Bowel and Bladder Management in Rehabilitation Flashcards

A patient with a T6 complete spinal cord injury is at risk for autonomic dysreflexia (AD). Which stimulus is the MOST common trigger?

Answer: Bladder distension or bowel impaction

Bladder distension is the most common trigger of autonomic dysreflexia in SCI at or above T6, causing uncontrolled sympathetic discharge below the injury level.

A CRRN identifies that a patient with T4 SCI is experiencing autonomic dysreflexia. The patient's BP is 195/110 mmHg. Which is the PRIORITY intervention?

Answer: Sit the patient upright, loosen constrictive clothing, and identify/remove the noxious stimulus

The first priority in AD is sitting the patient upright (to lower BP via orthostasis) and identifying and removing the triggering noxious stimulus, such as bladder distension.

A patient with a lower motor neuron (flaccid) neurogenic bladder dysfunction is most likely to exhibit which pattern?

Answer: Urinary retention with overflow incontinence due to acontractile detrusor

Lower motor neuron lesions below the sacral micturition center cause flaccid/acontractile detrusor with urinary retention and overflow incontinence.

A patient with SCI begins an intermittent catheterization (IC) program. Which teaching point is MOST important regarding catheter frequency?

Answer: Catheterize every 4–6 hours to keep bladder volume below 400–500 mL

Bladder volumes above 400–500 mL cause overdistension and increase AD and UTI risk; catheterizing every 4–6 hours maintains safe volumes in neurogenic bladder management.

Which finding BEST indicates a successful neurogenic bowel program in a patient with SCI?

Answer: Predictable bowel evacuation every 1–2 days without incontinence episodes

A successful neurogenic bowel program produces predictable, timed evacuations every 1–2 days without incontinence, enabling social participation and skin integrity.

A patient with upper motor neuron (spastic/reflexic) neurogenic bowel from SCI requires bowel care. Which intervention is MOST appropriate to trigger reflex defecation?

Answer: Digital rectal stimulation or insertion of a suppository to trigger the gastrocolic reflex

Digital rectal stimulation (DRS) or suppository insertion triggers the anorectal reflex in UMN neurogenic bowel, promoting coordinated reflex evacuation.