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NURS509A

Urinary Elimination & Dysfunction

QuestionAnswer
7 Types of UI 1. Stress 2. Urge 3. Overactive Bladder 4. Functional 5. Overflow 6. Mixed 7. Transient
Which type of UI is described as: leakage of small amounts of urine during physical movement (coughing, sneezing, exercising)? Stress Incontinence
Which type of UI is described as: leakage of large amount of urine at unexpected times, including during sleep Urge Incontinence
Which type of UI is described as: urinary frequency and urgency, with or without urge incontinence Overactive bladder incontinence
Which type of UI is described as: untimely urination because of physical disability, external obstacles, or problems in thinking or communication that prevents a person from reaching the toilet Functional Incontinence
Which type of UI is described as: unexpected leakage of small amounts of urine because of a full bladder Overflow Incontinence
Which type of UI is described as: usually the occurrence of stress and urge incontinence together Mixed Incontinence
Which type of UI is described as: leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing) Transient Incontinence
Normal capacity of bladder is ~550 mL, when do we get the first urge to void at ~200 mL
what are some first line non-pharmacological tx modalities for incontinence? Kegel/PFME (pelvic floor muscle training)---e stim---biofeedback
Some other non-pharmacological tx modalities? Bladder training, prompted voiding, incontinence undergarments----vaginal cones, catheters---surgical intervention
If an elderly pt presents with sudden onset confusion of unknown origin, we should consider that they might have . . . a UTI . . .or possibly pneumonia
What is the main reason for a pt to receive catheritization urinary retention----also used for incontinence, pressure ulcers, cancer, comfort care
What manifestations DOUBLES the risk for receiving a cathetar cognitive decline or pressure ulcers
What manifestation QUADRUPLES the risk for cathetarization severe functional decline
common urinary diversion treatments include continent vesiscostomy (Kock puch)---ilial conduit (urostomy)
What is CISC Clean Intermittent Self Catheterization---every 3-4 hours to remove ~350 mls of urine each time
an acidic urine pH can contribute to urolithiasis (kidney stones), but assists in preventing preventing UTI
What other preventions are indicated for UTI limiting caffeine/ETOH---wipe front to back---showers instead of baths---void immediately AFTER sex
What % of women >60 yo have UI = urinary incontinence 38%
one common misconception about UI is many people think it's part of the aging process
Specific gravity should range from 1.005 - 1.025
What is the maximum specific gravity at 80 years of age? 1.024
The maximum specific gravity for younger ages is 1.032
Normal urine pH levels 4.6 - 8
What are you assessing from a pt's urine sample? -Specific gravity -pH (alkaline is most often associated with infections) -Free of glucose and protein -Color -Odor
Factors to assess in the pt is in incontinent of urine 1. Medical hx 2. Medications 3. Functional status 4. Cognition 5. NM function in lower extremities 6. Urinary control and retention 7. Bladder fullness and pain 8. Elimination pattern 9. Fecal impaction 10. Sx's 11. Diet 12. Reactions to incont
What do changes in the renal threshold for glucose cause older adults to be? Hyperglycemic - without have any evidence of glycosuria
What can a nurse NOT assume about pt's with long standing incontinence? Nurses can not assume that these pt's have received a comprehensive evaluation of the problem - a careful review of the medical hx and interview with the pt are important to determine whether diagnostic testing has been done.
What age group are more than 90% of the cases of bladder cancer found? Over age 55
Who is at increased risk for bladder cancer? -Older men have 4 times the rate of older women -White individuals are dx'd with this CA nearly twice as often as black or Hispanic people.
What is micturition? Urination
Created by: MEPN 2013