A client is receiving rehabilitation for paralysis following a spinal cord injury and is diagnosed with reflex incontinence. Which of the following is the highest priority intervention the nurse should include in the plan of care?

Limit fluid intake to prevent incontinence

Provide regular perineal care to prevent skin breakdown

Administer hypotonic IV fluids

Teach Kegel exercises to strengthen the pelvic floor

Answer and Explanation

The Correct Answer is B

Choice A: Limit fluid intake to prevent incontinence. This is incorrect because limiting fluid intake can lead to dehydration, urinary tract infections, and kidney stones. Fluid intake should be adequate to maintain hydration and flush out bacteria from the urinary tract.

Choice B: Provide regular perineal care to prevent skin breakdown. This is correct because reflex incontinence can cause urine leakage and skin irritation, which can increase the risk of infection and pressure ulcers. Regular perineal care can help keep the skin clean and dry, and prevent complications.

Choice C: Administer hypotonic IV fluids. This is incorrect because hypotonic IV fluids can cause fluid overload, hyponatremia, and cerebral edema. Hypotonic IV fluids are not indicated for clients with reflex incontinence.

Choice D: Teach Kegel exercises to strengthen the pelvic floor. This is incorrect because Kegel exercises are effective for clients with stress or urge incontinence, but not for clients with reflex incontinence. Reflex incontinence is caused by a loss of voluntary control over the bladder due to a spinal cord injury, and Kegel exercises cannot restore this function.

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Correct Answer is C

Explanation

Choice A reason: Mitigation is not the correct level of the National Response Framework, as it refers to the actions taken to reduce or eliminate the long-term risk to human life and property from natural or man-made hazards. Mitigation activities include implementing building codes, zoning ordinances, land use planning, and flood insurance programs. Mitigation is a continuous process that occurs before, during, and after a disaster.

Choice B reason: Security is not the correct level of the National Response Framework, as it refers to the actions taken to protect the nation from threats or attacks by terrorists, criminals, or hostile states. Security activities include conducting intelligence operations, screening travelers and cargo, enforcing laws and regulations, and preventing cyberattacks. Security is a shared responsibility among federal, state, local, tribal, territorial, and private sector partners.

Choice C reason: Preparedness is the correct level of the National Response Framework, as it refers to the actions taken to plan, organize, equip, train, and exercise to build and sustain the capabilities necessary to prevent, protect against, mitigate the effects of, respond to, and recover from those threats that pose the greatest risk. Preparedness activities include developing emergency plans, conducting drills and exercises, educating the public, and establishing partnerships and coordination mechanisms. Preparedness is a continuous cycle of improvement that involves assessing needs, setting goals, implementing plans, and evaluating outcomes.

Choice D reason: The response phase is not the correct level of the National Response Framework, as it refers to the actions taken to save lives, protect property and the environment, stabilize the situation, and meet basic human needs in the immediate aftermath of a disaster. Response activities include activating emergency operations centers, deploying resources and personnel, providing mass care and sheltering, restoring critical infrastructure and services, and conducting search and rescue operations. Response is a short-term process that aims to restore normalcy as soon as possible.

A. Advances in surgical techniques and procedures B. Sanitation and other public health activities C. Technology increases in the field of medical laboratory research D. Use of antibiotics to fight infections

Correct Answer is B

Explanation

Choice A reason: Advances in surgical techniques and procedures have improved the outcomes of many patients, but they are not the main factor for the increase in life expectancy. Surgical interventions are often costly, risky, and inaccessible to many people, especially in developing countries.

Choice B reason: Sanitation and other public health activities have had a significant impact on reducing mortality from infectious diseases, such as cholera, typhoid, and tuberculosis. These activities include providing safe water, improving hygiene, promoting vaccination, and controlling vector-borne diseases. Sanitation and public health measures are relatively low-cost, effective, and preventive strategies that can benefit large populations.

Choice C reason: Technology increases in the field of medical laboratory research have contributed to the diagnosis and treatment of many diseases, such as cancer, diabetes, and genetic disorders. However, these technologies are often expensive, complex, and dependent on specialized equipment and personnel. Therefore, they are not the main reason for the increase in life expectancy.

Choice D reason: The use of antibiotics to fight infections has been a major breakthrough in medicine, saving millions of lives from bacterial infections. However, antibiotics have also led to the emergence of antibiotic-resistant bacteria, which pose a serious threat to public health. Moreover, antibiotics are not effective against viral infections, such as influenza, HIV, and COVID-19. Therefore, antibiotics are not the most responsible factor for the increase in life expectancy.

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