A client has a spinal cord injury with paralysis at C5 level. ...

[SO00]

A client has a spinal cord injury with paralysis at C5 level. When completing discharge teaching, which client statement would require further teaching?
 
  1. I need to perform self-catheterization three times daily.
  2. I know I cannot look to see if my bladder is full.
  3. I need to avoid bladder distention.
  4. I'll drink adequate amounts of liquids.

Question 2

A client presents with a medical diagnosis of uremia. Which clinical manifestations does the nurse anticipate upon assessment? Select all that apply.
 
  1. Itching.
  2. Weight loss.
  3. Altered mental status.
  4. Fluid retention.
  5. Insomnia.

[Brenm]

Answer to Question 1

Correct Answer: 1
Dysreflexia occurs in clients with spinal cord injuries at level T7 or higher. Bladder distention causes a sympathetic response that can trigger a potentially life-threatening hypertensive crisis. It would be crucial for the client with this type of injury to avoid bladder distention by performing self-catheterization before this happens, most likely every 3 to 4 hrs. By the time the client can see his abdomen expand or have a sense of bladder fullnessif able to have this sensationit may be too late to avoid dysreflexia. Liquids are important in maintaining the urinary system.

Answer to Question 2

Correct Answer: 1, 2, 3, 4
Uremia is a classic sign of renal failure in which urea and other nitrogen-containing waste products are found in the blood. Common symptoms include itching, weight loss, altered mental status, and fluid retention. Fatigue rather than insomnia is another symptom.