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Exam & Evaluation (Bladder Management after Spinal Cord Injury)
 
Questions: Please respond to following statements.

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1 After SCI, problems with urinary and bladder function are common. Which of the following problems are associated with SCI?
  Urinary tract infections
  Bladder stones
  Kidney deterioration
  Kidney failure
  All of the above
2 Another name for the bladder muscle is:
  micturition
  ureter
  detrusor
  sphincter
3 Sympathetic stimulation inhibits voiding, while parasympathetic stimulation allows voiding to occur.
True     False
4 We normally become aware of the need to void when the bladder holds:
  50 cc
  100 cc
  150 cc
  200 cc
  250 cc
5 A bladder that is hyperreflexic is overactive. It tends to empty "automatically."
True     False
6 Suprasacral lesions (lesions above the sacrum) often are associated with detrusor sphincter dyssynergia (DSD).
True     False
7 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.
8 Patients in spinal shock frequently require urinary catheterization.
True     False
9 Bladder management protocols stress that it's important the amount of urine in bladder not exceed:
  150 cc
  300 cc
  500 cc
  600 cc
10 Specific goals of a bladder training program after SCI include prevention of:
  bladder overdistention
  urinary tract infections
  kidney damage
  all of the above
11 The best time to perform urodynamic assessment testing after spinal cord injury is during the period of spinal shock.
True     False
12 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.
True     False
13 For ideal bladder training, the 3 disciplines of nursing, physical therapy and occupational therapy work hand-in-hand.
True     False
14 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.
15 Autonomic Dysreflexia (AD) is associated with injuries at the spinal cord level:
  T12
  Sacral root
  T6 and above
  L1 through L12
16 Autonomic dysreflexia most often occurs within the first 6 months after SCI.
True     False
17 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
18 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
19 SCI patients with a lower urinary tract infection commonly display the following symptoms, EXCEPT:
  Cloudy, strong smelling urine
  New onset of urinary incontinence
  Fever
  Extraordinary pain or burning on urination
  An episode of autonomic dysreflexia with lesions above T6
20 A urine culture should be repeated if it comes back with more than how many organisms present?
  one
  two
  three
  four
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