Continence (250) Flashcards
What is stress incontinence?
Sudden leakage of urine as a result of an activity that in-creases abdominal pressure, such as lifting, coughing, sneezing, laughing or exercise.
What is urge incontinence?
Involuntary urinary leakage soon after perceiving the urge to void.
Define mixed incontinence.
Involuntary leakage of urine with both the sensation of urgency and activities such as coughing, sneezing or exertion.
What type of incontinence involves involuntary loss of urine due to overdistention of the bladder associated with underactive detrusor muscle or outlet obstruction?
Overflow incontinence.
What type of incontinence involves involuntary loss of control over urination due to inability to reach appropriate toileting facility?
Functional incontinence.
What type of incontinence involves involuntary release of urine at predictable intervals when bladder fullness is reached?
Reflex incontinence.
What are some treatments for urge incontinence?
- Kegel exercises
- Timed voiding
- Medications
- Avoiding caffeine
- Avoiding lifting heavy objects
- Electrical stimulation
- Surgery
What are some physical consequences of incontinence?
- Physical consequences of incontinence include a predisposition to falls, fractures, pressure ulcers, UTIs & limitation of functional status
What are some psychosocial consequences of incontinence?
- Decreased quality of life
- Shame or embarrassment
- Anxiety
- Depression
- Social isolation
- Loss of self-confidence
What are some environmental factors that can affect incontinence?
- Stairways between the bathroom level and the living or sleeping areas
- A distance to the bathroom that is more than 40 feet
- Living arrangements where several or many people share a bathroom
- Small bathrooms and narrow doors and hallways that do not accommodate walkers or wheelchairs
- Chair designs and bed heights that hinder mobility
- Poor colour contrast, as between a white toilet and seat and light-coloured floor or walls
- Public settings with poorly visible or poorly colour-contrasted signs designating gender-specific bathroom facilities
- Public settings with dim lighting and out-of-the-way bathroom facilities
- Very bright environments, where glare interferes with the perception of signs for bathrooms
- Mirrored walls, which reflect bright lights and create glare
What are some interventions for functional incontinence?
- Set a toileting schedule.
- Eliminate environmental barriers to toileting in the acute care, long-term care or home setting.
- Place an appropriate, safe urinary receptacle such as a 3-in-1 commode, female or male hand-held urinal, no-spill urinal, or containment device when toileting access is limited by immobility or environmental barriers. Provide privacy.
- Assist the person to change their clothing to maximize toileting access.
- limit fluid intake 2 to 3 hours before bedtime and to void just before bedtime.
What are some interventions for stress incontinence?
- Pelvic floor muscle exercises
- Optimizing fluid consumption and timing
- Bladder training
- Lifestyle changes if applicable (smoking cessation, weight loss, treating a chronic cough)
- Possible use of devices if appropriate
What are some interventions for overflow incontinence?
- Medication to address underlying causes (e.g. enlarged prostate)
- Waiting 30 seconds after urinating to try again
- Timed urination every 2-3 hours
What are some interventions for reflex incontinence?
- Tell the patient to limit fluid intake 2 to 3 hours prior bedtime and to void just before going to bed.
- Allow voiding at scheduled intervals before predictable urination.
- If spontaneous voiding is not possible, catheterize the patient at regular intervals.
- Explain the importance of absorbent pads in social situations.
What are some behavioural cues that may be indicative of urinary incontinence in the older adult?
- Does the older adult use disposable or washable pads or products?
- Is there an odour of urine on clothing, floor coverings or furniture (particularly couches and stuffed chairs)?
- Has the older adult withdrawn from social activities, particularly those held away from home?
