Question

Mr. Haverford has the planned surgery and immediately postoperatively he has a urinary catheter inserted. After the urinary catheter is removed Mr. Haverford is urinating normally, however he is experiencing occasional incontinence with dribbling. Mr. Haverford is to be discharged.

Mr. Haverford says to the nurse, "I'm so embarrassed. What will my wife think about this dribbling?" In addition to acknowledging his feelings, the nurse should encourage the patient to
1) limit oral intake of fluids before bedtime.
2) palpate his bladder to check for distention three times a day.
3) perform pelvic floor exercises several times daily.
4) avoid interrupting the urinary stream during voiding.

Answer 1

To address Mr. Haverford's postoperative urinary incontinence, the nurse should encourage him to perform pelvic floor exercises several times daily to strengthen the muscles for better bladder control.

Step-by-step explanation:

In response to Mr. Haverford's concerns about occasional incontinence with dribbling after his catheter removal, a professional course of action would include suggesting pelvic floor exercises. These exercises, often referred to as Kegel exercises, help in strengthening the muscles responsible for urinary control. Encouraging the patient to perform pelvic floor exercises several times daily can assist in managing urinary incontinence and improve bladder control, thus reducing episodes of incontinence.

While limiting fluid intake before bedtime can help reduce nocturia, it is not the primary approach to strengthen bladder control. Also, regularly palpating the bladder for distention or avoiding interrupting the urinary stream during voiding might not directly address the strength of the pelvic floor muscles. As urinary incontinence can significantly impact quality of life, addressing Mr. Haverford's psychological concerns in tandem with these exercises will be important for his overall well-being.