A patient with paraplegia resulting from a T9 spinal cord injury has a neurogenic reflexic bladder. Which action should the nurse include in the plan of care?

Catheterize for residual urine after voiding.

Instruct the patient how to self-catheterize.

Assist the patient to the toilet every 2 hours.

Teach the patient to use the Credé method.

Answer and Explanation

The Correct Answer is B

A. Catheterize for residual urine after voiding: While catheterization for residual urine may be necessary in some cases, it is not the most appropriate long-term solution for managing a neurogenic reflexic bladder. It does not promote patient independence or long-term bladder health.

B. Instruct the patient how to self-catheterize: Self-catheterization empowers the patient to manage their bladder function independently and reduces the risk of urinary tract infections
associated with indwelling catheters. It is the preferred method for managing neurogenic bladder in patients with spinal cord injury.

C. Assist the patient to the toilet every 2 hours: While assisting the patient to the toilet at regular intervals may help prevent urinary accidents, it does not address the underlying issue of neurogenic bladder or promote long-term bladder management.

D. Teach the patient to use the Credé method: The Credé method involves applying manual pressure to the bladder to promote voiding. While it may be used in some situations, it is not the preferred method for managing neurogenic bladder, especially in patients with spinal cord injury.

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Correct Answer is C

Explanation

A. The patient reports chronic severe back pain: Chronic severe back pain may indicate underlying spinal issues but does not necessarily require immediate action compared to acute symptoms such as new-onset weakness of both legs.

B. The patient expresses anxiety about having surgery: While addressing the patient's anxiety is important for providing holistic care, it is not the most immediate concern compared to new- onset weakness of both legs, which may indicate spinal cord compression requiring urgent
intervention.

C. The patient has new-onset weakness of both legs: New-onset weakness of both legs suggests potential spinal cord compression or neurological deficit requiring immediate evaluation and intervention to prevent further neurological damage or complications.

D. The patient starts to cry and says, "I feel hopeless": While addressing the patient's emotional needs is important, it is not the most immediate concern compared to addressing acute neurological symptoms such as new-onset weakness of both legs.

A. Oral Levetiracetam B. IV Lorazepam C. IV Ondansetron D. Magnesium Sulfate

Correct Answer is B

Explanation

A. Oral Levetiracetam: Oral medications are not appropriate for immediate seizure management during an active seizure. Intravenous medications are typically used for acute seizure management.

B. IV Lorazepam: Lorazepam is a benzodiazepine that is commonly used as a first-line medication for terminating acute seizures. It acts quickly to suppress seizure activity and is often administered intravenously during a seizure episode.

C. IV Ondansetron: Ondansetron is an antiemetic medication used to prevent nausea and vomiting and is not indicated for seizure management.

D. Magnesium Sulfate: Magnesium sulfate is not typically used for seizure management in the acute setting. It may be used for certain types of seizures or as a treatment for eclampsia, but it is not a first-line medication for acute seizure termination.

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A patient with paraplegia resulting from a T9 spinal cord injury has a neurogenic reflexic bladder. Which action should the nurse include in the plan of care?

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