Nurse Karen is caring for a client who had a cerebrovascular accident (CVA). Which nursing intervention promotes urinary continence?
A. Encouraging intake of at least 2 L of fluid daily.
B. Giving the client a glass of soda before bedtime.
C. Taking the client to the bathroom twice per day.
D. Consulting with a dietitian.
Correct Answer: A. Encouraging intake of at least 2 L of fluid daily.
By encouraging a daily fluid intake of at least 2 L, the nurse helps fill the client’s bladder, thereby promoting bladder retraining by stimulating the urge to void. Assess the patient’s ability to communicate the need to void and/or ability to use the urinal or bedpan. Take the patient to the bathroom at periodic intervals for voiding if appropriate.
Option B: The nurse shouldn’t give the client soda before bedtime; soda acts as a diuretic and may make the client incontinent. Patient may have a neurogenic bladder, be inattentive, or be unable to communicate needs in an acute recovery phase, but usually is able to regain independent control of this function as recovery progresses.
Option C: The nurse should take the client to the bathroom or offer the bedpan at least every 2 hours throughout the day; twice per day is insufficient. Maintain a supportive, firm attitude. Allow the patient sufficient time to accomplish tasks. Don’t rush the patient. Patients need empathy and to know caregivers will be consistent in their assistance.
Option D: Consultation with a dietitian won’t address the problem of urinary incontinence. Refer the patient to a physical and occupational therapist. Rehabilitation helps to relearn skills that are lost when part of the brain is damaged. It also teaches new ways of performing tasks to circumvent or compensate for any residual disabilities.
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