KEEPING A RECORD OF BLADDER AND BOWEL FUNCTION

Transcription

1 KEEPING A RECORD OF BLADDER AND BOWEL FUNCTION The ma purpose of a bladder log is to document how your bladder functions. A log can give your health care provider an excellent picture of your bladder functions, habits and patterns. At first, the log is used as an evaluation tool. Later, it will be used to measure your progress on bladder retrag or leakage episodes. Please complete a bladder/bowel log every day for 3 days and brg it with you to your appotment. Your log will be more accurate if you fill it out as you go through the day. It can be very difficult to remember at the end of the day exactly what happened the morng. INSTRUCTIONS Column 1 - The log begs with midnight and covers a 24 hour period. Afternoon times are bold. Select the hour block that corresponds with the time of day you are recordg formation. Column 2 - Type & Fluid & Food Intake Record the type and amount of fluid you drank Record the type and amount of food you ate Record when you woke up for the day and the hour you went to sleep Column 3 - (Elimated): Three methods Record the time of day and amount voided. Use the first method unless directed by your health care provider to directly measure or count ure amounts. Record a bowel movement with a BM at the appropriate time. Make comments on form of stool. Record uration with a U and give an estimate of the amount. 1. Place an S,M,L, the box at the correspondg time terval each time you urate. S- SMALL= seemed like a small amount, or urated just case. M- MEDIUM= seemed like an 8 ounce measurg cup would run over. L- LARGE= seemed like the amount you urate when you first wake up the morng. 2. If you have difficulty gaugg the amount of ure, you may record seconds by countg one - one thousand (this equals one second) while emptyg your bladder. Record the total number of seconds it took you to void. 3. Measure ure amounts with a collection device. The best method is a collection hat that can be placed directly over the toilet. Ask your provider where to get one. Some people use 2-4 cup measurg contaers, but it is sometimes difficult to catch the ure with these. Record the measured ounces of ure the box at the correspondg time terval each time you urate. Column 4 - Record the amount of ure loss at the time it occurred. S- SMALL= drop or two of ure M- MEDIUM= wet underwear L- LARGE= wet outerwear or floor For bowel movement use: S - Sta of underwear, P - Partial movement, C - Complete loss Column 5 - Was Urge Describe the urge sensation you had as: 1- MILD= first sensation of need to go 2- MODERATE= stronger sensation or need 3- STRONG= need to get to toilet, move aside!

2 Page 2 Keepg A Record Column 6 Describe the activity associate with the leakage, i.e. coughed, heard runng water, sneezed, bent over, lifted somethg or had a strong urge. Comments-(at the bottom of the log table) Special problems and new or changes medication are recorded here. If a pad change was neede, record the number used durg the day at the bottom of the page Daily Voidg Log Sample Food or Woke up at 6:45 U-L 3 Coffee, bagel M Fast walkg Apple BMpellets 2 1 U-S 1 Key door Tuna sandwhich, milk, pear U-M 2 Tea, cookies S Runng water Chicken, corn, puddg, salad, apple juice S 3 To bed at 10:30 U-M 3 3 week before period 2

3 Food or 1

4 Food or 1

5 Food or 1