A nurse is providing safe sex education to a group of adolescents.Which of the following statements should the nurse include in the education? (Select all that apply.)

Choice A rationale

Stress incontinence is characterized by the involuntary loss of urine during activities that increase intra-abdominal pressure, such as coughing, sneezing, or lifting. This condition is typically caused by a weakened pelvic floor musculature or urethral sphincter incompetence, which is distinct from nerve damage following a spinal cord injury.

Choice B rationale

Overflow incontinence involves the involuntary leakage of urine from an overly full bladder that is unable to empty completely, leading to constant dribbling. This is often caused by an obstruction or an underactive detrusor muscle, resulting in large residual urine volumes, which is a potential but not the most specific result of spinal nerve damage.

Choice C rationale

Reflex incontinence is the involuntary loss of urine that occurs at somewhat predictable intervals when a specific bladder volume is reached, without the client sensing the need to void. This is directly caused by a lack of communication and control between the brain and the bladder, a common consequence of upper motor neuron damage following a spinal cord injury.

Choice D rationale

Urge incontinence, or overactive bladder, is the involuntary loss of urine associated with a sudden, strong desire to void (urgency). It is typically caused by involuntary contractions of the detrusor muscle and is generally not the specific type of neurogenic bladder dysfunction directly and primarily associated with a debilitating spinal cord injury.

Choice A rationale

Hydrochlorothiazide is a thiazide diuretic that works by inhibiting sodium and chloride reabsorption in the distal convoluted tubule. This mechanism causes increased excretion of both water and potassium, making the client susceptible to hypokalemia (serum potassium <3.5 mEq/L), not hyperkalemia, thereby requiring regular electrolyte monitoring.

Choice B rationale

Furosemide is a potent loop diuretic that acts on the ascending limb of the loop of Henle, blocking the reabsorption of sodium, chloride, and potassium. Its high efficacy in causing diuresis leads to significant renal loss of potassium, which places the client at a high risk for developing hypokalemia (serum potassium <3.5 mEq/L), not the elevated levels of hyperkalemia.

Choice C rationale

Mannitol is an osmotic diuretic that acts primarily by increasing the osmotic pressure of the glomerular filtrate, which inhibits the reabsorption of water. It is predominantly used for reducing cerebral edema and intraocular pressure; it does not significantly interfere with the renal tubular handling of potassium, so it poses little risk for hyperkalemia.

Choice D rationale

Spironolactone is a potassium-sparing diuretic that functions as an aldosterone receptor antagonist in the distal nephron. By blocking aldosterone's effects, it promotes sodium and water excretion while retaining potassium, which, especially in clients with impaired kidney function, significantly elevates the risk for life-threatening hyperkalemia (serum potassium >5.0 mEq/L). 80mm.5pt.