A nurse is monitoring a client with a cervical spinal cord injury. Which complication should the nurse be particularly vigilant for?

In patients with cervical spinal cord injuries, especially those higher up in the cervical region, the disruption of sympathetic nervous system function can lead to significant cardiovascular changes, including hypotension. This occurs due to loss of sympathetic tone to the blood vessels, leading to vasodilation and a decrease in systemic vascular resistance. As a result, these patients are at risk for orthostatic hypotension, which can manifest as dizziness, fainting, or even shock if not appropriately managed.

Monitoring for hypotension is critical because the decreased blood pressure may impair organ perfusion and can lead to serious complications if it remains uncorrected. Additionally, hypotension in this population may also indicate potential other underlying issues such as internal bleeding or infection, necessitating careful observation.

The other complications may not be as immediate or prominent in the context of cervical spinal cord injuries. For example, while a weak gag reflex can occur in a patient with respiratory issues, it is not as critical an immediate concern in terms of monitoring as hypotension. Similarly, polyuria and hyperthermia may be seen in various conditions but are not as directly related to the acute management of a patient with cervical spinal cord injury. Therefore, vigilance regarding hypotension is a priority in this clinical scenario.