UI and Kidney Stones Flashcards
patient population at greatest risk for UI
females, older adults
Risk factors for UI
◦ Pregnancy
◦ Obesity –> pressure on pelvic floor, weakening –> stress UI
◦ Diabetes Mellitus –> neurogenic bladder
◦ May or may not be related to another disorder
◦ All people over 65 should be screened for UI
5 types of UI
- Stress Incontinence
- Urge Incontinence
- Overflow Incontinence
- Functional Incontinence
- Mixed Incontinence
type of incontinence: Loss of small amounts of urine when detrusor muscle pressure increases and is greater than the pressure of the urethra (aka Unable to tighten the urethra to overcome the pressure of the bladder)
stress incontinence
causes of stress incontinence + 2 biggest risk factors
◦ Coughing
◦ Sneezing
◦ Jogging
◦ Lifting
-Risk factor: child birth, and decrease estrogen with aging causes loss of tone in pelvic floor
stress incontinence interventions
- Kegel Exercises
- Vaginal Cone
- Electrical Stimulation
- Urethral Occlusion Devices
- Magnetic Resonance
- Nutrition— urge incontinence, avoid bladder irritant s in the dietL: coffee, artificial sweeteners, alcohol, tobacco
- Pharmacological
• End goal is to strengthen the pelvic floor!
type of incontinence: Perception of an urgent need to urinate regardless of amount of urine in the bladder
urge incontinence aka overactive bladder
causes of urge incontinence
◦ Neurological disorders
◦ Urinary tract problems
◦ *Bladder irritants
urge incontinence interventions
• Neuromodulation • Pharmaceuticals • Nutritional Modifications • Avoid Bladder Irritants ◦ Caffeine ◦ Alcohol ◦ Artificial Sweeteners ◦ Tobacco • Behavioral Interventions ◦ Bladder Training- go every hour and try to stretch that time out
which type of incontinence is managed by removing bladder irritants and doing bladder training ?
urge incontinence
which type of incontinence is greatly improved by pelvic floor strengthening exercises like kegels?
stress incontinence
type of incontinence: Detrusor muscles fail to contract and bladder becomes over-distended (no urge to go) and has involuntary release of urine when bladder reaches its maximum capacity (dribbling)
-overflow incontinence aka underactive or reflex incontinence
causes of overflow incontinence
◦ obstructed urethra
◦ urinary retention, BPH
Interventions: Reflex/Overflow Incontinence
• Removal of obstruction ◦ Prostate removal ◦ Uterine Prolapse • Pharmaceutical Therapy ◦ Short-term ◦ Urecholine • Behavioral Interventions ◦ Bladder Compression ◦ Self-Catheterization if have neurogenic bladder
which type of incontinence is managed by removing an obstruction or self cathing?
overflow incontinence
preferred method of bladder emptying for neurogenic bladder
Intermittent Self-Catheterization
education for Intermittent Self-Catheterization
- Hand Hygiene/ Technique
- Small Lumen and lubrication
- Schedule
• Don’t teach people to do sterile intermittent cath- it is a clean procedure and they can reuse the catheter
type of incontinence : Incontinence is related to something other than dysfunction of bladder or urethra
functional incontinence
causes of functional incontinence
◦ Loss of Cognitive function
◦ Physical Disability
functional incontinence interventions?
• Treatment of reversible causes • Habit Training (Cause not reversible) • Containment- use a brief but best thing is habit training ◦ Protect Skin • Indwelling Catheterization- if they have a bad wound • Applied Devices ◦ Urethral occlusion ◦ Pessary- device that holds bladder up ◦ Penile clamp
