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Boardz > Incontinence/sexuality > Flashcards

Incontinence/sexuality Flashcards

1
Q

Incontinence

A

loss of voluntary control over urination or defecation

urinary incontinence most common in women over 50
caused by enlarged prostate in men (BPH)

caused by weak muscles of pelvic floor/urethra, multiple pregnancy, decreased estrogen

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2
Q

4 type of incontinence

A

stress incontinence
OAB
Overflow incontinence
Functional incontinence

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3
Q

Stress Incontinence

A

leaking due to strain on bladder from movement (coughing, sneezing, jumping, laughing) most common, weak pelvic floor/menopause

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4
Q

Overactive Bladder OAB

A

sudden/unstoppable urgency even when the bladder is not full, hyperstimulation of detrusor muscles due to nerve damage, infection, medication or abdominal trauma

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5
Q

Overflow incontinence

A

inability to fully empty the bladder leading to urine build up that may leak out unexpectedly

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6
Q

Functional incontinence

A

urinary leakage due to cognitive issues such as dementia, delirium, intellectual disability and neurological/muscular limitations such as arthritis, inability to recognize need for bathroom

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7
Q

Fecal incontinence

A

due to weakening of external anal sphincter or lack of awareness (Dementia), exacerbated during episodes of diarrhea

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8
Q

Results of incontinence

A

social isolation, increased risk of infection, skin irritation, anxiety, depression, reduced sexual activity, and reduced QOL

fear of incontinences leads to self-management –>dehydration–>falls

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9
Q

Assessing incontinence

A

Occupational profile- gather data impacting daily function and QOL

Evaluate body posture, core strength, breath hold and release pattern

Eval posture on toileting; identify if added pressure or tightening of pelvic floor decrease emptying, breath holding can strain/weaken pelvic floor

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10
Q

Incontinence Intervention

A

Lifestyle modfication
Pelvic floor exercises: knack vs. kegel
Core and LB strengthening: bridges, hip abduction/adduction
Postural training when toileting and sit to stand

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11
Q

Lifestyle modification: incontinence

A

Scheduled toileting
Keep bowel/bladder diary
Dietary/fluid intake modification
Medication timing
Breathing techniques when voiding

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12
Q

Knack technique

A

In standing turn toes out tighten from back/release, repeat with toes turned in

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13
Q

Adaptive/environmental approach to incontinence

A

Avoid bulky pads that might trap moisture

Clothing options for easier management

Bedside commode

Pinch/grip strength for clothing management

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14
Q

Sexuality

A

Plays role in sense of self, embraces how one feels about themselves, how they relate to others, how they create relationships with others, and overall
How they express themselves

Includes: sex, gender identity, sexual orientation, eroticism pleasure, intimacy, reproduction

Biosocial, psycho, spiritual, ethical, and cultural influences

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15
Q

Sexual expression

A

Encompasses ways that sexuality can be expressed through feelings/actions associates with QOL, wellbeing, and health

Includes flirting, kissing, holding hands, masturbating, intercourse

Thoughts, desires, beliefs, attitudes, roles, and relationships

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16
Q

Sexual activity

A

aDL, participation in a gamut of possibilities of sexual expression, requires ROM, strength, endurance, mobility, ability to receive and give consent

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17
Q

Sexual functioning

A

Ability to participate in sexual activities w/o difficulty that results in satisfaction

Difficulties include pain/discomfort, physiological challenges, dysfunction due to physical/psychological, medication side effects

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18
Q

Sexual health

A

Ability to embrace/enjoy sexuality, right to access services and information

Proper education to fulfill sexuality

Healthy sex life = good physical and mental health, better health associated with increased QOL

19
Q

Changes in aging affecting sexuality

A

-Hormones: decreased estrogen/testosterone
-Skin: drier less elastic, wrinkles, fat layer thins, loss of cushion
-Muscle: shrink/lose mass, decrease in size/fibers, decreased water contents within tendons = stiffer muscles, deceased hand strength, heart muscle less able to push blood
-Bones/joints: decreased bone mass, decreased mineral contents, cartilage breakdowns, loses water content, restricts flexibility due to stiffer tendon/ligaments
-cognition: decreased attention, processing speed, working memory, executive function

20
Q

Reduced testosterone

A

Andropause
Decreased libido, ED
Increased depression
Enlarged prostate

21
Q

Reduced estrogen

A

Menopause, shortening/narrowing of vaginal walls, vagina becomes less flexible, then, reduced lubrication, decreased libido, decreased arousal and orgasm

