A nurse is collecting data for a client who has fluid volume deficit. Which of the following is an expected finding?

A. Nocturnal enuresis refers to nighttime bedwetting. In clients with paraplegia and neurogenic bladder, nocturnal enuresis can occur due to impaired bladder sensation or control. However, it does not necessarily indicate the immediate need for catheterization unless accompanied by significant bladder distension or discomfort.
B. Suprapubic discomfort or pain suggests bladder distension, which can occur when the bladder fills beyond its capacity. In clients with neurogenic bladder, this discomfort can be an indication that the bladder needs to be emptied to prevent overdistension and potential complications such as urinary retention or bladder rupture. Therefore, suprapubic discomfort may indicate the need for catheterization.
C. Urge incontinence refers to the sudden and uncontrollable urge to urinate, which leads to involuntary leakage of urine. In clients with neurogenic bladder, urge incontinence can occur due to involuntary bladder contractions. While it indicates an inability to control bladder function, it may not always necessitate immediate catheterization unless it persists or is accompanied by other symptoms.
D. Reflex incontinence occurs when the bladder empties without the person's control due to a spinal cord injury or neurological condition. In clients with paraplegia, reflex incontinence is often managed through intermittent catheterization programs. If reflex incontinence episodes are frequent or result in inadequate bladder emptying, it may indicate the need for more frequent catheterization.

A. This response may come across as judgmental or directive, which can be perceived as dismissive of the client's struggle. It does not acknowledge the complexity of the disorder or the client's feelings of helplessness, potentially hindering open communication and trust.
B. While this question encourages exploration of the underlying reasons for the behavior, it might feel probing or intrusive to the client. It could be interpreted as focusing solely on the behavior itself rather than acknowledging the client's recognition of its abnormality or their feelings of helplessness.
C. This response acknowledges and validates the client's awareness of the problem, which can be empowering. It reinforces the client's self-awareness and readiness to address their behavior, promoting a therapeutic alliance based on mutual understanding and respect.
D. This response demonstrates empathy and understanding of the client's feelings. It acknowledges the emotional struggle the client is experiencing and opens the door for further exploration of their feelings and thoughts. It encourages the client to express their emotions and concerns, which is essential in building a supportive therapeutic relationship.