A nurse working in a community pediatric clinic explains the ...

[joesmith1212]

A nurse working in a community pediatric clinic explains the process of toilet training to mothers of toddlers. Which is a recommended guideline for initiating this training?
 
  A) The child should be able to hold urine for four hours.
  B) The child should be between 18 and 24 months old.
  C) The child should be able to communicate the need to void.
  D) The child does not need the desire to gain control of voiding.

Question 2

A nurse is caring for older adult clients in an assisted-living facility. Which effect of aging should the nurse consider when performing a urinary assessment?
 
  A) The diminished ability of the kidneys to concentrate urine may result in urinary tract infection.
  B) Increased bladder muscle tone may reduce the capacity of the bladder to hold urine, resulting in frequency.
  C) Decreased bladder contractility may lead to urine retention and stasis, which increase the likelihood of urinary tract infection.
  D) Neuromuscular problems may result in the client finding urinary control too much trouble, resulting in incontinence.

[atrochim]

Answer to Question 1

Ans: C
Voluntary control of the urethral sphincters occurs between 18 and 24 months of age. However, many other factors are required to achieve conscious control of bladder function, and toilet training usually begins at about 2 to 3 years of age. Toilet training should not begin until the child is able to hold urine for two hours, recognize the feeling of bladder fullness, communicate the need to void, and control urination until seated on the toilet. The child's desire to gain control is also important.

Answer to Question 2

Ans: C
Decreased bladder contractility may lead to urine retention and stasis, which increase the likelihood of urinary tract infection. The diminished ability of the kidneys to concentrate urine may result in nocturia (urination during the night). Decreased bladder muscle tone may reduce the capacity of the bladder to hold urine, resulting in increased frequency of urination. Neuromuscular problems, degenerative joint problems, alterations in thought processes, and weakness may interfere with voluntary control and the ability to reach a toilet in time. Individuals who view themselves as old, powerless, and neglected may cease to value voluntary control over urination, and simply find toileting too much bother no matter what the setting. Incontinence may be the result.