Exam & Evaluation (Bladder Management after Spinal Cord Injury)
Questions: Please respond to following statements.
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After SCI, problems with urinary and bladder function are common. Which of the following problems are associated with SCI?
Urinary tract infections
All of the above
Another name for the bladder muscle is:
Sympathetic stimulation inhibits voiding, while parasympathetic stimulation allows voiding to occur.
We normally become aware of the need to void when the bladder holds:
A bladder that is hyperreflexic is overactive. It tends to empty "automatically."
Suprasacral lesions (lesions above the sacrum) often are associated with detrusor sphincter dyssynergia (DSD).
The following statements about vesicoureteral reflux are correct, EXCEPT:
It commonly occurs with suprasacral injuries.
The bladder is more stretchable and compliant.
Urine in the bladder returns to the ureters and kidneys.
Potentially results in kidney damage.
Patients in spinal shock frequently require urinary catheterization.
Bladder management protocols stress that it's important the amount of urine in bladder not exceed:
Specific goals of a bladder training program after SCI include prevention of:
urinary tract infections
all of the above
The best time to perform urodynamic assessment testing after spinal cord injury is during the period of spinal shock.
If a patient has frequent UTIs using "clean" intermittent catheterization procedures, it may be necessary to switch to only using sterile equipment and aseptic technique.
For ideal bladder training, the 3 disciplines of nursing, physical therapy and occupational therapy work hand-in-hand.
The following statements about the medication Ditropan (oxybutynin chloride) are correct, EXCEPT.
It is a medication that decreases bladder muscle tone.
It is a cholinergic medication.
It has a local anesthetic effect on the bladder.
It tends to increase bladder capacity.
Autonomic Dysreflexia (AD) is associated with injuries at the spinal cord level:
T6 and above
L1 through L12
Autonomic dysreflexia most often occurs within the first 6 months after SCI.
The first interventions to perform for an episode of autonomic dysreflexia include the following, EXCEPT:
Place the patient in an upright position.
Catheterize the bladder, and/or check for bladder distention.
Administer medication to bring the blood pressure back up.
Loosen restrictive clothing
Check for pressure sores
According to the National Institute on Disability and Rehabilitation, the amount of bacteria found in urine cultures from patients with an indwelling urinary catheter that is considered significant is:
100 CFU/ml is significant
10,000 CFU/ml is significant
100,000 organisms per high power field is significant
Any detectable bacteria is significant
SCI patients with a lower urinary tract infection commonly display the following symptoms, EXCEPT:
Cloudy, strong smelling urine
New onset of urinary incontinence
Extraordinary pain or burning on urination
An episode of autonomic dysreflexia with lesions above T6
A urine culture should be repeated if it comes back with more than how many organisms present?
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