A 55 year old woman reports stress incontinence when sneezing and playing tennis.

She asks what she can do to prevent this from happening.

Which response would the nurse provide first?

Choice A rationale

Anticholinergic medications, such as oxybutynin or tolterodine, are typically used to treat urge incontinence by blocking muscarinic receptors in the bladder, which decreases involuntary detrusor muscle contractions. While they may be considered for mixed or severe stress incontinence, non-pharmacological behavioral therapies, like timed voiding and pelvic floor muscle exercises (Kegels), are the initial, first-line interventions due to their low risk.

Choice B rationale

Voiding immediately prior to activities that increase intra-abdominal pressure, like playing tennis or sneezing, is a primary, first-line behavioral strategy for managing stress incontinence. This action ensures the bladder volume is minimized, reducing the pressure exerted on the urethral sphincter and consequently decreasing the likelihood and volume of urine loss during the activity.

Choice C rationale

Choosing more supportive undergarments, such as specialized incontinence pads or absorbent liners, addresses the management of urine leakage but does not address the underlying cause or provide a preventative strategy for the stress incontinence itself. While helpful for comfort and hygiene, this is a secondary measure, not the initial treatment of choice.

Choice D rationale

Restricting calcium-containing foods is not an established or beneficial intervention for stress incontinence. Dietary restrictions are mainly focused on bladder irritants like caffeine, alcohol, and acidic foods. Furthermore, restricting calcium intake is detrimental to bone health, especially in post-menopausal women who are already at risk for osteoporosis.