Campbell - Geriatric II

Question 1

Urinary Incontinence - Normal Bladder Function

stretch receptors notify brain that bladder is full and needs to empty
- ___ receptors support detrusor relaxation/filling

Neurologic stimulation initiates conctraction
- ___ receptors in the dome (top)
- ___ receptors in the base and proximal urethra

Sphincter ___ allowing relrease of urine

Answer 1

• B3
• ach
• alpha-adrenergic
• relaxes

Question 2

Urinary Incontinence

Age released changes to the bladder and urethra
- decreased bladder ___
- increased spontaneous ___ contractions
- decreased ___ compliance

May result in
- incomplete bladder ___
- decreased ability to ___ urination

Answer 2

• capacity/elasticity
• detrusor
• sphincter
• emptying
• postpone

Question 3

Three types or Urinary Incontinence

Answer 3

• overflow
• stress
• urge

Question 4

Urge Urinary Incontinence

• AKA: ___ bladder
• hyperactivity of ___ muscle causes sudden and unpredictable voiding
• symptoms include: ___ and ___
• can be caused by ___ conditions or medications
• example: ___ inhibitors for Alzheimer’s disease
• small and large volume accidents

Answer 4

• overactive
• detrusor
• frequency, urgency
• neurological
• acetylcholinesterase

Question 5

Stress Urinary Incontinence

• ___ incompetence ( ___ urethral sphincter) with abdominal pressure
• occurs more in ___ due to multiple ___ or ___ deficiency
• can be exacerbated or caused by ___ antagonists
• ___ volume urine loss associated with sneezing, laughing, alcohol and caffeine

Answer 5

• outlet, external
• women, childbirths, estrogen
• alpha
• small

Question 6

Overflow Incontinence

• results from outlet obstruction or inability to or uncoordinated detrusor constriction
• most commonly from ___ or ___ blockage of urethra
• sympotms: ___ discomfor/pain, frequency, feeling the need to void shortly after voiding

Question 7

Neurogenic (Atonic) Bladder

• disrution in neurologic innervation of the bladder
• inability or uncoordinated detrusor constriction
• may also be __ of bladder muscle from stroke, neuropathy, spinal cord injury
• ___ urine volume during voiding
• ___ volume accidents
• loss of feeling that bladder is full
• drippling
• frequency, urgency
• increased risk for ___ and ___

Question 8

Functional Incontinence

inability to get to bathroom ina timely fashion caused by
- physcial impairment
- change in mental status
- UTI
- ___ medications

Question 9

Medication causes for Incontinence

Frequency (2)

Answer 9

• diuretics
• alpha antagonists

Question 10

Medication causes for Incontinence

Urgency (1)

Answer 10

acetylcholinesterase inhibitors

Question 11

Medication causes for Incontinence

Overflow (2)

Answer 11

• alpha antagonists
• antihistamines

Question 12

UI Treatments: Non-PCOL

should be provided for all types of urinary incontinence
1. scheduled/timed voiding
2. pelvic floor muscle strengthening (Kegal): 30-60x/day
3. avoiding irritants (coffee, alcohol, caffeine, water hs)
4. absorbent products
5. catheters

Question 13

UI PCOL Management Options

Urge: ___ and ___
Overflow: ___
Stress: ___ (topical) , ___ , and ___

Answer 13

• anticholinergic (antimuscarinic) and B3 agonists
• alpha-antagonists
• estrogen, apha-agonists, SNRI

Question 14

Urge UI Management

1. Non-PCOL
2. PCOL Goal: reduce ___ contraction frequency using ___ , ___ , or combo
3. injections/surgery

Question 15

Stress UI Management

• Non-PCOL : Kegel
• Duloxetine ___ mg BID

Question 16

Overflow UI Management

1. address the obstruction
2. alpha-adrenergic blockers if ___
3. catheterization

Question 17

Neurogenic UI Management

No Pharmacologic Management routinely effective