Genitourinary management
A patient in neurogenic shock experiences abrupt loss of voluntary muscle control and reflexes, resulting in acute urinary retention. An indwelling urinary catheter must be placed to decompress the bladder and allow close urinary output monitoring during the initial resuscitation and critical management phases. The patient may need the catheter for the duration of the hemodynamic push period to prevent bladder distention and bladder injury. During the acute phase, fluid shifts may result from I.V. fluid administration coupled with use of vasopressors to support blood pressure. The catheter stays place until the patient achieves hemodynamic stability, typically defined in intensive care environments as when the patient no longer needs vasopressors.