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68wm6 p2 Void Disf

Voiding Disfunctions

QuestionAnswer
What is the trigone of the bladder? a rectangular area that is created from ligaments that suspend and anchor the bladder within the pelvic and pubic bones
What is the transitional epithelium? a continuous layer of cell that line the renal pelvis and the ureters and is continuous with the urinary bladder
How long is the male urethra? 18-20 cm
How long is the female urethra? 2.5-3.0 cm
What is the potential bladder volume? 750ml to 1000ml
At what volume in the bladder do you feel the urge to urinate? 250ml
Where does the awareness of the need to void come from? the stretch receptors in the walls of the bladder
Stimulation of stretch receptors can result in what? involuntary contraction of the bladder
How much urine remains in bladder after urination? 10ml
95% of urine is what? What is the remainder? About 95% is water, the rest is nitrogenous waste
Define Enuresis: Involuntary urination at an age when continence should be present
At what age do most children acheive bladder control? By age 5
As a maturational problem, when does enuresis cease in children? between 6 and 8 years of age
Other than age, what can enuresis result from? *Decreased renal concentrating ability *Heart failure *Diabetes mellitus *Poor bladder emptying
Define pneumaturia: Passage of gas in urine during voiding
What does pneumaturia result from? *Sigmoid diverticulitis (most common) *Fistula between bowel and bladder *Rectosigmoid cancer *Regional ileitis *Gas-forming urinary tract infections
What is the tympanic sound of a full bladder? 'dull'
When will the bladder be palpable? The bladder will only be palpable if there is at least moderate distention
How do you assess the kidneys for tenderness and pain? by striking one fist lightly over the costovertebral angle.
What do you assess if an assessment of the kidneys is positive for pain/tenderness? signs of electrolyte and water imbalance
What is cystocele? Downward displacement of the bladder
What is urethrocele? Downward displacement of the urethra
what can cystocele/urethroceles cause? Stress incontinence
What is urge incontinence? A strong desire to void caused by CNS disorders (such as a stroke or brain tumor), infection, or uninhibited bladder contractions
What is functional incontinence? function of the lower urinary tract (bladder, urethra and pelvic floor muscles) is intact but other factors (immobility or severe cognitive impairment) may cause the problem
What effect does Ditropan have? reduce bladder spasticity and involuntary contractions
What effect does Dibenzaline have? improve sphincter control
What effect does Urecholine have? increase muscle contraction of the detusor muscle
What effect does Detrol/Detrol LA have? decreases urinary frequency, urgency, or urge incontinence
Why are fluids encouraged in a PT with incontinence? Reduction in fluid intake may cause urine to become more concentrated, irritating the bladder mucosa and increasing the urge to urinate
Who are kegel exercises helpful for? Female PTs
How often should kegels be done? Ten repetitions five times a day (another slide in the same PPT says 3-4 sets a day)
How are kegel exercises done? Clench the muscles used to stop the flow of urine. Hold the tension for 10 seconds, then relax for 10 seconds
What is urinary retention? Inability to void even with an urge to void
What is Phimosis? Inability to retract foreskin
What drugs can cause urinary retention? *anticholinergics *antihistamines *General anesthesia
What is chronic urinary retention? Able to void but unable to completely empty the bladder (retention with overflow), Residual urine >50 ml (May exceed several hundred ml)
What causes neurogenic bladder? a lesion of the nervous system that interferes with normal nerve conduction to the urinary bladder
What amount of residual urine is not normally percussible? 130mL and below
What drug that diminishes urinary tract discomfort causes orange-red urine? Pyridium
What does Prosed DS do? kills bacteria in urine, decreasing pain and inflammation, and reducing muscle spasms in the urinary tract
What does Uroxatrol do? relaxes smooth muscle in the bladder neck and the prostate
What is a spastic bladder? a lesion above the voiding reflex arc (UPPER motor neuron) that results in a loss of sensation to void and a loss of motor control. The bladder wall atrophies, decreasing bladder capacity.
What is a flaccid bladder? Caused by a lesion of a LOWER motor neuron The bladder continues to fill and distend, with urine stasis and incomplete emptying Patient loses sensation to void.
What urinary catheter is used in PTs with an enlarged prostate? Coude. Designed with a curved and tapered tip
What urinary catheter is used to drain urine from the renal pelvis of the kidney? Malecot and de Pezzer (Also called a mushroom catheter)
Which I&O urinary catheter has multiple openings in the tip to facilitate intermittant drainage? Red Robinson
Which urinary catheter has a slanted, larger orifice at its tip to be used with patients with hematuria (to prevent occlusion if clots are present) Whistle-tip
Which urinary catheter is long and slender to pass into the ureters? Ureteral
Which urinary catheter is designed with a balloon near its tip which is inflated after insertion, holding the catheter in the urinary bladder for continuous drainage? Foley
Which urinary catheter is inserted surgically through the abdominal wall above the symphysis? Suprapubic
When is a suprapubic catheter removed? When the PT is able to void and measured residual urine is consistently less than 50 ml
What is an external (Texas or Condom) Catheter? A non-invasive drainage system attached to external genitalia in an incontinent male to minimize skin irritation from urine.
How often are condom catheters removed for cleaning and inspection? Daily.
If a PT with a urine drainage system attached voids less than 50mL over 4 hours, what must first be done? check the drainage system for proper placement and function prior to contacting the physician
What can a PT with a urinary catheter drink to help prevent UTIs? drinking fluids that acidify urine, such as cranberry juice
How often is catheter care performed? twice daily
How is cleansing around urinary catheter performed Cleanse perineum with mild soap and warm water, rinse well, and pat dry
What do you rinse the urine collection bag with? Solution of vinegar and water
At what decrease in urine output should the PT contact the physician? <30cc/hr for 2hrs
Up to how many groups of repetitions of kegel exercises should the PT build up to? Groups of 20 repetitions at least 4 times a day (another slide says 5 times a day, and another says 3-4 times a day)
What is the suggested voiding pattern for PTs with voiding difficulties? Void upon arising, before each meal, and at bedtime
Created by: Shanejqb