A patient with paraplegia resulting from a T9 spinal cord injury ...

[craiczarry]

A patient with paraplegia resulting from a T9 spinal cord injury has a neurogenic reflexic bladder. Which action will the nurse include in the plan of care?
 
  a. Teach the patient the Cred method.
  b. Instruct the patient how to self-catheterize.
  c. Catheterize for residual urine after voiding.
  d. Assist the patient to the toilet every 2 hours.

Question 2

The nurse is admitting a patient with a neck fracture at the C6 level to the intensive care unit. Which assessment finding(s) indicate(s) neurogenic shock?
 
  a. Hyperactive reflex activity below the level of injury
  b. Involuntary, spastic movements of the arms and legs
  c. Hypotension, bradycardia, and warm, pink extremities
  d. Lack of sensation or movement below the level of injury

[yasmin]

Answer to Question 1

ANS: B
Because the patient's bladder is spastic and will empty in response to overstretching of the bladder wall, the most appropriate method is to avoid incontinence by emptying the bladder at regular intervals through intermittent catheterization. Assisting the patient to the toilet will not be helpful because the bladder will not empty. The Cred method is more appropriate for a bladder that is flaccid, such as occurs with areflexic neurogenic bladder. Catheterization after voiding will not resolve the patient's incontinence.

Answer to Question 2

ANS: C
Neurogenic shock is characterized by hypotension, bradycardia, and vasodilation leading to warm skin temperature. Spasticity and hyperactive reflexes do not occur at this stage of spinal cord injury. Lack of movement and sensation indicate spinal cord injury, but not neurogenic shock.