The nurse is using different toileting schedules. Which ...

[Mimi]

The nurse is using different toileting schedules. Which principles will the nurse keep in mind when planning care? (Select all that apply.)
 
  a. Habit training uses a bladder diary.
  b. Timed voiding is based upon the patient's urge to void.
  c. Prompted voiding includes asking patients if they are wet or dry.
  d. Elevation of feet in patients with edema can decrease nighttime voiding.
  e. Bladder retraining teaches patients to follow the urge to void as quickly as possible.

Question 2

A nurse administers an antimuscarinic to a patient. Which findings indicate the patient is having therapeutic effects from this medication? (Select all that apply.)
 
  a. Decrease in dysuria
  b. Decrease in urgency
  c. Decrease in frequency
  d. Decrease in prostate size
  e. Decrease in bladder infection

[xMRAZ]

Answer to Question 1

ANS: A, C
Habit training is a toileting schedule based upon the patient's usual voiding pattern. Using a bladder diary, the usual times a patient voids are identified. It is at these times that the patient is then toileted. Prompted voiding is a program of toileting designed for patients with mild or moderately cognitive impairment. Patients are toileted based upon their usual voiding pattern. Caregivers ask the patient if they are wet or dry, give positive feedback for dryness, prompt the patient to toilet, and reward the patient for desired behavior. Timed voiding or scheduled toileting is toileting based upon a fixed schedule, not the patient's urge to void. The schedule maybe set by a time interval, every 2 to 3 hours or at times of day such as before and after meals. In bladder retraining, patients are taught to inhibit the urge to void by taking slow and deep breaths to relax, perform 5 to 6 quick strong pelvic muscle exercises (flicks) in quick succession followed by distracting attention from bladder sensations. When the urge to void becomes less severe or subsides, only then should the patient start the trip to the bathroom. Encourage patients with edema to elevate the feet for a minimum of a few hours in the afternoon to help diminish nighttime voiding frequency; while this is helpful, it is not a toileting schedule.

Answer to Question 2

ANS: B, C
When newly started on an antimuscarinic, you should monitor the patient for effectiveness, watching for a decrease in symptoms such as urgency, frequency, and urgency urinary incontinence episodes. Patients with painful urination are sometimes prescribed urinary analgesics that act on the urethral and bladder mucosa (e.g., phenazopyridine). Antibiotics are used to treat bladder infections. Agents that shrink the prostate include finasteride and dutasteride.

[Mimi]

TYSM

[LVPMS]

Excellent