A registered nurse is attempting to change the method for documenting client care in a medical/surgical floor setting. What questions should be considered before planning change? (Select all that apply.)

Choice A rationale:
Focuses on avoiding change rather than managing it effectively. Change is often necessary for improvement and growth. Seeking ways to avert it can hinder progress and prevent potential benefits.
Undermines the nurse's role as a change agent. Nurses are expected to play a proactive role in initiating and implementing change to enhance patient care and organizational effectiveness.
May lead to missed opportunities to address issues or challenges. By focusing on averting change, underlying problems may remain unaddressed, potentially compromising patient care or organizational efficiency.
Choice B rationale:
Addresses group cohesion, which is crucial for successful change implementation. Cohesive groups demonstrate better communication, collaboration, and support, facilitating acceptance and adaptation to change.
Recognizes that change can disrupt group dynamics and relationships. Assessing group cohesion allows for identification of potential challenges and development of strategies to strengthen relationships and foster teamwork during the change process.
Highlights the importance of considering the social and relational aspects of change. Change is not only a technical process; it involves individuals with emotions, beliefs, and social connections that need to be considered for successful implementation.
Choice C rationale:
Assesses the group's overall openness and willingness to accept change. Some groups may be more resistant to change due to past experiences, fear of the unknown, or attachment to existing practices.
Determines if the change aligns with the group's values and beliefs. Change that conflicts with deeply held values is likely to encounter stronger resistance and may require additional strategies to address concerns and build consensus.
Recognizes that not all groups are equally adaptable to change. Understanding the group's amenability to change helps in tailoring implementation strategies and managing potential resistance.
Choice D rationale:
Evaluates the group's preparedness for change in terms of knowledge, skills, and resources. Insufficient preparation can lead to confusion, frustration, and decreased effectiveness during the change process.
Considers the group's emotional readiness to accept and adapt to change. Even if a change is technically feasible, emotional resistance can hinder its success. Assessing readiness allows for addressing concerns and providing support to facilitate the transition.
Ensures that the group has the necessary support and resources to implement the change successfully. Change often requires training, guidance, and time for adjustment. Providing adequate support systems is essential for successful implementation.

Choice A rationale:
Total urinary incontinence is the involuntary loss of all urine from the bladder. It is not synonymous with micturition, which is a controlled process of bladder emptying.
Incontinence can stem from various factors, including neurological disorders, muscle weakness, medication side effects, and structural abnormalities.
It's essential to distinguish between incontinence and micturition for accurate diagnosis and treatment.
Choice B rationale:
Micturition, also known as urination or voiding, is the physiological process of emptying the urinary bladder. It involves a coordinated interplay between the nervous system, bladder muscles, and urethral sphincters. When the bladder fills with urine, stretch receptors signal the nervous system, prompting the urge to urinate. If conditions are appropriate, the nervous system initiates a series of events:
The detrusor muscle in the bladder wall contracts.

The internal urethral sphincter relaxes, opening the pathway for urine to flow.
The external urethral sphincter, under voluntary control, relaxes to allow urine to pass through the urethra and out of the body.
Choice C rationale:
The inability to completely empty the bladder is called urinary retention.
It can result from various causes, including obstruction (e.g., enlarged prostate, urethral stricture), neurological disorders, medications, and pelvic floor dysfunction.
Urinary retention differs from micturition, as it involves incomplete bladder emptying.
Choice D rationale:
Catheterization is the process of inserting a thin, flexible tube (catheter) into the bladder to drain urine.
It's a medical procedure performed for various reasons, such as urinary retention, bladder obstruction, or to collect urine samples.
Catheterization is not a natural process of micturition, but a medical intervention.