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?

Choice A reason: Natural history of disease is not an approach that explains the factors that allow the reproduction and spread of infectious disease. Natural history of disease is a concept that describes the progression and outcome of disease in the absence of any intervention. It includes stages such as susceptibility, exposure, incubation, prodrome, clinical, recovery, disability, or death.

Choice B reason: Health promotion is not an approach that explains the factors that allow the reproduction and spread of infectious diseases. Health promotion is a process that enables people to increase control over and improve their health. It involves strategies such as education, advocacy, policy, or community development.

Choice C reason: Levels of prevention is not an approach that explains the factors that allow the reproduction and spread of infectious disease. Levels of prevention is a framework that classifies different types of interventions based on their timing and purpose. It includes primary prevention (before disease occurs), secondary prevention (early detection and treatment), and tertiary prevention (reducing complications and disabilities).

Choice D reason: Epidemiologic triangle is an approach that explains the factors that allow the reproduction and spread of infectious disease. Epidemiologic triangle is a model that identifies three essential components of an infectious disease: agent (the microorganism that causes the disease), host (the person or animal that is infected), and environment (the physical, biological, or social factors that influence the transmission). The interaction and balance among these components determine the occurrence and spread of an infectious disease.

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.