Q. Please design a rehabilitation management plan to address Edith’s continence problems by choosing four primary components of that plan from the list below.
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Q. Please design a rehabilitation plan to address Edith’s continence problems by choosing four primary components of that plan from the list below.
Pelvic floor exercises – Correct – In the case of Edith although her main predominant symptom is urgency teaching Edith pelvic floor exercises as a deferment strategy or as a technique to help suppress urge will assist with her bladder training programme. ✓
Teach Mid-Stream Stop -Incorrect – The use of the mid stream stop exercise is not advocated because it can be harmful to recovery.
Advise leaving at least four hours between visits to the toilet – Incorrect – An ideal daytime interval between voids is 3-4 hours.
Review medication- Correct – This is always good practice as many drug impact continence. ✓
Fluid advice – Correct – Edith is drinking 6-7 cups of coffee daily. While the volume is good she should reduce her caffeine intake by replacing 3 – 4 cups daily with decaffeinated coffee, water or a juice alternative. ✓
Individualised bladder training programme – Correct – Edith will benefit from an individualised bladder training programme, based on the findings from a 3-day frequency-volume chart. This indicates she should start with a compulsory void every 1hr 15mins. Edith should be encouraged to aim for a 3-4 hour between-void interval. Using distraction and urge suppression techniques, the time between voids can be increased weekly by 10-15 minutes until she reaches her target of 3-4 hourly intervals. Edith is well-motivated, which is essential to the success of bladder training as it is the person’s own efforts that will make the difference. . ✓
Encourage her to toilet during the night- Incorrect – Bladder training is conducted throughout the daytime and sleep is promoted at night time. Getting up at night frequently increases risk of falls.
Teaching her techniques to suppress urgency – Correct – You should teach Edith distraction and urge suppression techniques, such as counting backwards, sucking her thumb, deep breathing or performing several fast pelvic floor contractions so she can develop better bladder control and delay going to the toilet by a set period of time. ✓
Review in 4 weeks- Incorrect – Edith’s bladder problem should respond to active rehabilitation. Doing nothing is not an option.
Page last reviewed: 31 Jan 2022
