School Age Children’s Continence Parent Seminar School Nursing.
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Transcript of School Age Children’s Continence Parent Seminar School Nursing.
School Age Children’s Continence
Parent Seminar
School Nursing
WelcomeAim of today’s session is:• To look at daytime and night time wetting
and constipation/soiling.• To provide information and awareness to
help you support your child.
Information on the Kidneys and
Bladder
Kidneys
Ureters
BladderUrethra
How the kidneys and bladder work
General Information about the bladder• Between 2 – 3 years bladders mature and
child can become dry• Usually pass urine 6 – 8 times a day• Urine usually pale yellow in colour• How much the bladder holds depends on
age• 83.6% of children are dry at night by the age
of 7 years
How the Bladder works
How much a bladder can hold
Age Bladder Capacity
5 180mls
6 210mls
7 240mls
8 270mls
9 300mls
10 330mls
11 360mls
12 390mls
Daytime Wetting
1 in 75 children have day time wetting
What can cause day time wetting
• Fluids – not drinking enough or types of fluids
• Urinary Tract Infection• Constipation
• Delay in emptying bladder• Overactive bladder – twitchy bladder• Small bladder size• Physical or learning needs
What can be done
• Gradually increase fluids – water based & take a drink to school
• Reduce dark coloured fluids and fizzy drinks
• Regular toileting throughout the day • Counting • Use a reminder to go to the loo
What can be done
• See your doctor• Reward charts• Avoid constipation• Easily removable clothing• Stay calm and relaxed• Opportunity and access to toilet
Drinking
Night time Wetting
1 in 10 age 5 - 6 years bed wet, decreases with age
What can cause night time wetting
• Fluids – not drinking enough or types of fluids
• Arousability – not waking to signal of needing the toilet
• Lack of vasopressin• Constipation• Overactive bladder –
twitchy bladder• Genetic
What can be done
• Treat day time and constipation first• Fluids – encourage to drink and look at types• Praise• Toilet prior to bedtime and return 5-10 mins • Easy access to toilet & Night light• Advisable not to lift
What can be done
Alarm
Medication
Reward charts
Child’s responsibility
Constipation
Affects 30% of children
How the bowel works
Liver
Large Intestine
Stomach
Small Intestine
RectumAppendix
Information about constipation can cause• Many parents/carers don’t recognise the
signs and symptoms of constipation
• Signs: small hard stools; less than three times a week; painful; night time soiling
Bristol Stool Chart
Which one is the ideal poo?
What happens when constipated
What can be done
• Exercise• Diet• Fluids• Toilet routine• Toilet comfortable• Position on toilet & foot stool• Praise & rewards• Medication
• Restricting fluids• Telling your child off• Having too high expectations• Thinking you’ve failed• Taking all the responsibility yourself
Traffic Lights
• Family/Environmental History
• Your child as an individual• Fluid intake• Frequency of toileting• Bedtime routine• Your own reaction
• To your child• To yourself• The support offered • To others experiences
Stop
Look At
Listen
Baseline Charts
• Input & Output - 4 days for wetting
• Baseline - 14 days for wetting
• Soiling & toileting charts - soiling
Remember …. For all continence issues:• You and your child are not alone• Don’t tell off – they are not doing it to
annoy you• Listen to advice• Work with your child• Increase fluids• Praise! Praise! Praise!
Further Information and help• Enuresis Resource website – www.eric.org.uk
• School Nurse website – www.healthforkids.co.uk/illness
• School Nurse• GP