Urinary Incontinence Flashcards
Top 8 risk factors for urinary incontinence:
- females
- increased age
- medications
- obesity/pregnancy
- pelvic muscle weakness
- immobility/impaired cognition
- benign prostatic hyperplasia (BPH)
- neurogenic disorders
Females have increased risk of urinary incontinence b/c of…
- changes in estrogen
- shorter urethra (less resistance to pressure)
Increased age increases the risk of urinary incontinence b/c…
- kidney’s ability to [ ] urine decreases, so larger volume of urine
- decreased muscle tone in bladder, sphincters, and pelvic muscles
Medications increase the risk of urinary incontinence b/c of the…
side effects
- muscle relaxants
- diuretics
Obesity/pregnancy increases the risk of urinary incontinence b/c of:
increased mass and pressure on bladder and urinary tract
Pelvic muscle weakness increases the risk of urinary incontinence b/c…
- plays role in voluntary control of urination
- strengthening muscles is treatment option
Immobility/impaired condition increases the risk of urinary incontinence b/c…
pt might not be able to reach bathroom or unwilling to release urine in proper place
Benign prostatic hyperplasia (BPH) increases the risk of urinary incontinence b/c…
prostate gland is enlarged and blocks urethra
- common cause of overflow incontinence in males
Neurogenic disorders increase the risk of urinary incontinence b/c of…
can cause loss of voluntary control of urinary tract
- ex: diabetic neuropathy/spinal cord injury
4 types of urinary incontinence (can use absorbent OTC supplies):
- stress incontinence
- overactive bladder (OAB) or urge
- overflow incontinence
- functional incontinence
Most common type of incontinence in women:
stress incontinence
Common symptoms of stress incontinence involve the involuntary leakage or urine due to…
- sudden increase in abdominal pressure
- sneezing
- laughing
- coughing
- lifting
- pregnancy
- obesity
Stress incontinence occurs due to…
weakness or urethral sphincter and pelvic floor muscles
Treatment of stress incontinence:
- pelvic floor exercises (knack maneuver/kegel exercises)
- can use Rx topical estrogen creams (no oral)
Rx topical estrogen cream only works if…
primary cause is due to estrogen deficiency
Overactive bladder (OAB) or urge is more common w/…
increased age
Symptoms of overactive bladder (OAB) or urge:
- sudden and profound urgency
- increased frequency ( > 8 times a day)
- nocturia
Treatment of overactive bladder (OAB) or urge:
- OTC Oxytrol patch
- Rx anticholinergics
- usage of absorbent supplies
Overflow incontinence occurs due to…
- over-distention of bladder
- outlet obstruction/underactive bladder
Symptoms of overactive bladder (OAB) or urge:
- dribbling
- decreased force
- increased urgency
- incomplete voiding
Treatment of overactive bladder (OAB) or urge:
Rx medications and absorbent supplies
Functional incontinence is more common in…
older pt
Functional incontinence occurs due to…
- stroke
- decreased mobility
- impaired cognition
- functionally impaired pts
Urine loss for functional incontinence is due to…
impaired physical/cognitive impairment
- interferes w/ pt’s ability to reach bathroom
Nonpharm treatment options:
- toileting assistance
- bladder training
- pelvic floor exercises
- absorbent supplies
First line of treatment for all types of urinary incontinence except overflow:
behavioral modifications (toileting assistance)
Toileting assistance:
using routine/scheduled voiding at regular intervals (Q2-4H)
Bladder training:
- type of behavioral modification
- delay voiding when urge occurs and increase urine volume by increasing interval between voids
- positive reinforcement
Bladder training is recommended for…
OAB/urge incontinence
Pelvic floor exercises:
- type of behavioral modification
- improves urethral closure pressure by activating muscles of urethra
- knack maneuver
- kegel exercises
Knack maneuver:
contracting pelvic floor muscles in anticipation of and during increases in intra-abdominal pressure
Kegel exercises:
- squeezing pelvic muscles to stop flow of urine
- 10 reps 3-4 times a day (hold for 10 seconds)
Choosing an absorbent supply depends on…
amount of urine leakage
Absorbent supplies are used to…
- absorb urine
- minimize skin contact w/ urine
- protect clothing, bedding, and furniture while allowing mobility
Absorbent supplies will help ______ but not _______
relieve pt discomfort, doesn’t treat condition
OTC Oxytrol/oxybutynin patch are for women/males
women
OTC Oxytrol/oxybutynin patch:
anticholinergic medication that relaxes detrusor muscle of bladder
OTC Oxytrol/oxybutynin patch only treats…
OAB/urge
T/F: OTC Oxytrol/oxybutynin patch is the only OTC pharm treatment option approved for OAB/urge urinary
T, only approved for women
OTC Oxytrol/oxybutynin patch should be applied every…
4 days to abdomen, hips, or butt
Common adverse effects of OTC Oxytrol/oxybutynin patch:
- skin irritation
- constipation
- dry mouth
Pt should see a doctor if there’s no relief after ______ of using OTC Oxytrol/oxybutynin patch
2 weeks
