school age children’s continence parent seminar school nursing
TRANSCRIPT
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School Age Children’s Continence
Parent Seminar
School Nursing
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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.
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Information on the Kidneys and
Bladder
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Kidneys
Ureters
BladderUrethra
How the kidneys and bladder work
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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
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How the Bladder works
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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
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Daytime Wetting
1 in 75 children have day time wetting
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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
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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
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What can be done
• See your doctor• Reward charts• Avoid constipation• Easily removable clothing• Stay calm and relaxed• Opportunity and access to toilet
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Drinking
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Night time Wetting
1 in 10 age 5 - 6 years bed wet, decreases with age
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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
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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
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What can be done
Alarm
Medication
Reward charts
Child’s responsibility
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Constipation
Affects 30% of children
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How the bowel works
Liver
Large Intestine
Stomach
Small Intestine
RectumAppendix
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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
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Bristol Stool Chart
Which one is the ideal poo?
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What happens when constipated
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What can be done
• Exercise• Diet• Fluids• Toilet routine• Toilet comfortable• Position on toilet & foot stool• Praise & rewards• Medication
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• 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
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Baseline Charts
• Input & Output - 4 days for wetting
• Baseline - 14 days for wetting
• Soiling & toileting charts - soiling
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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!
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Further Information and help• Enuresis Resource website – www.eric.org.uk
• School Nurse website – www.healthforkids.co.uk/illness
• School Nurse• GP