A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?

A. Polyuria: Polyuria, or excessive urination, is not typically associated with cervical spinal cord injury. In fact, urinary retention or neurogenic bladder is more commonly observed due to disruption of bladder control. Clients with cervical spinal cord injury often experience bladder dysfunction, which can lead to urinary retention rather than polyuria.
B. Hypotension: Hypotension is a common complication of cervical spinal cord injury, particularly in cases involving injury above the level of T6. Damage to the sympathetic nervous system can result in neurogenic shock, characterized by vasodilation and bradycardia, leading to hypotension. Monitoring for signs of hypotension, such as decreased blood pressure and altered mental status, is essential for early intervention and prevention of complications.
C. Weakened gag reflex: Cervical spinal cord injury can impair the gag reflex due to disruption of the glossopharyngeal nerve (CN IX) and vagus nerve (CN X) function. This impairment can lead to difficulty swallowing, aspiration risk, and increased susceptibility to respiratory complications such as aspiration pneumonia. Therefore, monitoring the gag reflex and assessing for signs of dysphagia are crucial in clients with cervical spinal cord injury to prevent respiratory compromise and aspiration-related complications.
D. Hyperthermia: Hyperthermia is less commonly associated with cervical spinal cord injury. However, in some cases, autonomic dysreflexia—a potentially life-threatening condition—can occur, leading to increased body temperature among other symptoms. This is more common in injuries above the T6 level.
E. Absence of bowel sounds: Neurogenic bowel dysfunction, including the absence of bowel sounds, is a common complication of cervical spinal cord injury. Disruption of autonomic nervous system function can lead to decreased peristalsis and absent bowel sounds.

A. Asking the client if they have talked to their parents about their anxiety may not be appropriate, as it assumes the client is comfortable discussing their concerns with their parents. It's important to establish rapport and trust with the client before delving into personal matters such as family dynamics.
B. Asking "Why do you think you are so anxious?" may come across as confrontational and put the client on the defensive. It's important to approach the client's concerns with empathy and understanding rather than seeking an explanation for their anxiety.
C. This response acknowledges the client's feelings and validates their experience, showing empathy and understanding. It opens the door for further exploration of the client's concerns and allows the nurse to provide support and assistance.
D. While assessing the duration of symptoms is important, asking "How long has this been going on?" as an initial response may feel dismissive to the client's current distress. Starting with an empathetic acknowledgment of the client's experience can help build rapport and trust before delving into more specific questions about the duration and severity of symptoms.