What occurs to renal/kidney function during normal aging?
- Decreased number of nephrons
- less efficient blood filtration
Reduced renal/kidney function in normal aging is secondary to what?
Decreased cardiac function
What is a major implication of reduced renal/kidney function that results from normal aging?
Increased risk of toxic build up of drugs due to reduced elimination
What occurs to the lower urinary tract during normal aging?
- Decreased bladder capacity
- increased post void residual
- Detrusor instability
How can decreased bladder capacity increase the risk of dehydration?
A full bladder or fear of a full bladder can reduce the desire to drink
What are the implications of a unstable detrusor muscle
- incontinence
- Overactive bladder
How does the reproductive system generally change due to aging?
-Altered appearance and function of genital tract
How can menopause be treated?
With HRT
What are the main effects of menopause?
7
- Decreased in estrogen
- Pelvic floor relaxation
- Detrusor instability
- Atrophy of genital and breast tissue
- Mood alterations
- Increased bone loss
- Increased androgen
What are the main effects of Andropause?
7
- decrease testosterone
- decreased size of reproductive tract
- decreased libido
- Decreased function of accessory sex organs
- mood changes
- decreased bone mass
- Hypertrophy of prostate
What are the three main drug types that can cause decreased libido?
- Anti-depression
- Cardio
- Statins
What are the four most common disorders of the genitourinary system?
- BPH
- UTI
- Nocturia
- Incontinence
What is BPH?
Benign Prostatic Hypertrophy
What are the common symptoms of BPH?
- Dribbling
- Problems starting and stopping flow
- urgency
- 50% experience prostatitis
What are the two kinds of UTI?
Upper and lower
Upper UTI’s are also called _____ and effect which organs?
pyelonephritis
-kidneys
Lower UTI’s are also called ____ and effect which organs?
cystitis
-bladder
What are some symptoms of an upper uti?
Fever, chills, anorexia
What are some symptoms of a lower uti?
- Pain on urination
- confusion
- sudden incontinence
- behavior changes
An upper UTI can lead to _____ also known as sepsis
bacterima
What is the main antibiotic used for lower UTI’s
Cyphilexin
What is nocturia?
-increased urine production at night due to an interruption of circadian pattern
What 7 factors do you assess for in incontinence?
- Time
- Frequency
- Pain
- Amount
- Flow
- Urgency
- Dribbling
When assessing incontinence, it is important to obtain or start to collect data to create a ______
Void pattern history
What are the four types of incontinence?
- Functional
- Stress
- Urge
- Overflow
What is functional incontinence?
-patient is unable to control their bladder before reaching the bathroom due to limitations in moving, thinking, or communicating
What is the main action to take in functional incontinence?
Modify the environment to allow easy access to commode
What are three disorders that can cause functional incontinence?
- Alzheimer’s
- Parkinson’s
- Arthritis
What is stress incontinence?
-Leaking small amounts when coughing, sitting down/standing up, laughing
Caused by loss of pelvic floor tone, pelvic prolapse, prostatectomy,
What can be done to lessen stress incontinence?
Kegel exercises
What is urge incontinence?
Shortened time between need and occurrence of void
-caused by detrusor muscle instability
What can be done to treat urge incontinence?
Bladder training
What is overflow incontinence?
Dribbling or reduced stream. Can not completely empty bladder.
-Caused when the bladder is overly distended but the detrusor muscle does not contract
What can be done to treat overflow incontinence?
The crede maneuver
-Manual compression
What two types of medications can be used to treat incontinence?
- Tricyclic antidepressants
- Anticholinergics/antispasmodics
What is the main tricyclic antidepressant used to treat incontinence?
imipramine
What is the main Anticholinergics/antispasmodics used to treat stress/urge incontinence?
oxybutynin
