Urinary Incontinence: Types, Causes and Treatments
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Questions and Answers

Which medication class is least likely to contribute to urinary incontinence?

  • Diuretics
  • ACE Inhibitors
  • Anticholinergics
  • Beta-blockers (correct)

A patient reports urine leakage when laughing or sneezing. Which type of urinary incontinence is the patient most likely experiencing?

  • Reflex Incontinence
  • Urge Incontinence
  • Overflow Incontinence
  • Stress Incontinence (correct)

Which of the following is least likely to be a contributing factor to urinary incontinence?

  • Atrophic Vaginitis
  • Urinary Retention
  • Increased Mobility (correct)
  • Fecal Impaction

Which of the following is a recommended treatment for stress incontinence related to relaxed pelvic floor musculature?

<p>Kegel Exercises (B)</p> Signup and view all the answers

Which of the following is a treatment approach for urge incontinence?

<p>Treating the underlying cause (A)</p> Signup and view all the answers

Why is urinary incontinence more prevalent in older women, although it is not considered a natural consequence of aging?

<p>Hormonal and physical changes related to pregnancy and menopause (C)</p> Signup and view all the answers

A patient with benign prostatic hyperplasia (BPH) undergoes prostate surgery and subsequently experiences stress incontinence. What is the most likely cause?

<p>Damage to the urethral sphincter during surgery (B)</p> Signup and view all the answers

Besides medication, what lifestyle change is most likely to reduce symptoms of stress incontinence?

<p>Weight loss (C)</p> Signup and view all the answers

A patient reports a sudden, strong urge to urinate followed by involuntary urine loss before reaching the toilet. Which type of urinary incontinence is the MOST likely diagnosis?

<p>Urge Incontinence (C)</p> Signup and view all the answers

A patient with urinary incontinence voids frequently in small amounts. Which additional symptom would MOST strongly suggest overflow incontinence?

<p>Constant dribbling of urine. (C)</p> Signup and view all the answers

A nurse is caring for an older adult patient who has started using absorptive perineal pads for urinary incontinence. What is the MOST important nursing intervention related to the use of these pads?

<p>Monitoring the patient's skin for signs of irritation or breakdown. (C)</p> Signup and view all the answers

A patient presents with urinary urgency, frequency, and small-volume voids. Which diagnostic test should the nurse anticipate the healthcare provider ordering FIRST to help determine the underlying cause?

<p>Urinalysis (A)</p> Signup and view all the answers

A patient is experiencing urinary incontinence after undergoing a hysterectomy. Which of the following is the most likely cause of their incontinence?

<p>Fistula formation. (D)</p> Signup and view all the answers

A patient presents with symptoms of urgency and frequency, voiding small amounts. After urinalysis rules out a UTI, what would be the MOST appropriate NEXT step in the diagnostic process?

<p>Perform a bladder scan to assess post-void residual volume. (C)</p> Signup and view all the answers

An elderly patient with balance and mobility issues is experiencing functional incontinence. Which of the following interventions would be MOST appropriate as an initial treatment?

<p>Modifying the environment to ensure easy access to the toilet (B)</p> Signup and view all the answers

When assessing a patient for urinary incontinence, which of the following is the MOST important component of the physical assessment?

<p>Pelvic examination with inspection of the perineal area. (A)</p> Signup and view all the answers

A patient is prescribed an external condom catheter as part of their urinary incontinence treatment. What type of incontinence is this treatment MOST likely addressing?

<p>Fistula-related incontinence (D)</p> Signup and view all the answers

According to the 'DIAPERS' mnemonic, which of the following is a transient cause of urinary incontinence that should be addressed first?

<p>Atrophic vaginitis (C)</p> Signup and view all the answers

A patient presents with urinary incontinence following a transurethral resection of the prostate (TURP). What is the most likely cause of the incontinence?

<p>Postoperative complications. (C)</p> Signup and view all the answers

Which diagnostic study provides information about the amount of urine remaining in the bladder after voiding?

<p>Post Void Residual Volume (D)</p> Signup and view all the answers

A patient's bladder log reveals frequent urination, including multiple episodes of nocturia. Which element of the DIAPERS mnemonic does this correlate with?

<p>Excess urine production (C)</p> Signup and view all the answers

A patient with urge incontinence is prescribed tolteradine. What is the primary mechanism by which this medication helps manage their condition?

<p>Blocking muscarinic receptors, which reduces bladder contractions. (A)</p> Signup and view all the answers

Which treatment strategy is MOST appropriate for managing overflow incontinence caused by bladder outlet obstruction?

<p>Performing intermittent catheterization to decompress the bladder. (C)</p> Signup and view all the answers

A patient with a spinal cord lesion above S2 experiences reflex incontinence. What is the underlying mechanism causing this type of incontinence?

<p>Loss of conscious control over urination due to disruption of CNS inhibitory pathways. (C)</p> Signup and view all the answers

For a male patient experiencing overflow incontinence due to benign prostatic hyperplasia (BPH), which medication would directly address the underlying cause?

<p>Finasteride (Proscar). (C)</p> Signup and view all the answers

Following a surgery, a female patient reports continuous leakage of urine. Further examination reveals a vesicovaginal fistula. What surgical intervention is MOST likely required?

<p>Fistula repair. (C)</p> Signup and view all the answers

A patient is diagnosed with urge incontinence. Which lifestyle modification should be initially recommended?

<p>Reducing intake of dietary bladder irritants like caffeine and alcohol. (C)</p> Signup and view all the answers

What is the PRIMARY goal of bladder retraining as a behavioral intervention for urinary incontinence?

