A nurse is collaborating in the plan of care for a client who has neurogenic bladder due to a spinal cord injury. Which of the following should the nurse include in the plan of care?

Administer an anti-spasmodic when the client reports a sudden urge to urinate.

Have the client urinate when they feel the need to void.

Educate the client on how to perform self-catheterization.

Inform the client that a one-week trial is needed to know if the plan is effective.

Answer and Explanation

The Correct Answer is C

A. Administer an anti-spasmodic when the client reports a sudden urge to urinate: While anti-spasmodics may help manage bladder spasms, neurogenic bladder often impairs the sensation of urgency, making this approach less reliable as a primary intervention. Medication is typically adjunctive rather than the cornerstone of management.

B. Have the client urinate when they feel the need to void: Clients with neurogenic bladder may have impaired bladder sensation and cannot rely on the urge to void. Waiting for a sensation can lead to urinary retention, infection, or incontinence.

C. Educate the client on how to perform self-catheterization: Intermittent self-catheterization is a standard and effective management strategy for neurogenic bladder. It helps maintain bladder emptying, prevents urinary retention, reduces infection risk, and promotes independence in clients with spinal cord injuries.

D. Inform the client that a one-week trial is needed to know if the plan is effective: Management of neurogenic bladder requires ongoing assessment and adjustments over time. A single-week trial is insufficient to evaluate effectiveness or detect complications, making this instruction inaccurate.

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Correct Answer is B

Explanation

A. Reviewing the results of the client's celiac screening with their parents, without the client's consent: Routine pediatric screenings for general health conditions, such as celiac disease, are typically shared with parents because they are involved in the minor’s overall medical care. This does not constitute a breach of confidentiality.

B. Reviewing the results of the client's chlamydia screening with their parents, without the client's consent: Sexually transmitted infection (STI) testing is confidential for adolescents in most jurisdictions. Sharing these results with parents without the minor’s consent violates the client’s legal and ethical right to privacy.

C. Reviewing the results of the client's complete blood count (CBC) with their parents, without the client's consent: Routine lab results like a CBC can usually be shared with parents for adolescents under 18, as they are part of standard health monitoring. This is generally not considered a breach of confidentiality.

D. Reviewing the results of the client's urinalysis with their parents, without the client's consent: Urinalysis results for general health purposes can typically be shared with parents. Confidentiality concerns mainly arise when the test relates to sensitive conditions, such as STIs or reproductive health.

A. Place no more than one small pillow in the crib. B. Remove bibs when the infant is going to sleep. C. Start using a highchair for feedings. D. Make sure the crib mattress is soft.

Correct Answer is B

Explanation

A. Place no more than one small pillow in the crib: Infants under 12 months should not have pillows in the crib due to the risk of suffocation or sudden infant death syndrome (SIDS). Crib sleep surfaces should be firm and free of soft bedding.

B. Remove bibs when the infant is going to sleep: Bibs can pose a strangulation or suffocation hazard if left on while the infant sleeps. Removing bibs ensures a safe sleep environment and reduces risk of accidental injury.

C. Start using a highchair for feedings: Highchairs are not recommended until the infant can sit independently, typically around 6 months. Using a highchair too early increases the risk of falls and injury.

D. Make sure the crib mattress is soft: A soft mattress increases the risk of suffocation and SIDS. A firm, flat mattress is the safest sleep surface for infants under 12 months.

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A nurse is collaborating in the plan of care for a client who has neurogenic bladder due to a spinal cord injury. Which of the following should the nurse include in the plan of care?

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