A nurse is teaching a client who has a new diagnosis of urge incontinence. Which of the following information should the nurse include in the teaching? Select all that apply.

Choice A rationale Limiting fluids in the evenings is a helpful behavioral strategy for managing nocturnal polyuria and preventing nighttime incontinent episodes, which is a component of urge incontinence management. However, for urge incontinence, where the primary issue is involuntary bladder muscle contractions, this is a supportive measure, and other interventions directly address the detrusor muscle overactivity. Choice B rationale Caffeine is a known bladder irritant and a diuretic, which can increase urine production and stimulate the bladder's detrusor muscle, exacerbating the urgency and frequency characteristic of urge incontinence. Restricting caffeine intake reduces this irritation and stimulation, helping to decrease the involuntary bladder contractions that define this condition, making it a key behavioral strategy. Choice C rationale Cholinergic medications (agonists), such as bethanechol, stimulate muscarinic receptors on the detrusor muscle, causing bladder contraction, which is used to treat urinary retention and a hypotonic or underactive bladder. These medications would worsen urge incontinence, which is already characterized by an overactive, contracting detrusor muscle. Choice D rationale Anticholinergic or antimuscarinic medications, such as oxybutynin or tolterodine, block muscarinic receptors on the detrusor muscle, inhibiting the involuntary contractions that cause the sensation of urgency and subsequent leakage. They work by relaxing the bladder muscle, thereby increasing bladder capacity and reducing episodes of incontinence, making them a primary pharmacological treatment. Choice E rationale Intermittent urinary catheterization is a procedure used to empty the bladder when the client is unable to do so effectively on their own, typically due to urinary retention or an underactive/atonic bladder. For urge incontinence, the bladder empties too readily due to overactivity; therefore, self-catheterization is generally not required or indicated for this condition.