22
Q

Cardiovascular d/s effect on sex

A

Increased ED, vaginal dryness, decreased libido, dyspareunia (painful intercourse), decreased genital sensation, decreased orgasms

23
Q

Diabetes effect on sex

A

ED, impaired ejaculation, decreased libido, painful intercourse, feelings of inadequacy, nerve damage to tip of penis/clitoris, decreased genital sensation

24
Q

Urinary tract d/s effect if sex

A

Chronic prostatitis
Interstitial cystitis= women bladder pressure and pelvic pain
CKD
Men= premature ejaculation, painful ejaculation, decreased libido

Women= frequency/urgency, suprapubic dysfunction, dyspareunia (painful intercourse), decreased libido, hypo active sexual desire, inability to achieve orgasms

25
Q

Arthritis effect in sex

A

Pain, fatigue, motor restriction, depression, loss of self-esteem

26
Q

Lung D/S (Ca/COPD) effects on sex

A

ED, depression, dyspnea, decreased libido, fatigue

27
Q

Medications impacting sexual dysfunction

A

Diuretics
Antihistamines
Antidepressants
Muscle relaxants
Statins/fibrates

28
Q

Physical changes impact on sexual function

A

Decreased ROM=increased difficulty with positioning and clothing mgmt

Decreased bone density and increased stiffness = difficulty transferring and moving

Decreased endurance from decreased cardiac function= long tome to recover with sexual partying

29
Q

Decreased sensation and skin eleasticity

A

Tears and less pleasurable

30
Q

Cognitive changes impact on sexual function

A

Increase processing time/decision making during intercourse
Difficulty sequencing steps and responses, giving/receiving consent

31
Q

Psychosocial changes impact on social
Functioning

A

Decreased self-esteem can lead to challenges with sexuality and intimacy
Losing partner leads to decreased sense of belonging/security
Motivation= reduced meaningful
Occupational

32
Q

Evaluation of sexual function

A

Bring up topic, normalize it, make it a routine to address within evaluation, give client permission to discuss concerns

Create comfortable and open environment

Prepare resources and build rapport

33
Q

BETTER Model

A

B bring it up
E explain
T tell
T timing (based on pt preference)
E educate
R record info

34
Q

Occupational Performance Inventory of addressing Sexuality and intimacy (OPISI)

A

Self report addressing client factors/ body functions concerning sex and intimacy

4 item performance measure

35
Q

Changes in Sexual Functioning Questionnaire

A

14 item questionnaire to measure changes in sexual functioning, specific version male vs. female

Desire, pleasure, arousal, orgasm

36
Q

PROMIS sexual function and satisfaction

A

Assess sexual functioning in males/females in 7 domains
Interest in sexual activity
Vaginal discomfort
Lubrication ED
Orgasm
Overall sexual satisfaction

37
Q

Owestry Disability index

A

Symptoms associated with low back pain

Domains: self-care, lifting, functional mobility, sitting, standing, sleeping, sexual activity, social participation, and traveling

38
Q

Brief Pain Inventory (BPI)

A

Not specific to sexually related concerns, self report measure on location of pain, intensity, how often it interfere, and pain management strategies

39
Q

Physical interventions for sexual functioning

A

Modifications—> lighting, bed height, hand rails, grab bar

Pain mgmt/ECT

Personal hygiene

Increase UE ROM to maintain position during expression

Increased strength to support self/partner

Increased endurance for longer duration of sexuality activity

Increased safety during transfers

Sensation impairment =explore other forms of intimacy

40
Q

PLISSIT model

A

Permission- give permission to raise sexual issues

Limited Info- give limited info on sexual side effects of tx

Specific Suggestion- based on eval

Intensive Therapy- sex tx, psychological, biomedical

Linear in nature

41
Q

EX PLISSIT

A

Extended PLISSIT model

Permission giving normalizing sexuality at every stage, throughout process we ask open ended questions

Allows for reflection, self-awareness of clinician, and allows for discussion

42
Q

Sexual Rehab Framework (SRF)

A

Identifies key components of sexual health and outlines roles of team members

Sexual drive/interest—>sexual function—>factors associated with condition—>motor/sensory influences—>bladder/bowel influences—>fertility/contraceptions —>sexual self view/esteem—>partnership issues

OT= sexual function, factors associated with condition, motor/sensory influences, bladder/bowel issues, self-esteem and sexual self-view

43
Q

Referrals for sexual function

A

Make referral, advocate pt’s need to referral source, educate pt on self-advocacy, educate on how to bring up conversation

PCP if due to meds, sx, or chronic condition

Sex therapy talk tx aimed at helping people past physical or emotional problems

Pelvic floor

Boardz (16 decks)

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