Continence Assessment Form And Care Plan (Page 4 of 7) in pdf

SECTION B: Bladder & Bowel pattern (continued)

Assessment Cues

Care Options

(tick appropriate care option)

(tick appropriate response)

15. Does the resident have a urinary

If yes, ask the RN, Continence Nurse or GP about the care required and refer to resident’s catheter

catheter in place?

care plan.

■

Yes

■

No assistance required to empty catheter bag

■

Supervise the resident to empty catheter bag

If yes, is the catheter

■

Physically assist the resident to empty catheter bag

Suprapubic?

■

Urethral?

16. How often does the resident normally

If less than 3 times per week, or if yes to question 17:

use their bowels?

discuss the following options with RN, Continence Nurse or GP

■

Daily to second daily

■

Increase fluid to __________________ a day.

■

Less than 3 times per week

■

Increase fibre by ______________________________.

17. In the past two weeks has the

■

Increase mobility (refer to mobility / activity care plan).

resident leaked, or had accidents or lost

■

control with stool/bowel motion?

Medication (as determined by RN, Continence Nurse or GP).

■

Yes

■

Refer for further investigation (i.e. Abdominal X-Ray, GUT motility study).

■

Monitor bowel elimination frequency and stool consistency.

■

Prompt / supervise / assist resident to the toilet at _________________ each day.

■

Encourage the resident to respond to the urge to use their bowels.

■

Supervise / prompt / assist the resident to sit on the toilet and rest their elbows on their knees

with their feet flat on the floor or stool to facilitate bowel emptying.

18. Has the resident got any of the

If yes to any symptom, ask the RN, Continence Nurse or GP about the care required.

following symptoms when they use

their bowels?

■

Pain and discomfort

■

Straining

■

Bleeding

■

Hard, dry motions

■

Very fluid bowel motions

19. Has the resident had a urine test

If the resident’s urine dip-stick shows blood or nitrites or leukocytes or has a pH equal to 8 or above,

(dipstick) done in the past 28 days?

ask the RN, Continence Nurse or GP about the care required.

■

Yes

■

No (this needs to be done)

pH __________ SG __________

■

Blood

Yes

■

Nitrites

Yes

■

Leukocytes

Yes

Further comments and/or observations ____________________________________________________________________________________

____________________________________________________________________________________________________________________

Developed by Deakin University and funded under the National Continence Management Strategy

Continence Assessment Form And Care Plan Page 4

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