The nurse is caring for a patient with a spinal cord injury who has a flaccid or atonic bladder. The nurse would provide discharge education to the patient and family regarding which bladder management technique?

Scheduled voiding

Intermittent catheterization

Indwelling urinary catheter

External catheter

Answer and Explanation

The Correct Answer is B

A. Scheduled voiding is less effective in patients with a flaccid bladder because there is no voluntary control of bladder function.

B. Intermittent catheterization is the preferred management technique for a flaccid or atonic bladder, allowing the bladder to empty at regular intervals and reducing the risk of infection associated with continuous catheters.

C. An indwelling catheter is usually avoided for long-term use due to a higher risk of infection.

D. An external catheter is generally not effective for flaccid or atonic bladder management in spinal cord injuries as it doesn’t actively empty the bladder.

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Correct Answer is B

Explanation

A. The low blood pressure (90/64) may indicate hypovolemia or shock but is not specific for ICP concerns.

B. This set of vital signs is concerning due to the extremely high blood pressure (220/46) combined with a very low heart rate (30) and low respiratory rate (6), which can indicate an autonomic response to increased ICP, potentially leading to Cushing's triad (hypertension, bradycardia, and irregular respirations).

C. Although the blood pressure is high (200/94), the heart rate is normal and the respiratory rate is stable, making this less alarming compared to option B.

D. The elevated temperature and abnormal heart rate (132) indicate potential fever and tachycardia, but the blood pressure (82/50) is low and does not directly indicate increased ICP.

A. Establish IV access and bolus 250 mL normal saline B. Assess for bladder distension and perform digital disimpaction C. Reschedule the therapy session for later in the day D. Lower the head of the bed and obtain vital signs

Correct Answer is D

Explanation

A. Establishing IV access may be necessary if hypotension persists but is not the initial priority.

B. Bladder distension assessment is essential for managing autonomic dysreflexia in SCI patients; however, symptoms here suggest orthostatic hypotension rather than autonomic dysreflexia.

C. Rescheduling therapy may be considered if dizziness persists, but it does not address the immediate concern.

D. Lowering the head of the bed and obtaining vital signs can help stabilize blood pressure and monitor for orthostatic hypotension, which is common in patients with SCI due to autonomic dysfunction. This intervention helps to prevent syncope.

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The nurse is caring for a patient with a spinal cord injury who has a flaccid or atonic bladder. The nurse would provide discharge education to the patient and family regarding which bladder management technique?

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