1 / 30

Urinary Incontinence

Urinary Incontinence. Dan Fraser Amanda Geddes Donnie MacDonald Jenna Power. What are some of the common myths surrounding urinary incontinence? Where have you come across clients with urinary incontinence in your clinical practice or personal experiences?

dionysius-hilary
Download Presentation

Urinary Incontinence

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Urinary Incontinence Dan Fraser Amanda Geddes Donnie MacDonald Jenna Power

  2. What are some of the common myths surrounding urinary incontinence? • Where have you come across clients with urinary incontinence in your clinical practice or personal experiences? • True or False – both men and women of all ages can suffer from urinary incontinence? • True or false – urinary incontinence is a normal age related change and is commonly found in older adults, especially women. Pre-presentation Questions

  3. Introduction • Anatomy • Classifications • Risk Factors • Assessment • Diagnosis • Treatment • Nursing Implications • Patient Education Urinary Incontinence

  4. Urinary Incontinence is the involuntary loss of urine • Symptom of many other disorders • More common in Elderly • Under-reported Introduction

  5. Anatomy

  6. Anatomy

  7. Stress • Urge • Reflex • Overflow • Functional • Iatrogenic Classifications

  8. Pregnancy (vaginal delivery) • Menopause • Genitourinary surgery • Immobility • High-impact exercise • Diabetes Mellitus • Stroke • Age-related changes in the urinary tract • Morbid obesity • Cognitive disturbances • Medications Risk Factors

  9. Health History • Physical Examination • Diagnostic Tests –Urinalysis, Urodynamics Assessment

  10. Health History • Detailed history of symptoms • Onset, frequency, severity • Stress UI- leakage with cough, sneeze physical activity, UI in small amounts, no UI at night, UI without UI sensation • Urge UI – strong, uncontrolled urge, larger volume, urinary frequency, frequent nighttime urination • Overflow UI – difficulty starting urine stream, weak or intermittent stream, post void dribbling, feeling of fullness after voiding, small amount • Functional UI - mobility impairments, sedatives, hypnotics, CNS depressants, diuretic, anticholinergic Assessment

  11. Health history • Risk factors assessment – smoking, caffeine, alcohol, fluid intake/output, obesity • Medication assessment • include both OTC and prescription drugs • sedatives, hypnotics, anticholinergic, antidepressants • diuretics, narcotics, calcium channel blockers Assessment

  12. Health history • Functional assessment – mobility, dexterity, cognitive function • Environmental assessment - distance to bathroom, lighting, availability of assistance from care givers, appropriate assistive devices Assessment

  13. Physical Exam • abdominal – abnormal masses • genitals – skin irritation, odor, discharge • examine urethral opening • sphincter assessment – elicit anal and pelvic contraction Assessment

  14. Screening

  15. Under diagnosed • Prevalent • Have the conversation! Urinary incontinence

  16. Diagnosis Diagnosis

  17. Client’s subjective description of their history of urinary incontinence • Medication history • Voiding history • Intake and output diary Subjective Data

  18. Tests to determine type of incontinence; • - residual urine test • - stress manoeuvers • Urodynamic tests • Urine sample taken to do urinalysis and urine culture Objective Data

  19. Urodynamics

  20. Uroflometry • Cystometrography (CMG) • Urinary Pressure flow • Electromyography (EMG) • Urethral pressure profile • Video Fluorodynamic study

  21. 1) As a student how would you address the issue of urinary incontinence with your client? • 2) In what types of patients would you make sure to address this issue with? • 3) How would you prepare a client who is about to undergo urodynamic testing? What questions do you think they might have? QUESTIONS

  22. Treatment

  23. Incidence Nursing Implication

  24. Health Care Costs • Medications • Absorbent Products • Surgical • Non-surgical Nursing Implications

  25. Psychosocial Costs • Shame • Guilt • Fear • Restricted Social Activities Nursing Implications

  26. Physical Costs • Rashes • Pressure Ulcers • Urinary Tract Infections Nursing Implications

  27. Stop smoking • Exercise pelvic muscles daily • Establish a regular voiding schedule • Avoid bladder irritants • Limit diuretics • Be aware of amount and timing of fluid intake Patient Education

  28. Day, R.A., Paul, P., Williams, B., Smeltzer, S.C., Bare, B.G. (2010). Brunner & Suddarth’s Textbook of Canadian Medical-Surgical Nursing (2nd Ed.). Philadelphia, Pa; Wolters Kluwer, Lippincott Williams & Wilkins • Ebersole, P., Hess, P., Touhy, T., Jett, K. (2005). Gerontological Nursing & Healthy Aging. 2nd Edition. • LeCroy, C. (2009). Incontinence Patient Education: Strategies to Enhance the Teachable Moment. Urologic Nursing, 29 (3), 155-157. • The Canadian Continence Foundation. (2007) Incontinence: A Canadian Perspective • Canadian Urological Association References

More Related