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Incontinence: Practical Tips for the Occupational Therapy Practitioner (Part 1)

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1.  Your client has complaints of bowel incontinence. During your evaluation, he describes his bowel habits. All of the following are true of healthy bowel movements/habits EXCEPT:
  1. People should have a bowel movement as little as every three days or as often as three times a day
  2. Taking laxatives multiple times a day
  3. Heavy straining should be avoided
  4. Stool should be the size, shape, and consistency of a ripe banana - Level 4 of the Bristol Scale
2.  Your client vacillates between fecal incontinence and constipation. What area of your clients diet do you want to further assess?
  1. Carbohydrate intake
  2. Dairy
  3. Breakfast meals
  4. Fiber
3.  A new client comes to see you and is having difficulty with mixed urinary incontinence and bowel incontinence. Which of the following would be the best start to your treatment plan?
  1. Start pelvic floor muscles exercises
  2. Focus on managing urinary incontinence first
  3. Focus on managing bowel incontinence first
  4. Tell the client to start eating more fiber
4.  Which is the best position for sitting on the toilet to have a bowel movement?
  1. Sit leaning forward, heels pulled back and consider using a stool under the feet to create more of a squatted position while seated
  2. Sit with your back straight and try to lean back towards the toilet tank
  3. There is not an optimal position for sitting on the toilet
  4. Move around often on the toilet to help with motility, change position often
5.  Your client has Parkinson's Disease which affects her fine motor control to manage her clothing fasteners and her walking speed is very slow. When she starts telling you about her issues with urinary loss what may you want to consider addressing during the treatment plan?
  1. Bowel incontinence
  2. How many pads she uses every week
  3. Functional incontinence
  4. Fiber intake
6.  Which of the following are bowel irritants?
  1. Milk and milk products
  2. Alcohol and caffeinated fluids
  3. Salads, eggs, tomatoes and tomato based foods
  4. All of the above
7.  You've been working with a client and determine his fiber intake is too low. What strategy might you focus on in one of your treatments?
  1. Creating a fiber station
  2. Calling the doctor to report issues with fiber
  3. Improving posture on the toilet
  4. Picking out laxatives
8.  Clients with healthy bowel habits should produce stool that is at what level on the Bristol Scale?
  1. 1
  2. 2
  3. 4
  4. 5
9.  Your client is struggling with constipation which can cause what aggravating issue?
  1. Rash
  2. Headache
  3. Fatigue
  4. Urinary incontinence
10.  Exercising the pelvic floor:
  1. Improves or provides maintenance of strength, tone, and elasticity of the pelvic floor muscles
  2. Helps with bladder and bowel control
  3. Improves sexual response for both you and your partner
  4. All of the above

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