Urinary Incontinence ( 5 types) Flashcards
What are the 5 types of urinary incontinence?
Stress
Urge
Overflow
Functional
Secondary to meds
Stress Incontinence pathology?
Weak urethral sphincter
Intra-abdominal pressures higher than what the urethra can handle (Coughing, laughing, sneezing)
Stress Incontinence in females is cause by ?
poor muscular support of pelvic floor - keagles
Stress Incontinence in males is cause by ?
following prostate surgery
Stress incontinence History and Physical?
Momentary leakage of small amounts of urine
Not associated with urge to void
Urge Incontinence pathology?
Bladder sensitivity – infection or neurologic disorder
Strong detrusor contractions – overcome urethral resistance
Urge Incontinence usually have _______ bladders?
small
Urge Incontinence has a ___________ urge to void.
moderate
Volume sizes with urge incontinence?
small to moderate volume
Stress incontinence is _____ associated with urge to to void
NOT
Overflow Incontinence pathology?
Detrusor can’t overcome urethral resistance
Overflow Incontinence typically have _____ bladders?
large
Overflow Incontinence history and physical?
Continuous dripping or dribbling
Decreased stream force
Possibly enlarged, tender bladder
Causes of Overflow Incontinence?
BPH
peripheral nerve disease
DM
Functional Incontinence causes?
poor health or environment conditions
Functional Incontinence: Health issues?
weakness, arthritis, poor vision, etc
Functional Incontinence: Environmental issues?
unfamiliar setting, bed rails, restraints
Incontinence secondary to meds can contribute to ___ of the incontinence pathologies.
any
Medication examples that cause incontinence?
Sedatives, tranquilizers, anticholinergics, diuretics, etc.
Take a history!
Acute Urinary Cystitis - UTI sxs?
Dysuria, frequency, urgency
Suprapubic discomfort
Possible hematuria (usually microscopic)
Acute Urinary Cystitis - UTI pathology?
Bacteria ascends from urethra – E. coli most common
Much less common in men cause the urethera is longer
Acute Urinary Cystitis - UTI diagnostic studies?
Dip UA positive – pyuria, bacteruria, hematuria
Urine C&S positive ( culture and sensitivity)
Educate regarding prevention
Acute Urinary Cystitis - UTI diagnostic studies: Dip UA results??
pyuria, bacteruria, hematuria
Education on UTI?
hygiene ( from front to back )
urine after intercourse ( get
bacteria away from urethra)
increase fluids to flush out bladder as much a possible
Acute Pyelonephritis pathology?
Infection ascends – involves kidney
Acute Pyelonephritis history and physical?
Fever, flank pain (CVA tenderness), dysuria, urgency, frequency
Acute Pyelonephritis labs?
Dip UA positive
Urine culture positive
CBC
Acute Pyelonephritis CBC results?
left shift
Acute Pyelonephritis Tx?
ATB’s
If severe – admit!
Nephrolithiasis history and physical?
Severe flank pain, radiating to groin (“Loin to groin”)
N/V
5 major types of stones so are we going to use contrast?
NO!
some are radiolucent, so non-contrast CT
Dx for Nephrolithiasis?
Strain urine – ID stone type
netting to catch the stone - want to see what the stone is made out of and maybe need to adress dietary changes etc.
Nephrolithiasis Tx?
Lithotripsy - shock waves pulverize the stone
Extra-Corporeal Shock Wave Lithotripsy - ESWL