<p>To increase the bladder's capacity and ability to hold urine. (A)</p> Signup and view all the answers

A patient with reflex incontinence is prescribed diazepam. How does diazepam assist in managing this condition?

<p>By relaxing the external sphincter to facilitate scheduled voiding. (C)</p> Signup and view all the answers

Which surgical intervention aims to reposition the urethra and stabilize the bladder neck by creating a supportive 'backboard'?

<p>Retropubic Colposuspension (A)</p> Signup and view all the answers

A patient is scheduled for a urethral sling procedure. What is the primary mechanism by which this surgery aims to improve urinary continence?

<p>Supporting and lifting the urethra (B)</p> Signup and view all the answers

Which of the following interventions is most appropriate for a patient experiencing stress urinary incontinence?

<p>Instructing the patient to perform pelvic floor muscle exercises (B)</p> Signup and view all the answers

What is the rationale behind advising a patient with urinary incontinence to reduce their intake of bladder irritants?

<p>To minimize stimulation of the detrusor muscle (B)</p> Signup and view all the answers

A nurse is educating a patient with urinary incontinence on lifestyle modifications. Which of the following recommendations is MOST appropriate to include?

<p>Consume adequate fluids and reduce intake of caffeine and alcohol. (A)</p> Signup and view all the answers

A patient reports difficulty initiating urination and frequent dribbling. Which type of incontinence is MOST LIKELY associated with these symptoms?

<p>Overflow Incontinence (B)</p> Signup and view all the answers

When teaching a patient about pelvic floor muscle exercises (Kegel exercises), which instruction is MOST important for the nurse to emphasize?

<p>Perform exercises consistently and correctly, multiple times daily. (A)</p> Signup and view all the answers

A patient with urge incontinence is prescribed an anticholinergic medication. What is the primary mechanism by which this medication helps to reduce urinary urgency and frequency?

<p>Relaxing the detrusor muscle of the bladder (C)</p> Signup and view all the answers

Flashcards

Urinary Incontinence (UI)

Uncontrollable leakage of urine; more common in older women, but not a normal part of aging.

UI Contributing Factors

Confusion, infection, mobility issues, fecal impaction, and certain drugs like diuretics or sedatives.

Cause of UI

Any interference with bladder or urethral sphincter control.

Clinical Manifestation of UI

Uncontrolled urine leakage due to bladder or sphincter issues, weak pelvic floor, or neurological problems.

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Stress Incontinence

Sudden urine leakage due to increased abdominal pressure (coughing, sneezing).

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Causes of Stress Incontinence

Weak pelvic floor muscles, pregnancy, urethral atrophy, or prostate surgery.

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Treatments for Stress Incontinence

Kegel exercises, weight loss, quitting smoking, topical estrogen, or surgery.

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Urge Incontinence

Random, involuntary urination preceded by sudden urinary urgency.

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Behavioral interventions

Interventions addressing behavior to improve bladder control.

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Bladder retraining & bowel regularity

Training the bladder to hold more urine and establishing regular bowel movements.

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Reduce Dietary Irritants

Reducing intake of substances that irritate the bladder.

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Kegel Exercises

Exercises to strengthen the pelvic floor muscles.

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Overflow Incontinence

Occurs when the pressure of urine in an overfull bladder overcomes sphincter control.

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Credé or Valsalva maneuver

Manual pressure applied to the bladder area to aid in emptying.

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Reflex Incontinence

No warning or stress precedes periodic involuntary urination.

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Reflex Incontinence Cause

Involuntary urination due to spinal cord lesion above S2 interfering with CNS inhibition.

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Fistula (Urinary)

An abnormal connection between two body parts, potentially caused by pregnancy complications, surgery, or cancer treatments.

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Fistula Treatment

Surgical repair of a fistula or urinary diversion to bypass the urethra and bladder.

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Functional Incontinence

Loss of urine due to cognitive, functional, or environmental limitations.

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Incontinence Environmental Modifications

Environmental modifications to improve access to the toilet, such as better lighting or ambulatory aids.

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Bladder Log/Voiding Record

A record documenting urination timing, leakage episodes, and nocturia frequency.

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Post Void Residual Volume

The amount of urine remaining in the bladder after urination.

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Transient Factors of UI

Delirium, Dehydration, Dietary Irritants, Infection, Atrophic urethritis/vaginitis, Pharmaceutical, Psychological Problems, Excess urine production, Restricted mobility, Stool impaction.

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Initial UI Treatment Strategy

Addressing temporary conditions before more invasive procedures.

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Urinalysis for UI

A lab test to identify possible contributing factors to urinary incontinence.

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Drug Therapy (for UI)

Using drugs as part of a treatment plan for urinary incontinence. Most effective for urge and reflex UI.

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Retropubic Suspension

A surgical procedure to reposition and support the urethra for better bladder control.

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Urethral Sling

A surgical procedure involving the placement of a mesh or tissue sling to support the urethra.

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Dignity and Privacy

Actions to respect the patient's dignity and privacy when managing their incontinence

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Lifestyle Interventions for UI

Drinking enough fluids and avoiding things that irritate the bladder.

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Behavioral Treatments for UI

Scheduled voiding, bladder retraining, and pelvic floor exercises to manage UI.

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Pelvic Floor Exercises (Kegels)

Pelvic floor muscle exercises to strengthen the muscles that control urination.

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Stress Incontinence Treatment

Exercises to increase the tone of the urethral sphincters.

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