Urine Incontinence

Subject: Geriatric Nursing (Theory)

Overview

Urine Incontinence

It is the uncontrolled or involuntary leakage of urine. According to prevalence surveys, the frequency and length of incontinence episodes are defined differently.

Risk factors:

  • Diseases such as parkinsonisms, dementia, and stroke
  • Obesity
  • Infection of the urinary tract
  • Males with BPH and females with prolapse
  • Little mobility
  • Medications
  • A respiratory issue creating a persistent cough

Classification of incontinence:

  • Stress incontinence: When pressure is applied to the bladder, such as when coughing, sneezing, or lifting heavy objects, stress incontinence occurs.
  • Urge incontinence: Urge incontinence is brought on by excessive bladder detrusor muscle activation.
  • Functional/psychogenic incontinence: Incontinence caused by a person's unwillingness or inability to use the restroom despite having normal bladder control
  • Mixed incontinence: The condition known as "mixed incontinence" affects a large number of people.

Symptoms:

Detrusor overactivity symptoms include urge incontinence, a sudden, strong urge to urinate that does not provide the person enough time to get to the restroom. Other symptoms include nocturia. Urine loss during actions that raise intraabdominal pressure, such as coughing, sneezing, or straining, are signs of stress incontinence.

Treatment and management:

  • Alterations in drinking habits and urine patterns. The term "bladder training" refers to the most popular behavioral therapy. Exercises for the pelvic muscles are useful in minimizing urge incontinence episodes, according to the most recent studies.
  • Drugs that lessen detrusor muscle spasms are used to treat urge incontinence pharmacologically. These drugs have anticholinergic or relaxing effects on the smooth muscles.
  • Surgery: Urinary diversion, bladder denervation, and argumentation cystoplasty are the most frequently advised procedures.
  • Catheterization
  • Electrical stimulation: Electrical stimulation of electrodes placed on the periurethral skin or in the vagina that causes contraction of the urethral sphincters when used to manage stress incontinence.

Nursing management:

General measures:

  • Analyze the elderly's urine and fluid intake patterns.
  • Give yourself enough time to urinate
  • Allow the patient to sit up normally if voiding is not recommended.
  • To reduce the risk of UTI, avoid using indwelling catheters whenever possible.
  • Eat less of the foods that cause bladder irritants like alcohol and coffee.
  • Encourage the patient to train their bladders and provide any required assistance.

Maintaining skin integrity:

  • Check the genito-perineal region every day.
  • In elderly and bedridden individuals, a two-hourly position change will help prevent pressure sores.
  • After an incontinent incident, immediate cleaning is required.
  • use of creams that act as a moisture barrier.

Reducing anxiety

  • Remind the elderly that urine incontinence is treatable and controlled and is not embarrassing.
  • Then, encourage them to express their emotions.
  • Providing encouragement for any attempts at self-care.
  • Changes to the environment, such as the use of urinals and toilets at the bedside for the elderly.
  • Encourage seniors to quit irritants like drinking alcohol and smoking.
Things to remember

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