A nurse is caring for a client who has paraplegia and is on an intermittent urinary catheterization program.
Which of the following findings indicates to the nurse the need to catheterize the client?
A.
Reflex incontinence
B.
Urge incontinence C. Nocturnal enuresis
C.
Suprapubic discomfort
The correct answer and Explanation is :
The correct answer is D. Suprapubic discomfort.
Explanation:
In clients with paraplegia who are on an intermittent urinary catheterization program, it’s essential to monitor for signs that indicate the need for catheterization. These individuals may have impaired bladder control and sensation due to their spinal cord injury, which makes them reliant on regular catheterization to manage bladder function and avoid complications.
- Reflex Incontinence: This occurs due to involuntary bladder contractions and is common in spinal cord injuries. It usually happens when the bladder fills to a certain point, and the reflex triggers an involuntary release of urine. However, reflex incontinence itself does not necessarily indicate that the client needs catheterization immediately; it suggests that the bladder’s autonomic control is impaired, but the need for catheterization is usually determined based on the overall urinary retention or symptoms.
- Urge Incontinence: This type of incontinence is characterized by a sudden, intense urge to urinate, leading to involuntary leakage. In individuals with paraplegia, urge incontinence may occur due to reflexive actions, but it does not directly indicate the need for catheterization. Instead, it highlights the need for careful management of bladder training and potentially medications to control urges.
- Nocturnal Enuresis: This refers to bedwetting during sleep, which is more common in children or those with specific conditions affecting bladder control. For clients with paraplegia, nocturnal enuresis might not be the primary concern unless they experience bladder function issues during the night that have not been managed by their catheterization schedule.
- Suprapubic Discomfort: This is a more direct indicator that the bladder may be overfilled or that there may be a blockage in the urinary tract. Suprapubic discomfort suggests that the bladder is not emptying properly, which is a key reason to catheterize the client. Regular catheterization aims to prevent urinary retention, which can lead to discomfort, pain, and potential complications such as urinary tract infections or bladder distension. The presence of suprapubic discomfort is a clear sign that immediate catheterization may be necessary to relieve the pressure and prevent further complications.
In summary, suprapubic discomfort is a specific and actionable sign that the client may need catheterization to manage bladder function effectively.