A nurse teaches a client who has a flaccid bladder. Which bladder ...

[iveyjurea]

A nurse teaches a client who has a flaccid bladder. Which bladder training technique should the nurse teach?
 
  a. Stroking the medial aspect of the thigh
  b. Valsalva maneuver
  c. Self-catheterization
  d. Frequent toileting

Question 2

A nurse is caring for a client who has a spinal cord injury at level T3. Which intervention should the nurse implement to assist with bladder dysfunction?
 
  a. Insert an indwelling urinary catheter.
  b. Stroke the medial aspect of the thigh.
  c. Use the Cred maneuver every 3 hours.
  d. Apply a Texas catheter with a leg bag.

[huda]

Answer to Question 1

ANS: B
With a flaccid bladder, the voiding reflex arc is not intact and additional stimulation may be needed to initiate voiding, such as with the Valsalva and Cred maneuvers. Intermittent catheterization may be used after the previous maneuvers are attempted. In reflex bladder, the voiding arc is intact and voiding can be initiated by any stimulus, such as stroking the medial aspect of the thigh. A consistent toileting routine is used to re-establish voiding continence with an uninhibited bladder.

Answer to Question 2

ANS: C
Two techniques are used to facilitate voiding in a client with a flaccid bladder: the Valsalva maneuver and the Cred maneuver. Indwelling urinary catheters generally are not used because of the increased incidence of urinary tract infection. Stroking the medial aspect of the thigh facilitates voiding in clients with upper motor neuron problems. If the spinal cord injury is above T12, the client is unaware of a full bladder and does not void or is incontinent. Therefore, the client would not benefit from a Texas catheter with a leg bag.

[iveyjurea]

TYSM

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