The nurse is developing a teaching plan for a client with stress incontinence. Which of the following instructions should be included?
A. Avoid activities that are stressful and upsetting.
B. Avoid caffeine and alcohol.
C. Do not wear a girdle.
D. Limit physical exertion.
Correct Answer: B. Avoid caffeine and alcohol.
Client’s with stress incontinence are encouraged to avoid substances such as caffeine and alcohol which are bladder irritants. Regardless of whether the patient desires any of the three options, all patients should receive counseling on lifestyle modifications. Bladder irritants to avoid include caffeinated beverages (coffee, tea, sodas) alcohol, citrus fruits, chocolate, tomato, spicy foods, and tobacco.
Option A: Emotional stressors do not cause stress incontinence. It is caused most commonly by relaxed pelvic musculature. Physical activities precipitating SUI include laughing, sneezing, straining, coughing, or exercising. Patients may refer to a sudden loss of urine as “leaking,” “dripping” or “flooding.” The patient may initially present with urinary complaints of frequency, urgency, and dysuria.
Option C: Wearing girdles is not contraindicated. Patients should receive education on all forms of management including conservative and surgical management and the prognosis utilizing evidence-based medicine. Resources for patients include the American College of Obstetricians and Gynecologists, American Urogynecologic Society, and Advancing Female Pelvic Medicine and Reconstructive Surgery.
Option D: Although clients may be inclined to limit physical exertion to avoid incontinence episodes; they should be encouraged to seek treatment instead of limiting their activities. Pelvic muscle exercises such as Kegel exercises – three sets of ten pelvic musculature contractions held for ten seconds three times a day should be done. Bladder retraining (timed voiding) or regularly scheduling urination leading to an empty bladder for longer periods throughout the day.
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