Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

Which bowel program is best for a patient with a spinal cord injury at C5-6?

1. Enemas daily during the morning

2. Using laxatives and suppositories every evening

3. Consistent time of day with gastrocolic reflex triggering

4. Bulk fiber products for stool formation

The correct answer is: Consistent time of day with gastrocolic reflex triggering

A consistent time of day with gastrocolic reflex triggering is key for establishing an effective bowel program in patients with a spinal cord injury at C5-6. This reflex can stimulate bowel movements in response to food intake, making it a reliable mechanism to promote regularity. By scheduling bowel movements at the same time each day and pairing them with meals, it utilizes the natural physiological response, enhancing the likelihood of successful and predictable bowel evacuations. This approach is particularly beneficial in patients with high-level spinal cord injuries, where autonomic dysreflexia is a concern and may impact bowel control. The routine reinforces the body’s natural rhythms and may alleviate some of the complications associated with bowel management in this population. In contrast, while enemas, laxatives, and bulk fiber products can be part of a bowel program, they might not address the underlying need for consistency and timing that capitalizes on the gastrocolic reflex effectively. Relying heavily on interventions like enemas or laxatives may overlook this important aspect and can sometimes lead to complications or irregularity if not carefully managed.