Medical Surgical Multiple Sclerosis MS #4

Question

The nurse is educating a client with multiple sclerosis (MS) who is at risk for urinary retention regarding neurogenic bladder. The nurse determines the client needs additional teaching if the client makes which of the following statements?

Answers

  1. “I will continue my vitamin C supplement and drink a lot of cranberry juice to help prevent urinary tract infections.”
    • Rationale:

      This answer is not correct because vitamin C and liberal intake of cranberry juice helps prevent UTIs. Vitamin C acidifies the urine while cranberry juice prevents bacteria from sticking to the bladder wall, thus reducing bacterial growth in the urinary tract.

  2. “When using the toilet, I will lean forward and place both of my hands on my lower abdomen and press downward towards my bladder while urinating.”
    • Rationale:

      This answer is not correct because this manual compression technique will help empty the bladder. This is called the Crede maneuver, or Crede method and used by clients with MS to stimulate complete emptying of the bladder.

  3. “I will notify my doctor if I have symptoms of a urinary tract infection, so I can start treatment as soon as possible.”
    • Rationale:

      This answer is not correct because a UTI can worsen the neurological symptoms in MS. If a UTI is suspected, it is important to start treatment quickly.

  4. “I need to decrease my fluid intake to control my incontinence, so as not to have an accident while in public.”
    • Rationale:

      This answer is correct since reducing fluids increases the risk of a urinary tract infection. Increasing fluids promotes urine output which reduces the risk of infection. A urinary tract infection can exacerbate the symptoms of MS.

Overview

Clients with multiple sclerosis (MS) are at risk for neurogenic bladder which contributes to the development of urinary tract infections caused by urinary retention. It is important for the client to know the signs of a urinary tract infection since this infection can exacerbate MS.

Explanation

Learning Outcomes

Clients with multiple sclerosis (MS) are at risk for neurogenic bladder which contributes to the development of urinary tract infections caused by urinary retention. Residual urine greater than 100 mL predisposes the client to infection. It is important for the client to know the signs of a urinary tract infection since this infection can exacerbate MS. Educating the client on neurogenic bladder and preventing UTIs are key. Initiating a bladder training program and incorporating the Crede method is a great way to facilitate complete bladder emptying. Encouraging the client to drink 2 to 3 L of fluid daily will promote urine output, which reduces the risk of infection. Intake of vitamin C supplements and drinking a lot of cranberry juice will reduce bacterial growth in the urinary tract.

Test Taking Tip

Remember, if a question states a need for “additional or further teaching”, the test taker is looking for a client statement that indicates confusion about something and needs to have more information or teaching to understand properly.

Video Rationale