An older adult diagnosed with moderate dementia is seen in the geriatric clinic. As the nurse is evaluating the client, the client's wife states that her husband has developed an increasing number of episodes of incontinence. She does not know what is precipitating the episodes, and states "maybe he just doesn't remember that he needs to urinate or maybe it's me, it takes me a while to walk him to the bathroom." The nurse develops a plan of care for this client and includes which of the following interventions to manage the incontinence? (Select all that apply.)
Use of a commode close by to where the client spends most of his time
Development of a toileting schedule
Use of an external catheter
Bladder diary to be completed by the client's wife
Correct Answer : A,B
Choice A reason: Use of a commode close by to where the client spends most of his time can reduce the distance and time required for the client to reach the toilet, and thus prevent accidents and embarrassment. It can also promote the client's independence and dignity.
Choice B reason: Development of a toileting schedule can help the client to establish a routine and habit of voiding at regular intervals, and thus prevent the bladder from becoming too full or overactive. It can also reduce the risk of urinary tract infections and skin breakdown.
Choice C reason: Use of an external catheter is not recommended for older adults with dementia, as it can cause irritation, infection, and obstruction of the urinary tract. It can also increase the client's confusion and agitation, and interfere with his mobility and comfort.
Choice D reason: Bladder diary to be completed by the client's wife is not a direct intervention to manage the incontinence, but rather a tool to assess the pattern and severity of the problem. It can help the nurse to identify the possible causes and triggers of the incontinence, and to evaluate the effectiveness of the interventions. However, it may not be feasible or reliable for the client's wife to complete the diary, as she may have other responsibilities or difficulties in observing and recording the client's urinary habits.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Choice A reason: Recommending an indwelling urinary catheter is not a good option, as it can increase the risk of urinary tract infections, bladder spasms, and catheter-associated complications.
Choice B reason: Prompted voiding is a technique that involves reminding or prompting the client to void at regular intervals, usually every two to four hours. It can help reduce the frequency and severity of urinary incontinence episodes.
Choice C reason: Scheduled voiding is a technique that involves setting a fixed schedule for the client to void, regardless of their urge or need. It can help prevent bladder overdistension and leakage.
Choice D reason: Pelvic floor muscle exercises, also known as Kegel exercises, are exercises that involve contracting and relaxing the muscles that support the bladder, urethra, and other pelvic organs. They can help strengthen the pelvic floor muscles and improve bladder control.
Choice E reason: None of the above is not a correct answer, as there are three choices that are appropriate for helping the client with urinary incontinence.
Correct Answer is ["A","B"]
Explanation
Choice A reason: Use of a commode close by to where the client spends most of his time can reduce the distance and time required for the client to reach the toilet, and thus prevent accidents and embarrassment. It can also promote the client's independence and dignity.
Choice B reason: Development of a toileting schedule can help the client to establish a routine and habit of voiding at regular intervals, and thus prevent the bladder from becoming too full or overactive. It can also reduce the risk of urinary tract infections and skin breakdown.
Choice C reason: Use of an external catheter is not recommended for older adults with dementia, as it can cause irritation, infection, and obstruction of the urinary tract. It can also increase the client's confusion and agitation, and interfere with his mobility and comfort.
Choice D reason: Bladder diary to be completed by the client's wife is not a direct intervention to manage the incontinence, but rather a tool to assess the pattern and severity of the problem. It can help the nurse to identify the possible causes and triggers of the incontinence, and to evaluate the effectiveness of the interventions. However, it may not be feasible or reliable for the client's wife to complete the diary, as she may have other responsibilities or difficulties in observing and recording the client's urinary habits.
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