Nurse Eve is caring for a client who had a cerebrovascular accident. Which nursing intervention promotes urinary continence?

• A. Encouraging intake of at least 2 L of fluid daily
• B. Giving the client a glass of soda before bedtime
• C. Taking the client to the bathroom twice per day
• D. Consulting with a dietitian.

Answer: (A)

Promoting urinary continence after a cerebrovascular accident centers on supporting normal bladder function, and adequate hydration is fundamental to that. Encouraging a daily fluid intake of about 2 liters helps ensure enough urine is produced to encourage regular bladder emptying and keeps urine dilute, which lowers the risk of bladder irritation and urinary tract infections that can worsen incontinence. This simple step works directly with the body's need to cycle urine and empty the bladder predictably, especially when combined with timely toileting cues.

Giving a soda before bed tends to increase nocturnal urine production and can irritate the bladder due to caffeine and carbonation, making continence harder, not easier. Taking the patient to the bathroom only twice a day doesn’t provide enough opportunities to void; more frequent, scheduled or cue-initiated toileting is typically needed to support continence. While a dietitian can offer valuable guidance on overall nutrition and bladder irritants, this option doesn’t directly address the immediate need to promote continence through hydration and regular voiding.