Question

Discuss a nursing care plan for bladder training for the elder.

Discuss a nursing care plan for bowel training for the elder.

Answer 1

care plan for bladder training in elderly:

Urinary incontinence:

Continent person's failure to hit the toilet in time to prevent accidental urine loss. in a normal person they have neaurological control mechanism for urination in which patient have control when they need to pass urine and control on urge for urination.

but as age increase they loss control on bladder to store urine properly.even person can not recognize urge to void.

reason for incontinence of urine:

musculo skeletal problems, some disease like muscular impairment, parkinson's diease, sclerosis etc.

ASSESSMENT:

Assess incontinence includes duration , frequency, leakage, episodes and factors that responsible for incontinence.

Assess patient can recognize or feel for urge to void urine.

Assess for disease or any problems like infections in UT, cancer, taking any medication which affect urination,normal schedule of voiding,psychology, functional facility like toilets, bedside urinel,dependency for care on family or care taker.

Plan for care

• set time schedule for toileting.
• remove barriers which are affecting normal voiding
• roper lighting in bathroom
• proper arrangement for safe urinary voiding like female or male urinal, privacy should be maintain, bed side urinal
• loose fitting cloth which are easy to remove before urination
• start toileting programme according to schedule to maintain duration, frequecy of urination
• praise patient to maintaining urination and schedule
• maintain fluid intake to regulate urination
• exercise for strengthening of muscles and sprincter contrl
• monitor for dehydration

CARE PLAN FOR BOWEL TRAINING IN ELDER

Bowel incontinence

bowel incontinence where patient loses his/her control on bowel movements.

even sometime person is not able to reach to toilet for elimination before that patient eliminate.

it make person feel embarrassed.

sometimes patient/ person who having bowel incontinence have risk for IMPAIRED SKIN INTEGRITY and distruptive in activity of daily living

Diagnosis:

Bowel incontinence related to lack of voluntary prhincter control as evidence by unable to control passage of stool.

NURSING CARE PLAN'

• encourage and help to develop daily bowel program based on patient's want and needs.
• assess bowel frequency amd movements daily.
• assess person's feelings for self control of bowel movements daily.
• teach to person how to keep bowel movemwnt regular by listing what food need to eat and how much fluid have to drink.
• should take care of bowel incontinence: encopresis
• if functional impairment than provide facility for stool elimination.
• psychological support is very important to make person feel comfortable with incontinence
• provide schedule and stimulus before positioning on toilet so will make easy defication of stool.
• pelvic floor exercise will help to person for strengthening muscles and sphincter control.
• perineal care and care of skin of perianal will help to prevent skin damage and infection.
• application of petrolium jelly to moisure the skin arround anal opening will help to prevent skin friction.

thank you