The nurse determines that the nursing diagnosis stress urinary incontinence related to decreased pelvic muscle tone is the most appropriate for an oriented adult female client. A therapeutic nurs-ing intervention based on this diagnosis is to:
1. Apply adult diapers
2. Catheterize the client
3. Administer Urecholine
4. Teach Kegel exercises
ANS: 4
Pelvic floor exercises, also known as Kegel exercises, improve the strength of pelvic floor mus-cles and consist of repetitive contractions of muscle groups. These exercises have demonstrated effectiveness in treating stress incontinence, overactive bladders, and mixed causes of urinary continence. The client is oriented and therefore could be taught Kegel exercises to improve pelvic floor muscle tone. Applying adult diapers does not improve the client's problem of incontinence and places the client at risk for skin breakdown. Because bladder catheterization carries the risk for urinary tract infection (UTI), it is preferable to rely on other measures for management of in-continence. The nurse can support the use of Kegel exercises as an inexpensive nonpharmacolog-ical intervention to reduce the client's stress incontinence. Bethanechol (Urecholine) stimulates the parasympathetic nervous system to promote complete bladder emptying and is primarily used to treat urinary retention and possible overflow incontinence. Nonpharmacological approaches should be attempted before pharmacological approaches are taken.
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