Bowel and Bladder Management in Rehabilitation Flashcards

A patient with stroke has urge urinary incontinence due to neurogenic detrusor overactivity. Which pharmacological intervention is most commonly used?

Answer: Anticholinergic medication such as oxybutynin

Anticholinergic medications such as oxybutynin reduce involuntary detrusor contractions, decreasing urge incontinence in patients with neurogenic overactive bladder.

A rehabilitation patient is being evaluated for a urinary tract infection. Which clinical finding is a reliable indicator of UTI in a patient with SCI who has no bladder sensation?

Answer: Increased spasticity, autonomic dysreflexia, cloudy urine with foul odor, and fever

In patients with SCI who lack bladder sensation, UTI presents with systemic and indirect signs including increased spasticity, AD, cloudy/foul urine, and fever rather than dysuria.

A patient post-prostatectomy has stress urinary incontinence. Which non-pharmacological intervention is the FIRST LINE treatment?

Answer: Pelvic floor muscle training (Kegel exercises)

Pelvic floor muscle training (PFMT) is the first-line non-pharmacological intervention for stress urinary incontinence post-prostatectomy, strengthening the external urethral sphincter.

A rehabilitation nurse is reviewing a clean intermittent catheterization technique with a patient for home use. Which modification distinguishes CLEAN from sterile technique for home IC?

Answer: Reusable catheters cleaned with soap and water; handwashing and clean technique are acceptable

Clean IC at home uses clean (not sterile) technique with reusable catheters washed with soap and water, which is safe and evidence-based for outpatient neurogenic bladder management.

A patient with a neurogenic bowel is experiencing constipation despite a scheduled bowel program. Which dietary intervention is MOST appropriate?

Answer: Increase dietary fiber to 25–38 grams per day and ensure adequate fluid intake

Adequate dietary fiber (25–38 g/day) combined with sufficient fluid intake (1.5–2 L/day) promotes stool bulk and motility, improving constipation in neurogenic bowel.

A patient has been using an indwelling urinary catheter for 3 weeks during acute rehabilitation. Which complication is the PATIENT AT HIGHEST RISK for?

Answer: Catheter-associated urinary tract infection (CAUTI)

Catheter-associated UTI (CAUTI) is the most common healthcare-associated infection and risk increases linearly with duration of indwelling catheter use.