1. The client/caregiver can define types of bladder control caused by nerve damage.
   1. Nerves carry signals from the brain to the bladder and sphincter. Damage can cause bladder control problems.
   2. Overactive bladder
      • Urinary frequency—eight or more times a day
      • Urinary urgency—sudden, strong need to urinate immediately
      • Urge incontinence—leakage of urine that follows a sudden urge
   3. Poor control of sphincter muscles—may allow leakage of urine
   4. Urine retention—bladder does not receive message to empty
2. The client/caregiver can list causes of this type of nerve damage.
   1. Vaginal childbirth
   2. Diabetes
   3. Stroke
   4. Infections of the brain or spinal cord
   5. Trauma or injury to the brain or spinal cord
   6. Multiple sclerosis
   7. Heavy metal poisoning
3. The client/caregiver can list measures to manage urinary control problems.
   1. Do bladder training (Chapter 23).
   2. Do Kegel exercises (Chapter 23).
   3. Use barrier garments or external collection devices (condom catheter).
   4. Assess for skin breakdown or irritation.
   5. Control odors by
      1. Frequent cleansing of the perineum
      2. Changing to clean clothes
      3. Room deodorizer
   6. Avoid using perfume or scented powders, lotions, or sprays.
   7. Keep a record of fluid intake. Drink plenty of fluids during morning and early afternoon. Decrease fluid intake during evening.
   8. Contact the physician if any of the following occurs:
      • Rash around the perineal area
      • Pain in lower abdomen
      • Fever or chills
      • Cloudy urine
4. The client/caregiver can list possible complications.
   1. Rashes, skin infections, or sores
   2. Urinary tract infections
   3. Sleep problems
   4. Less social and sexual activity
   5. A loss of self-esteem
   6. Depression

Resource

National Association for Continence
800-BLADDER (252-3337) or 843-377-0900
E-mail: memberservices@nafc.org
www.nafc.org

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B.
Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com