Bladders Case Study Essay

Ms. Boehmer has urge incontinence, which is involuntary loss of urine with strong urgency to void and nocturia, it is associated with over-active or unstable bladder (Huether, 2012). It is evidenced by Ms. Boehmer’s “nocturia X 2 and reports she sometimes has a strong urge to void and does not always make it to the toilet in time.”
Recommendations for Ms. Boehmer are lifestyle interventions, such as limit caffeine intake, modify fluid intake, avoid excessive fluid intake before bedtime, pay attention to how much water she is drinking and when she is drinking it. Caffeine can irritate the bladder, therefore increase the urge to void. Avoiding excessive fluid intake before bedtime will decrease the chances of nocturia. Sip small amount, less than 8 oz. of fluid at a time to decrease the amount of urine in the bladder at once. Physical therapies such as pelvic floor muscle training, will
Bladder training may also be helpful, Ms. Boehmer should try to schedule time for urination, and try not to urinate between these times, when urge occurs, try to wait for a set amount of time, and slowly increase the time to retrain the bladder. This exercise will increase the bladder retention of the urine, decrease he urgency. Medication schedule should be reviewed, Ms. Boehmer should take her diuretics for the treatment of heart failure early in the morning and avoid taking it too late in the afternoon if she is on twice a day regimen. Avoiding taking diuretics too late in the afternoon is to avoid nocturia. Neuromodulation device can be considered if behavioral interventions are not helpful. Sacral never stimulators which require surgical placement has shown to improve symptoms. It is a device that stimulate the bladder sphincter and pelvic floor muscle providing bladder control by mild electrical impulses Anticholinergic medications have several side effects, should not be used in older