Chapter 46, Problem 1CAQ

Summary Introduction

To determine:

She has recently begun pelvic muscle exercise (Kegel) and bladder retraining. She shares her concern that the exercise is not working and that she is still wet multiple times a day. Which additional teaching does Mrs. Grayson need.

Case summary:

Mrs. Grayson is a 75-year-old woman has had problems with urge incontinence for the past 2 years. She has not spoken to anyone about her problems because she is embarrassed. She finally confides to her health care practitioner that the problem is causing her to avoid social situations and she would like to regain urinary control. Mrs. Grayson has type 2 diabetes and is obese. She has been referred to a continence specialist. A plan of care was developed after a thorough assessment of her urinary pattern and symptoms.

Explanation of Solution

Urinary incontinence is an embarrassing problem in which the urinary bladder lost its control. It results in intense, sudden urine urgency and leads to involuntary control of urine. This condition might result by diabetes mellitus, infection, and in neurologic disorder.

Bladder retraining program is a behavior therapy which helps to treat urinary incontinence. This program uses to increase the time between bladder emptying.

Kegel exercise is also called as pelvic muscle exercise which is consists of relaxing and contracting the pelvic muscles. During exercise, relaxed breathing and tightening the stomach, thigh muscles are needed simultaneously. Increase the squeezes for every week and avoid overdoing it. Rest is needed between each set of squeezes that gives a better result.

Mrs. Grayson is encouraged to do exercise regularly as per the continence specialist. It gives results after 4 weeks of steady exercise. She is continuously observed by the continence specialist that she could do the exercise properly as continence specialist instruction. If the patient has any problems in doing correct exercise or identifying the correct muscles, she is back to the continence specialist.

Conclusion

Mrs. Grayson is needed to encourage to do exercise consistently, only after 4 weeks it gives best results. She is advised to do the exercise properly as the instruction of the continence specialist.