1. The client/caregiver can list the goals of bladder retraining.
   1. To re-establish bladder control
   2. To increase the self-esteem of the client
   3. To promote skin integrity
2. The client/caregiver can list general measures to promote bladder retraining.
   1. Keep a record for several days before training begins.
      1. Record amount of fluid intake.
      2. Record times that the client voids.
      3. Record amount voided.
   2. Encourage large fluid intake (approximately 3,000 ml if not contraindicated) during the day.
   3. Restrict fluid in the evening.
   4. Avoid drinks with diuretic effects (coffee, tea, etc.).
   5. Give diuretic medication early in the day to avoid nighttime incontinence.
   6. Strengthen perineal muscles with Kegel exercises. Tighten buttocks together, and hold several times a day.
   7. Notify the physician of signs of infection (i.e., frequency, burning, fever, and foul odor).
3. The client/caregiver can describe the procedure for bladder training procedure.
   1. Drink a glass of water about 30 minutes before voiding.
   2. Begin by taking the client to the bathroom every 1 to 2 hours and then gradually increasing the time between voiding to no more than every 3 to 4 hours.
   3. Several methods can be used to encourage voiding.
      1. Running water from the faucet
      2. Drinking water
      3. Pouring warm water over the perineum
      4. Tightening and relaxing pelvic muscles
      5. Massaging bladder
   4. The client should be taken to the bathroom if possible or provided a bedside commode so that the client can assume the position used to void.
   5. Establish a strict schedule of voiding, usually before and after meals and on rising and before bedtime.
   6. Keep accurate records of when client voids in the commode and when incontinence occurs.

References

Canobbio, M. M. (2006). Mosby’s handbook of patient teaching . St. Louis: Mosby Inc.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Timby, B. K. (2005). Fundamental nursing skills and concepts. Philadelphia: J. B. Lippincott Williams &
Wilkins.