Fundamentals of Nursing Q 256
A nurse is preparing to initiate a bladder training program for a client who has a voiding disorder. Which of the following actions should the nurse take? Select all that apply.
A. Establish a schedule of voiding prior to meal times.
B. Have the client record voiding times.
C. Gradually increase the voiding intervals.
D. Reminded client to hold urine until next scheduled voiding time.
E. Provide a sterile container for voiding.
Correct Answer: B, C, and D
Ask the client to keep track of voiding times is an appropriate nursing action. Gradually increasing the voiding interval is an appropriate nursing action. The client should be reminded to hold urine until the next scheduled voiding time. Bladder training involves voiding at scheduled in frequent intervals and gradually increasing these intervals to four hours.
Option A: Mealtimes are not regular, and the intervals may be longer than every four hours. Bladder training requires following a fixed voiding schedule, whether or not one feels the urge to urinate. If one feels an urge to urinate before the assigned interval, he should use urge suppression techniques — such as relaxation and Kegel exercises.
Option B: Keeping a diary of bladder activity is very important. This helps the health care provider determine the correct place to start the training and to monitor progress throughout the program.
Option C: Bladder training is an important form of behavior therapy that can be effective in treating urinary incontinence. The goals are to increase the amount of time between emptying the bladder and the amount of fluids the bladder can hold. It also can diminish leakage and the sense of urgency associated with the problem.
Option D: When the client feels the urge to urinate before the next designated time, he should use “urge suppression” techniques or try relaxation techniques like deep breathing. Focus on relaxing all other muscles. If possible, he must sit down until the sensation passes. If the urge is suppressed, adhere to the schedule. If the client cannot suppress the urge, wait five minutes then slowly make way to the bathroom. After urinating, re-establish the schedule. Repeat this process every time an urge is felt.
Option E: A sterile container is not used in a bladder training program. When the client has accomplished the initial goal, he should gradually increase the time between emptying the bladder by 15-minute intervals. He should try to increase the interval each week. However, he will be the best judge of how quickly he can advance to the next step. Increase the time between each urination until he reaches a three- to four-hour voiding interval.