Fluid & Electrolyte Q 112 - Gyan Darpan : Learning Portal
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Monday 28 March 2022

Fluid & Electrolyte Q 112

Lisa, a client with altered urinary function, is under the care of nurse Tine. Which intervention is appropriate to include when developing a plan of care for Lisa who is experiencing urinary dribbling?
    A. Inserting an indwelling Foley catheter.
    B. Having the client perform Kegel exercises.
    C. Keeping the skin clean and dry.
    D. Using pads or diapers on the client.

Correct Answer: B. Having the client perform Kegel exercises.

Kegel exercises, which help strengthen the muscles in the perineal area, are used to maintain urinary continence. To perform these exercises, the client tightens pelvic floor muscles for 4 seconds 10 times at least 20 times each day, stopping and starting the urinary flow.

Option A: Inserting an indwelling Foley catheter increases the risk for infection and should be avoided. Begin bladder retraining per protocol when appropriate (fluids between certain hours, digital stimulation of trigger area, contraction of abdominal muscles, Credé’s maneuver).
Option C: Proper perineal hygiene decreases the risk of skin irritation or breakdown and the development of ascending infection. The nurse should encourage the client to develop a toileting schedule based on normal urinary habits. However, suggesting bathroom use every 8 hours may be too long an interval to wait.
Option D: Pads or diapers should be used only as a resort. Refer to the urinary continence specialist as indicated. Collaboration with specialists is helpful for developing an individual plan of care to meet a patient’s specific needs using the latest techniques, continence products.

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