A nurse is obtaining a 24-hour urine specimen collection from the patient. Which action should the nurse take?

Choice A reason: Pelvic floor muscle exercises (Kegels) strengthen the pelvic floor and urethral sphincter, improving bladder control in stress incontinence. By enhancing muscle support, they reduce urine leakage during activities like coughing, making them a first-line, evidence-based treatment for this condition, promoting long-term continence.

Choice B reason: Avoiding frequent voiding is not a treatment for stress incontinence. It may help urge incontinence by training the bladder to hold more urine, but stress incontinence results from physical pressure, not bladder overactivity, making this advice irrelevant and potentially worsening symptoms.

Choice C reason: Wearing an adult diaper manages symptoms but doesn’t treat stress incontinence. It provides temporary protection but doesn’t address the underlying pelvic floor weakness. Relying on diapers may reduce quality of life and delay effective treatments like exercises or surgical options.

Choice D reason: Drinking cranberry juice is not a treatment for stress incontinence. It may help prevent urinary tract infections by inhibiting bacterial adhesion, but stress incontinence is a mechanical issue from pelvic floor dysfunction, not infection, making this irrelevant to the condition’s management.

Choice A reason: Sufficient medication in the PCA syringe does not indicate effective pain management. It may reflect underuse due to inadequate pain control or patient misunderstanding of PCA use. Pain relief is assessed by patient-reported outcomes, not medication volume remaining.

Choice B reason: Sleeping and being difficult to arouse suggests oversedation, a potential adverse effect of PCA, particularly with opioids. This indicates excessive dosing rather than effective pain management, risking respiratory depression or other complications, requiring immediate dose adjustment or monitoring.

Choice C reason: A pain rating of 2 on a 0 to 10 scale indicates effective pain management. PCA allows patients to self-administer doses within safe limits, achieving low pain levels without excessive sedation, reflecting optimal balance of analgesia and patient safety post-trauma.

Choice D reason: Pressing the PCA button shows patient engagement but not pain control effectiveness. Frequent pressing may indicate inadequate relief, while infrequent use could reflect sufficient control or misunderstanding. Patient-reported pain levels are the primary indicator of PCA efficacy.