A nurse is preparing a client for discharge home who is confused and incontinent after a stroke. Which instructions regarding bladder training will the nurse include in the teaching plan for the client's family?
"Offer the client the commode or urinal every 2 hours."
"Decrease the client's oral fluid intake to 1 L/day."
"Instruct the client to hold urine as long as possible to restore bladder tone."
"Use a Foley catheter at night to prevent accidents."
The Correct Answer is A
The nurse will include the instruction "Offer the client the commode or urinal every 2 hours" in the teaching plan for the client's family. This approach is known as timed voiding and can help the client re-establish a regular pattern of urination. Option "a" promotes frequent voiding, which helps
prevent accidents and promotes bladder health. Option "b" is not a recommended approach and can lead to dehydration, urinary tract infections, and other complications. Option "c" is also not recommended since holding urine for extended periods can lead to bladder distention and increase the risk of urinary tract infections. Option "d" is also not recommended since catheterization should only be considered in specific cases where other options have failed or are not feasible.
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Related Questions
Correct Answer is A
Explanation
Kegel exercises are designed to strengthen the pelvic floor muscles, which can help improve urinary incontinence. By teaching the patient how to perform Kegel exercises, the nurse can provide a non-invasive, effective intervention that the patient can perform on her own to help manage her urinary incontinence.
Assisting the patient to the bathroom q3hr (b) may help reduce the frequency of incontinence episodes but it does not address the underlying issue of weakened pelvic floor muscles.
Demonstrating how to perform Crede’s maneuver (c) involves applying manual pressure to the bladder to assist with urination and is not appropriate for managing urinary incontinence related to laughing or coughing.
Placing a commode at the patient’s bedside (d) may be appropriate for patients who have difficulty with mobility or accessing the bathroom, but it does not address the underlying issue of weakened pelvic floor muscles causing urinary incontinence.
Correct Answer is D
Explanation
This is a critical finding that could indicate bleeding or compromised airway, both of which are potentially life-threatening complications following a thyroidectomy. Immediate intervention may be necessary to prevent further harm to the patient. The other options are important to note and should be addressed, but they do not require immediate intervention as the swelling in the neck does.
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