The Big Picture
Bladder training helps a client work toward better control of urination. Some clients need this training after an in-dwelling catheter has been removed.
After having an in-dwelling catheter for some time, a client might lose muscle tone in the bladder. The bladder might not stretch enough to hold urine. Bladder training aims to restore control of urination.
The bladder training program forms part of the client’s care plan. The CCA assists with the program as directed by the supervisor and the care plan.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Urinary incontinence means loss of bladder control.
- The goal of bladder training is control of urination.
- Bladder training follows the client’s care plan.
- One method uses scheduled times for the client to try to urinate.
- Another method involves periods when an in-dwelling catheter is clamped.
- After catheter removal, the client is encouraged to void every 3 to 4 hours, or as directed by the supervisor and care plan.
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Course Notes: Key Ideas You Need to Know
What Bladder Training Is
Bladder training programs are used for clients with urinary incontinence. Urinary incontinence means the client cannot control the passage of urine from the bladder.
The goal of bladder training is to help the client regain control of urination.
Urination means emptying urine from the bladder. It is also called voiding or micturition.
Why Bladder Training Might Follow Catheter Removal
Some clients need bladder training after removal of an in-dwelling catheter.
An in-dwelling catheter is a tube inserted into the bladder through the urinary meatus and urethra. A balloon inside the catheter is inflated after insertion to keep it from slipping out of the bladder. It is also called a Foley catheter or retention catheter.
After an in-dwelling catheter has been in place for some time, the bladder might lose muscle tone. The bladder might no longer stretch enough to hold urine.
The client might experience urinary incontinence until bladder tone returns.
The CCA’s Role in Bladder Training
Bladder training forms part of the client’s care plan.
CCA action: Assist with bladder training as directed by your supervisor and the care plan.
The directions from the supervisor and care plan guide the support you provide.
Method 1: Scheduled Voiding
One bladder training method gives the client scheduled times to try to urinate.
The client uses one of the following:
- toilet
- commode
- bedpan
- urinal
At the scheduled time, give the client 15 or 20 minutes to begin voiding.
Follow the guidelines for maintaining normal urination.
If possible, the client assumes the normal position for voiding.
Privacy: Protect the client’s privacy during the process.
Help the client relax and provide encouragement. These techniques support the client’s efforts to void.
Method 2: Training With a Catheter
The second method involves a client who has a catheter.
The catheter is clamped so urine does not drain from the bladder.
The timing changes as the program progresses:
- At first, the catheter is usually clamped for 1 hour.
- Eventually, it is clamped for 3 to 4 hours at a time.
- When the catheter is unclamped, urine drains from the bladder.
These catheter steps describe the bladder training method. The CCA follows the directions given by the supervisor and the care plan when assisting with the client’s program.
After the Catheter Is Removed
After catheter removal, encourage the client to void every 3 to 4 hours.
The supervisor or care plan might give different directions. Follow those directions when they differ from the usual 3-to-4-hour schedule.
Exam Clue Words
- Required: The CCA is required to assist with bladder training as directed by the supervisor and care plan.
- At first: Catheter clamping usually begins with periods of 1 hour.
- Eventually: The clamping period increases to 3 to 4 hours at a time.
- As directed: After catheter removal, encourage voiding every 3 to 4 hours, or follow the directions from the supervisor and care plan.
Fast Review
These are the main points to remember when you review this topic quickly:
- Urinary incontinence means loss of control over the passage of urine from the bladder.
- The goal of bladder training is control of urination.
- Some clients need bladder training after an in-dwelling catheter is removed.
- Loss of bladder muscle tone after catheter use might make it harder for the bladder to stretch enough to hold urine.
- Scheduled voiding gives the client 15 or 20 minutes to begin urinating.
- During scheduled voiding, use the normal position if possible, protect privacy, help the client relax, and offer encouragement.
- With the catheter method, clamping usually starts at 1 hour.
- Catheter clamping eventually reaches 3 to 4 hours at a time.
- After catheter removal, encourage the client to void every 3 to 4 hours, or as directed.
- The CCA assists with bladder training according to the supervisor’s directions and the client’s care plan.
Final Pep Talk
The timing numbers are easy to mix up, so keep the two methods separate: scheduled voiding uses 15 or 20 minutes, while catheter clamping usually starts at 1 hour and eventually reaches 3 to 4 hours. Review which number belongs to which method instead of trying to remember them as one sequence.