Bowel and Bladder Management in Rehabilitation Flashcards

A CRRN is teaching a patient with MS about bladder dysfunction. Which bladder problem is MOST common in MS?

Answer: Overactive bladder with urgency, frequency, and urge incontinence

Overactive bladder with urgency and urge incontinence is the most prevalent bladder dysfunction in MS, caused by demyelination of pathways controlling the detrusor muscle.

During a neurogenic bowel program, a patient with complete T8 SCI is found to have a fecal impaction. Which is the MOST appropriate initial intervention?

Answer: Perform manual removal of impacted stool using a well-lubricated, gloved finger

Manual disimpaction is the appropriate first intervention for fecal impaction in SCI patients; it must be performed carefully to avoid triggering autonomic dysreflexia.

When educating a patient about preventing UTIs during intermittent catheterization at home, which instruction is MOST important?

Answer: Maintain adequate hydration (2–2.5 L/day) and adhere to the scheduled catheterization frequency

Adequate fluid intake dilutes urine and reduces bacterial colonization, while strict IC scheduling prevents overdistension — both are essential UTI prevention strategies.

A patient with a lower motor neuron neurogenic bowel (flaccid) requires which bowel management strategy?

Answer: Scheduled timed evacuations using Valsalva maneuver, abdominal massage, and manual evacuation

LMN neurogenic bowel lacks the anorectal reflex, so evacuation relies on Valsalva, abdominal massage, and manual techniques rather than reflex stimulation methods.

A rehabilitation patient with SCI consistently has post-void residual (PVR) volumes of 350 mL after voiding attempts. What does this indicate?

Answer: Incomplete bladder emptying indicating potential for UTI and upper urinary tract damage

A PVR of 350 mL indicates significant urinary retention; volumes above 100 mL are associated with increased UTI risk and potential hydronephrosis from reflux.

A CRRN is educating a patient about the timed voiding program for functional urinary incontinence. Which description BEST explains this program?

Answer: Assisting the patient to void at regular scheduled intervals regardless of urge, to prevent incontinence episodes

Timed voiding (prompted or scheduled) is a caregiver-assisted program where the patient is taken to the toilet at fixed intervals to prevent incontinence in patients who cannot self-initiate.