Bowel, Bladder Continence care plan

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STROKE CARE PLAN: BLADDER & BOWEL CONTINENCESet bladder retraining schedule.Registered StaffFollow bladder retraining protocol byprompting resident to urinate as scheduled,reminding resident to practice pelvic floorexercises.PSW/HCACheck that all assistive devices andequipment are in place and secure beforetoileting (specify the assistive devicesrequired)PSW/HCAProvide positive feedback throughout theprocess and provide cueing / assistance asrequired.PSW/HCAEducate resident/family on urinaryincontinence and interventions.PSW/HCA/RegisteredStaffUrinary incontinence related tovision problems (cannot find wayto bathroom), decreased mobility(cannot get to bathroomindependently or quicklyenough), decreased motorcoordination (cannot mangeclothing, briefs, transfers or toilet)due to stroke.Resident will reduceepisodes ofincontinence from__ to __ per day.Resident’s score onADL Short Formdecreases from ___to ____.Resident’s score onSelf-PerformanceHierarchy Scale willdecrease from ___to )___.Position the individual on toilet/commode inposition that will help with toileting. Haveresident sit leaning forward with feet flat onfloor or on stool.Position resident on bedpan with head of bedraised as upright as possible.Orient resident to location of toilet, commode,bedpan, urinal.Keep path to bathroom clear of any obstaclesand that is lighted at night.PSW/HCAPSW/HCAPSW/HCAPSW/HCAAssist resident to adhere to toileting schedulethrough prompting and/or assistance withmobility and clothing.PSW/HCAPage 2 of 5
STROKE CARE PLAN: BLADDER & BOWEL CONTINENCEEnsure that all assistive devices andequipment are in place and secure beforetoileting (specify the assistive devicesrequired)PSW/HCAEducate resident/family on urinaryincontinence and interventions.PSW/HCA/RegisteredStaffUrinary retention related to lossof urge to urinate due to strokeResident will notexperience urinaryretention.Assess for full bladder and contact physicianas necessary.Reassessment of medications that maycontribute to urinary retention.Registered StaffRegistered StaffReport to registered staff if resident unable topass urine for 4 hours (excluding nighttime),has fever, complains of lower back orabdominal pain.PSW/HCAEducate resident/family on urinary retentionand interventions.PSW/HCA/RegisteredStaffRisk of urinary tract infectionrelated to indwelling catheter dueto stroke.Resident will notexperience anyurinary tractinfections.Offer resident drinks 6 to 8 cups of fluid perday. Limit caffeinated drinks to 2 cups/day.Offer cranberry juice.PSW/HCA/DietaryPSW/HCACheck that drainage bag is positioned belowlevel of bladder.PSW/HCAPosition catheter tubing so it does not kink orpull on catheter.PSW/HCASecure catheter tubing to resident’s leg.PSW/HCAPage 3 of 5
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Bowel, Bladder Continence care plan

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