A nurse is planning teaching about methods to reduce incontinent episodes for a client who has stress incontinence. Which of the following Instructions should the nurse plan to include?

"Plan to void every 6 hours."

"Squeeze your legs together when you feel the urge to void."

"Perform Kegel exercises three times daily."

"Drink 1 liter of fluids a day."

Answer and Explanation

The Correct Answer is C

A. "Plan to void every 6 hours.": Voiding every 6 hours may not be appropriate for clients with stress incontinence. A more individualized schedule based on the client's needs and fluid intake is better. Holding urine for too long could worsen symptoms.

B. "Squeeze your legs together when you feel the urge to void.": This is not effective in managing stress incontinence. Instead, strategies like pelvic muscle exercises (Kegel exercises) can help strengthen the muscles that control urination.

C. "Perform Kegel exercises three times daily.": Kegel exercises help strengthen the pelvic floor muscles, which can reduce stress incontinence by improving bladder control. This is an effective and recommended strategy for managing the condition.

D. "Drink 1 liter of fluids a day.": Restricting fluids can concentrate urine, irritating the bladder and worsening incontinence. It’s generally better to maintain adequate hydration, typically around 2 liters of fluids daily, unless otherwise directed by the healthcare provider.

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Correct Answer is D

Explanation

A. Encourage frequent visits from friends: While social interaction can be beneficial, it’s important to consider the individual’s needs and preferences. Overstimulation from too many visitors can cause anxiety or confusion, which can worsen cognitive symptoms.

B. Keep the over-the-bed light on: This may be helpful in preventing falls or confusion at night. However, it’s essential to avoid excessive lighting as it can disrupt the circadian rhythm, potentially leading to sleep disturbances. A dim nightlight is more appropriate.

C. Apply restraints to the upper extremities: Restraints should not be used as a first-line approach. They can increase confusion, anxiety, and the risk of injury. Non-restrictive interventions, such as proper positioning and a calm environment, should be prioritized.

D. Play serene, soothing music: Soothing music can be a helpful intervention to reduce anxiety, agitation, and confusion in clients with dementia. Music has been shown to have a calming effect, which can help the client feel more relaxed and at ease.

A. Remove weights when pulling the client up in bed. B. Check the rope for fraying every 8 hr. C. Cleanse the pin sites with hydrogen peroxide. D. Inspect the pin sites for infection every 24 hr.

Correct Answer is B

Explanation

A. Remove weights when pulling the client up in bed: Weights should never be removed from skeletal traction unless ordered by a healthcare provider. Removing weights disrupts the traction's purpose and alignment, potentially causing complications.

B. Check the rope for fraying every 8 hr: Checking the rope for fraying every 8 hours is an appropriate and safe practice in skeletal traction. Ensuring that the rope is intact and functioning properly is essential for maintaining the stability and effectiveness of the traction.

C. Cleanse the pin sites with hydrogen peroxide: Hydrogen peroxide can be too harsh for cleaning pin sites, as it may damage tissue and delay healing. A sterile saline solution is usually preferred for cleaning pin sites unless otherwise prescribed.

D. Inspect the pin sites for infection every 24 hr: Pin site inspections should be done at least once per shift, not just every 24 hours, to promptly detect any signs of infection, as early intervention is key.

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