A nurse is caring for a patient with a continent urinary reservoir. Which action will the nurse take?
a. Teach the patient how to self-cath the pouch.
b. Teach the patient how to perform Kegel exercises.
c. Teach the patient how to change the collection pouch.
d. Teach the patient how to void using the Valsalva technique.
ANS: A
In a continent urinary reservoir, the ileocecal valve creates a one-way valve in the pouch through which a catheter is inserted through the stoma to empty the urine from the pouch. Patients must be willing and able to catheterize the pouch 4 to 6 times a day for the rest of their lives. The second type of continent urinary diversion is called an orthotopic neobladder, which uses an ileal pouch to replace the bladder. Anatomically, the pouch is in the same position as the bladder was before removal, allowing a patient to void through the urethra using a Valsalva technique. In a ureterostomy or ileal conduit the patient has no sensation or control over the continuous flow of urine through the ileal conduit, requiring the effluent (drainage) to be collected in a pouch. Kegel exercises are ineffective for a patient with a continent urinary reservoir.
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