也高度一致。但在美國，對於脊髓損傷病人的長期照護與復健體系可能更為完善。