A nurse is teaching a client who has a complete spinal cord injury about bowel and bladder management. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
(Select All that Apply.)

"It will be necessary to take a stool softener to keep you from becoming constipated."

"Suprapubic catheterization might have to be done if you are unable to catheterize yourself."

"You will need to learn how to do self-intermittent catheterization to drain your bladder."

"Do not drink fluids excessively as this may cause diarrhea."

"To achieve a bowel movement, dally digital stimulation will need to be done."

Answer and Explanation

Correct Answer : A,B,C,E

Choice A Reason:

"It will be necessary to take a stool softener to keep you from becoming constipated." This instruction is correct. Individuals with spinal cord injuries often experience bowel dysfunction, including constipation, due to decreased mobility and impaired bowel function. Stool softeners can help soften the stool and facilitate easier bowel movements, reducing the risk of constipation and associated complications such as fecal impaction.

Choice B Reason:

"Suprapubic catheterization might have to be done if you are unable to catheterize yourself." This instruction is correct. Suprapubic catheterization involves the insertion of a catheter through the abdominal wall directly into the bladder to drain urine. It may be necessary if the client is unable to perform intermittent catheterization independently or if other methods of bladder management are ineffective or contraindicated.

Choice C Reason:

"You will need to learn how to do self-intermittent catheterization to drain your bladder." This instruction is correct. Self-intermittent catheterization involves inserting a catheter into the bladder to drain urine at regular intervals. It is a commonly used method of bladder management for individuals with spinal cord injuries to prevent urinary retention and bladder distention.

Choice D Reason:

"Do not drink fluids excessively as this may cause diarrhea," is not typically included in bowel and bladder management instructions for individuals with spinal cord injuries. Hydration is important for overall health and may help prevent complications such as urinary tract infections, kidney stones, and constipation. Therefore, option D is not appropriate for inclusion in the teaching for a client with a complete spinal cord injury.

Choice E Reason:

"To achieve a bowel movement, daily digital stimulation will need to be done." This instruction is incorrect. Digital stimulation involves gently stimulating the rectum with a lubricated gloved finger to initiate a bowel movement. It can help individuals with spinal cord injuries who have neurogenic bowel dysfunction to stimulate bowel motility and facilitate bowel evacuation.

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Correct Answer is B

Explanation

Choice A Reason:

"I have signed up for an aerobics class three times a week." This statement is incorrect. Participating in aerobics classes three times a week may not be suitable for someone with spinal stenosis, as certain movements and high-impact activities common in aerobics classes can exacerbate symptoms and increase the risk of injury to the spine.

Choice B Reason:

"I ride my bicycle every day." This statement is correct. Cycling is generally considered a low-impact exercise that can be beneficial for individuals with spinal stenosis, as it helps improve cardiovascular fitness without placing excessive stress on the spine. Riding a bicycle regularly may be a suitable exercise option for this client.

Choice C Reason:

"I like to jog a half a mile every day." This statement is incorrect. Jogging involves repetitive impact and can place significant stress on the spine, which may exacerbate symptoms of spinal stenosis. It is generally not recommended for individuals with spinal stenosis due to the high-impact nature of the activity.

Choice D Reason:

"I enjoy doing circuit training once a week.": Circuit training typically involves a combination of aerobic and strength-training exercises performed in rapid succession. While some components of circuit training, such as strength training, can be beneficial for individuals with spinal stenosis, the intensity and variety of exercises in circuit training may not be suitable for everyone with this condition.

A. "The nerves just go to sleep when I lie down because no message gets from my brain to the spinal cord." B. "The nerve damage may occur for unknown reasons in any individual." C. "The older I get, there is less blood flowing to my feet." D. "The elevated blood sugar from my diabetes can cause underlying nerve damage."

Correct Answer is D

Explanation

Choice A Reason:

"The nerves just go to sleep when I lie down because no message gets from my brain to the spinal cord." is incorrect because it does not accurately describe the mechanism of peripheral neuropathy. Peripheral neuropathy in diabetes is not simply the nerves "going to sleep" due to lack of communication between the brain and spinal cord.

Choice B Reason:

"The nerve damage may occur for unknown reasons in any individual" is incorrect because while the exact cause of peripheral neuropathy may not always be known, in the context of diabetes mellitus, the link between elevated blood sugar levels and nerve damage is well-established.

Choice C Reason:

"The older I get, there is less blood flowing to my feet. “is incorrect because while decreased blood flow (ischemia) can contribute to peripheral neuropathy in some cases, the primary mechanism in diabetic neuropathy is nerve damage due to hyperglycemia rather than reduced blood flow.

Choice D Reason:

"The elevated blood sugar from my diabetes can cause underlying nerve damage." Peripheral neuropathy is a common complication of diabetes mellitus, particularly when the condition is uncontrolled. Elevated blood sugar levels over time can lead to damage to the nerves, especially those in the feet and legs. This damage can result in symptoms such as numbness, tingling, burning sensations, or pain in the affected areas.

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A nurse is teaching a client who has a complete spinal cord injury about bowel and bladder management. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) (Select All that Apply.)

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Correct Answer is B

Explanation

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Explanation

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A nurse is teaching a client who has a complete spinal cord injury about bowel and bladder management. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
(Select All that Apply.)