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N3 GERO > Exam 2 - Chapter 16 > Flashcards

Exam 2 - Chapter 16 Flashcards

1
Q

what are the types of urinary incontinence?

A
  • urge
  • stress
  • functional
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2
Q

urge incontinence definition

A

inability to suppress need to urinate

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3
Q

characteristics of urge incontinence

A
  • urinary frequency (8 voids in 24 hrs)
  • urgency
  • nocturia
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4
Q

stress incontinence definition

A

loss of small amounts of urine when coughing, sneezing, exercising, lifting, or bending (increased abdominal pressure)

leakage of ≥ 50mL

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5
Q

stress incontinence is more common in women

A

true

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6
Q

stress incontinence can occur in men under which conditions?

A

post-op prostate surgery

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7
Q

functional incontinence definition

A

individual is unable to reach the toilet due to limitations in environment

lower urinary tract intact

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8
Q

what are the interventions to address incontinence?

A
  • assessment of incontinence
  • scheduled/ prompted voiding
  • Kegels
  • lifestyle modifications
  • medications
  • urinary catheters
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9
Q

what are some lifestyle modifications that older adults with incontinence can adapt?

A
  • limit intake of bladder irritants (caffeine and alcohol)
  • drink eight glasses of 8oz. water daily
  • smoking cessation
  • adopt physical activity
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10
Q

urinary catheters are the last resort to address incontinence

A

true

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11
Q

UTIs are the most common causes of sepsis in older adults

A

true

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12
Q

what are the elements of screening questions when assessing for urinary incontinence?

A
  • onset
  • duration
  • frequency
  • timing (day/ night)
  • dribbling
  • padding (do they use it to catch incontinence?)
  • pain
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13
Q

what are unconventional symptoms of older adults with UTI?

A
  • mental status change
  • decreased appetite
  • incontinence (due to asymptomatic bacteriuria)
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14
Q

what are the medications that treat incontinence?

A
  • tolterodine
  • tropsium chloride
  • darifenacin
  • fesoterodine
  • solifenacin

anticholinergic and antimuscarinic medications

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15
Q

why is oxybutynin (medication for incontinence) avoided for older adults?

A

may lead to increased cognitive impairment

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16
Q

it is normal for older adults to have asymptomatic bacteria in urine

A

true

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17
Q

age related changes in the small intestine

A
  • less functional
  • decreased blood flow
  • decreased absorption
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18
Q

age related changes in the large intestine

A
  • slowed peristalsis
  • reduced response to rectal filling
  • dysmotility (due to increased collagen deposits)
  • thicker anal sphincter
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19
Q

constipation is more common in older women

A

true

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20
Q

what are the complications of constipation?

A
  • impaction
  • obstruction
  • cognitive dysfunction
  • delirium
  • falls
  • increased morbidity and mortality
  • increased risk for bowel cancer
21
Q

what are the interventions for constipation?

A
  • increase physical activity
  • squatting on the toilet
  • attempt BM after meals
  • fluid intake 1500 mL
  • increase fiber intake
  • lay on left side after 30 mins of sitting up after meals
22
Q

what does it mean when an older adult shows no sign of incontinence or UTI but goes to the bathroom often?

A

they have no urinary problems

going to the bathroom often is a result of decreased bladder capacity (normal in older adults)

23
Q

what are foods high in dietary fiber?

A
  • fruits
  • vegetables
  • beans
  • wheat products
24
Q

types of laxatives

A
  • bulk-forming
  • emollients
  • osmotic
  • stimulants
25
Q

examples of bulk-forming laxatives

A
  • pysillium fiber
  • methylcellulose
26
Q

what are some side effects of bulk-forming laxatives?

A
  • abdominal distention
  • flatulence
27
Q

why are bulk-forming laxatives the first-line agents for constipation?

A
  • low-cost
  • fewer adverse effects
28
Q

which individuals should be cautious in taking bulk-forming laxatives?

A
  • frail older adults
  • bedbound patients
  • those with swallowing difficulties
29
Q

what is MOA of emollients?

A

increase moisture content of stool

30
Q

examples of emollients

A
  • docusate
  • mineral oil
31
Q

why should mineral oil be avoided?

A

there is a risk for lipoid aspiration pneumonia

32
Q

what is the main benefit of emollients?

A

alleviates straining

33
Q

what are the types of osmotic laxatives?

A
  • milk of magnesemia (MoM)
  • lactulose
  • sorbitol
  • polyethylene glycol (miralax)
34
Q

why should patients with renal insufficiency avoid MoM?

A

can lead to hypermagnesemia or hypophosphatemia

35
Q

what are the side effects of lactulose and sorbitol?

A
  • diarrhea
  • abdominal cramping
  • flatulence
36
Q

why is miralax more likely to be prescribed than other osmotic laxatives?

A
  • less bloating
  • less flatulence
37
Q

what is the MOA of osmotic laxatives?

A

causes water retention in the colon

38
Q

what is the MOA of stimulant laxatives?

A

stimulate colorectal motor activity

39
Q

what are some possible side effects of stimulant laxatives?

A
  • cramping
  • fluid or electrolyte imbalance
40
Q

when are enemas most appropriate to use?

A
  • other methods yielded no results
  • fecal impaction
41
Q

what is a side effect of enemas?

A

alteration of fluid and electrolyte status

42
Q

why are phosphate enemas contraindicated in older adults?

A

it irritates the rectal mucosa

43
Q

fecal impaction is most common among older adults in LTC (due to infrequent mobilization)

A

true

44
Q

what is a major complication of constipation?

A

fecal impaction

45
Q

what are the manifestations of fecal impaction?

A
  • malaise
  • urinary retention
  • increased temperature
  • incontinence
  • cognitive decline
  • hemorrhoids
  • intestinal obstruction
46
Q

how does a nurse perform fecal disimpaction?

A
  • use lots of lube (containing lidocaine)
  • let the patient know it will take several days & it is painful
  • use oil-retention enema beforehand (softens the stool first)

beware of large impaction & its effects on the vagal nerve

47
Q

define paradoxical diarrhea

A

leakage of fecal material around the impaction

occurs with fecal impaction

48
Q

lab work (CBC) is better in indicating dehydration than skin turgor

A

true

N3 GERO (19 decks)

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