Chapter urinary

Question 1

1. State a definition of urinary incontinence.

Answer 1

involuntary loss of urine

Question 2

2. Identify the patient population at greatest risk for urinary incontinence.

Answer 2

75% of elderly women (75 years of age or older)

Question 3

3. List the common symptoms of urinary incontinence.

Answer 3

Leaking urine when coughing, sneezing, laughing, or exercising
Feeling sudden, uncontrollable urges to urinate
Frequent urination
Waking up many times at night to urinate
Urinating during sleep

Question 4

4. State the usual presentation and proposed mechanism(s) for urgency incontinence

Answer 4

involuntary loss of urine associated with a sudden and compelling urge to void

Question 5

stress incontinence

Answer 5

urethral sphincter failure associated with increased intra-abdominal pressure resulting in the inability to retain urine when laughing, coughing, sneezing, during exercise, lifting, or when rising from a seated position

Question 6

5. List the non-surgical and drug therapies recommended for urgency incontinence and stress incontinence

Answer 6

pelvic floor muscle training which is often done by physical therapists.
Bladder training
Pelvic floor training + bladder training
drug therapy
Weight loss and exercise

Question 7

6. State the mechanism of action of anticholinergics for treatment of urgency incontinence.

Answer 7

drugs block cholinergic receptors and suppress premature detrusor muscle contractions of the bladder wall

Question 8

6. Identify the common adverse effects associated with anticholinergic drugs.

Answer 8

dry mouth – constipation – headache – dyspepsia - dry eyes - blurred vision - cognitive impairment – tachycardia – sedation - orthostatic hypotension

Question 9

7. State the precautions for using anticholinergic agents.

Answer 9

agents should be used cautiously in the elderly/frail patients because of the risk for mental status changes or falls

Question 10

9. State the name of the anticholinergic agent for urgency incontinence that is most likely to cause cognitive impairment.

Answer 10

First generation agents especially Oxybutynin

Question 11

12. Identify the complications associated with the use of urinary incontinence products.

Answer 11

Absorbent products increase the risk of skin irritation and maceration
May need Use of skin protectants
If urine loss is continual then products should be changed every 2-4 hours
Urine odor may need attention.
Urine in contact with skin wounds may delay healing.

Question 12

10. State the name of the anticholinergic agent for urgency incontinence that is most likely to cause cognitive impairment.

Answer 12

Oxybutynin on test