A spinal cord–injured client complains of severe dyspnea in the side-lying position. The nurse anticipates diagnostic testing to reveal
a. a pleural abscess.
b. a tension pneumothorax.
c. bilateral diaphragmatic paralysis.
d. pneumonia.
C
The most common causes of bilateral diaphragmatic paralysis include spinal cord injury, thoracic trauma, multiple sclerosis, nerve compression from tumors, anterior horn disease, and muscular dystrophy. Classic manifestations include dyspnea and hypoxemia in the side-lying position. There is generally no treatment for this condition unless the phrenic nerve is still intact, in which case a phrenic nerve pacemaker can be implanted.
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