Week 9: Elimination And Sleep Flashcards
Age related changes in he Reinaldo and urological system
- Age-related loss of nephrons, kidney mass, and ability to concentrate urine generally lead to little change in the body’s ability to maintain adequate fluid homeostasis
- Renal disease or urinary tract obstruction can amplify age-related decline in function
Is urinary incontinence and frequency considered a normal part of aging?
Should never be considered a normal part of aging
Urinary Incontinence: Risk Factors
- Dementia (b/c person may not be able to find the bathroom or recognize the urge to void)
- Drugs that increase UO, sedatives, tranquilizers, hypnotics that produce drowsiness, confusion or limited mobility promote incontinence by dulling the transmission or desire to urinate.
Consequences of Urinary Incontinence
- Affects quality of life and has physical, psychosocial and economic consequences.
- Associated with increased risk for falls, fractures, and hospitalization.
- Affects self-esteem and increases risk for depression, anxiety, dignity, autonomy, social isolation, skin breakdown, and sexual activity
- Increases the risk for admission to the nursing home in those over 65 years of age
- Psychosocial impact affects the person and his or her family caregivers
Types of Urinary Incontinence
-Classified as either transient (acute) or established chronic)
Transient Urinary Incontinence
- Sudden onset
- Present for 6 months or less
- Usually caused by treatable factors such as UTI, delirium, constipation, stool impaction or increased urine production.
Establish Urinary Incontinence
- May have sudden or gradual onset
- Categoriezed as: 1) stress 2) urge 3) urge, mixed, stress 3) functional 5) mixed
Urinary Incontinence Interventions
- Behavioral (Box 16-7)
- Scheduled (timed) voiding (Figure 16-1)
- Bladder training
- Pelvis floor muscle exercises (Box 16-8)
- Vaginal weight training
- Lifestyle modifications (Box 16-9)
Intermittent Catheterization
Usually used for weak destructor muscle, black age of the urethra, BPH or reflux incontinence.
Long term use of indwelling catheter
-Increases the risk for recurrent UTIs Leading to urosepsis, urethral damage in men, urethritis or fistula formation.
External catheter
“Condom catheters” used for male patients
Catheter Associated Urinary Tract Infections
-Persons who develop UTI with an indwelling catheter in place or within 48 hours of removal.
What can decrease catheter associated UTI’s?
- Implementation of evidence based guidelines
- Catheter reminders
- Stop orders
- Nurse-initiated removal
- Urinary catheter bundle
Urinary Incontinence Management include
- Absorbent products: Protective undergarments or briefs
- Pharmacological interventions: Not considered first-line Treatment; Anticholinergics and anitmuscarinics
- Surgical Interventions: for stress incontinence; procedures include colposuspension and “slings”
- Nonsurgical devices: Intravaginal or intraurethral devices to relieve stress.
Bowel Elimination: Constipation
Defined as the reduction in the frequency of stool or difficulty in formation or passage of stool.