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COMMUNITY NURSING BLADDER ASSESSMENT

enablensw Page 1 / 4 July 2009 COMMUNITY NURSING BLADDER ASSESSMENT Surname: First Name: Date: DOB: Sex: M F Referred by: Presenting problems, previous treatment & management strategies: Onset: sudden gradual Comments: Is condition: improving same worsening How does your BLADDER problem affect your life? Client s treatment goal: Medical History Surgical History Diabetes Dementia Chronic cough Nicotine use Allergy_____ Mental health condition _____ Neurological Disease_____ Recurrent UTI Obesity Back pain Spinal Injury: if yes refer to neurogenic BLADDER ASSESSMENT Other_____ _____ _____ Cystoscopy Urethral dilatation TURP Radical Prostatectomy

EnableNSW Page 4 / 4 July 2009 _____ Assessment fully completed today Assessment unable to be completed today – to be completed on _____ Management Plan Bladder training_____ Pelvic Floor exercise program - ref to Nurse continence adviser or continence physiotherapist_____ ...

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