Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

When assessing bowel function in a child with spina bifida, what issue is most likely encountered?

1. Ineffective defecation reflex and leakage of fecal matter

2. Constipation

3. Diarrhea

4. Impacted stool

The correct answer is: Ineffective defecation reflex and leakage of fecal matter

When assessing bowel function in a child with spina bifida, the most likely issue encountered is the ineffective defecation reflex and leakage of fecal matter. This is primarily due to the neurological deficits associated with spina bifida, where the spinal cord's development may be incomplete, leading to impaired nerve function that controls bowel movements. Children with spina bifida often have alterations in the autonomic nervous system, which can affect the coordination of the muscles in the rectum and anus. As a result, an individual may not have a strong or effective defecation reflex, making it difficult for them to control bowel movements effectively. This can lead to involuntary leakage of fecal matter, a condition often referred to as fecal incontinence. While constipation, diarrhea, and impacted stool can potentially occur in any child, they are not the primary issues directly related to the neuropathic effects of spina bifida. Constipation can be a concern, but it more often results from dietary factors, limited mobility, and muscle function – rather than the primary dysfunction related to the condition itself as seen in ineffective reflexes.