Week 11 - Interventions to Promote Continence

Question 1

One intervention to promote continence is a voiding diary. What can you write in it? (3, 6)

Answer 1

1. Record of continence
   - gold standard for obtaining objective information about voiding patterns
2. Bladder and bowel routines but also other factors
   - pain, difficulty stopping and starting
3. Character of urine
   - colour, sediment, odour, clarity

Question 2

What is the nursing role in UI? (3)

Answer 2

1. teach about urinary health in aging
2. Educate about false perceptions
3. Identify reversible causes

Question 3

What assessments/interventions can you do as a nurse? (6)

Answer 3

1. assess/ modify the environment
2. Pelvic floor muscle exercises (PFME)
3. Assess meds
4. catheters not used to manage UI
5. Refer to specialist
6. Continence training program

Question 4

What are the 4 factors of continence training? (4, 8)

Answer 4

1. Scheduled voiding
   - going at regular intervals every 2-4 hours
2. Prompted voiding
   - Cuing the person to go and providing positive reinforcement when they are dry between intervals
3. Bladder training
   - Increasing amount of time between intervals
4. Pelvic floor muscle contractions
   - 30-100 times a day, hold for 10 secs

Question 5

True or false: urinary catheters are used to manage incontinence

Answer 5

false

Question 6

What are the risks to using external catheters? (7)

Answer 6

• risk for fungal infection
• penile skin macerations
• edema
• fissures
• burns from uria
• UTI
• septicemia

Question 7

How often should external catheters be cleaned?

Answer 7

removed and cleaned once daily

Question 8

What are long tern indwelling catheters used for?

Answer 8

manage urinary retention

Question 9

Why is the use of catheters in hospital unjustified some times? (2)

Answer 9

• medical error
• risk for delirium

Question 10

How can we optimized continence? (6)

Answer 10

1. Drink 2000 ml of non-caffeinated liquids per day
2. Lifestyle modifications
3. Drink most liquids during the day (limit 2-4 hours before bed)
4. Access to bathroom optimized
5. Color contrast optimized to highlight bathroom and toilet
6. bed or chair provide ease of independence

Question 11

What are the current research in LTC about incontinence? (7)

Answer 11

1. Lack of communication with residents about continence needs
2. Residents nor families are consulted about management strategies
3. Low Expectation
4. Myths that incontinence is normal
5. Heavy reliance on products
6. Need to educate staff on hygiene, urinary retention, constipation, fluid
7. Enable high quality of care