A nurse is planning care for a client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client's plan of care?
Encourage fluid intake at and between meals.
Cleanse the perineum from back to front.
Offer the client the bedpan every 2 hours.
Obtain a prescription for an indwelling urinary catheter.
The Correct Answer is A
A. Encouraging fluid intake at and between meals helps to dilute urine and can reduce the risk of urinary tract infections (UTIs) by promoting regular urination.
B. Cleansing the perineum should be done from front to back to prevent the introduction of bacteria from the rectal area to the urethra, so this option is incorrect.
C. Offering the bedpan every 2 hours may not be sufficient for individuals at risk for UTIs, as more frequent voiding can help prevent infection.
D. An indwelling urinary catheter increases the risk of urinary tract infections and should be avoided unless absolutely necessary; intermittent catheterization is generally preferred for those with spinal cord injuries to minimize this risk.
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Correct Answer is A
Explanation
A. The primary purpose of administering an osmotic diuretic, such as mannitol, is to lower ICP by promoting diuresis, which results in increased urinary output and decreases fluid volume in the brain.
B. Osmotic diuretics do not specifically reduce cerebral blood flow; rather, they work by reducing fluid volume and thus intracranial pressure.
C. While osmotic diuretics can help manage edema, their primary role is not solely to prevent the formation of cerebral edema but to actively reduce existing pressure.
D. Osmotic diuretics do not directly decrease brain oxygen consumption; their main function is to create an osmotic gradient that pulls fluid from the brain to reduce ICP.
Correct Answer is ["A","B","C","D"]
Explanation
A. Reducing body weight can relieve pressure on the lumbar spine, which can help decrease pain and improve function.
B. Avoiding painful positions helps prevent exacerbation of symptoms and protects the affected area.
C. Physical therapy is an important part of conservative treatment to strengthen supporting muscles, improve flexibility, and promote recovery. Chiropractic therapy may be recommended but should be guided by a physician's recommendation.
D. NSAIDs are commonly prescribed to manage inflammation and relieve pain associated with lumbar herniated disks.
E. Corticosteroids may be prescribed in some cases but are generally not part of initial conservative management unless inflammation is severe and not managed by NSAIDs.