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51 Cards in this Set
- Front
- Back
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What GI change associated with aging increases bowel incontinence?
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Decreased muscle tone at rectal sphincters
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What GI change associated with aging decreases digestion rate?
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Decrease in gastric secretions
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What GI change associated with aging increases risk of constipation and bowel impaction?
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Decreased peristalsis
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What happens to the kidneys as we age that effects urinary output?
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Decreased number of functioning nephrons and decreased blood supply to the kidney (maybe from HTN)
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A result of decreased nephrons and decreased blood supply to kidney is....
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decreased filtration rate
decreased removal of body wastes Increased concentration of urine |
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As we age, muscle tone decreases in the body. How does this effect the urinary system?
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Increases volume of residual urine b/c can't push it all out
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With decreased tissue elasticity as we age, this effects the urinary system by causing...
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decreased bladder capacity
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BPH is an increase in the size of the prostate. How does this effect elimination?
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Decreased stream of urine
Increased hesistancy/frequency of urination |
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Why is there an increased risk of infection in elderly due to urinary issues?
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Urine stasis. Difficulty starting a stream of urine, so they strain to urinate and just don't empty it all the way.
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When does BPH usually start?
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Around 50-60. Most men have it by age 80
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Is urinary incontinence normal?
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No. Not normal. It is due to physiological changes
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What are some risk factors for elimination issues?
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immobility
change in diet change in routine lack of privacy med side effects embarassment thinking it is normal to have issues |
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What is issue with BUN in elderly?
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Slightly increased. Remember that there are fewer functioning nephrons and lower blood flow to kidney. Higher concentration of urine, would be higher BUN
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What percentage of residents are effected by constipation?
What percentage of people in population take laxatives? |
50-75% in LTC have constipation
20% in community do laxatives |
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What is normal transit time for bowel movement?
What is considered "slow transit"? |
24 hours is normal
48-72 is SLOW TRANSIT |
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How long do you have to go without a BM to be constipated?
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72 hours
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What are the risk factors to constipation?
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immobility
slow transit decreased fluid and roughage lack of physicial activity Lack of privacy Change in routine Chronic use of laxatives Emotional distrubances Stress Cognitive impairment |
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How frequently do you assess for s/s of constipation?
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Every 2-3 days and PRN
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What is an important intervention for constipation?
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Know their normal bowel pattern for a baseline
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What do you have to do before you give meds for constipation?
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Try all non pharmaceutical interventions first.
(activity, fiber, privacy, good position, schedule toileting, look at meds for SE, |
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You would consult an MD about checking for fecal impaction and digitially removing stool of client if _______ days has passed or if there are signs of ____________.
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3 days
encoporesis |
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What is lowest level that can do digital fecal impaction removal?
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CNAII
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What is order of abdominal assessment?
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Look
Listen Feel Lastly, rectal exam |
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Pericolace is a....
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stool softener and a laxative.
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What are some laxatives?
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senocot
myrilax MOM dulcolax lactalose |
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What are your bowel sounds if bowel obstruction?
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hyperactive...no stool
boriborgmi |
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What are your bowel sounds if fecal impaction?
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hypoactive
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What is the order of meds for treating constipation?
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Dulcolax suppository
Then enema: fleets Then oil retention Then soap suds |
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I am urinary incontinence caused by increased intra abdominal pressure.
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STRESS
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I am urinary incontinence caused by physical or psychological factors impairing my ability to get to the toilet
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FUNCTIONAL
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I am urinary incontinence caused by poor muscle tone and overextended bladder.
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Overflow
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I am urinary incontinence caused by detrusor instability and internal sphincter weakness.
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URGE
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I am also known as over active bladder.
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URGE
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I am identified by my inability to reach the toilet.
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FUNCTIONAL
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I am identified as involuntary leakage of urine due to distended bladder.
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OVERFLOW
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What types of drugs would cause overflow incontinence?
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anticholinergics (decreasing bladder spasm)
Ca Channel blockers - vasodilate so urine overflows adrenergics |
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What assessment tool is used for identifying new onset incontinence?
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DIAPPERS
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How often do you assess for s/s of urinary incontience, like wet clothing, wet bed linens, etc.
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q 2 hours and PRN
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When doing bladder training...how often do you take them to the bathroom?
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q 2 -4 hours
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What is the Crede procedure?
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Applying pressure over suprapubic bone to make them pee
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For all types of urinary incontinence, you might want to limit these beverages in your client.
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Alcohol and caffeine
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When implementing bladder training, how often do you prompt patient to toilet?
What are the time intervals to increase to? |
every 2 hours initially, then you want to increase at intervals from 2 to 4 hours, training the bladder to hold slightly more amounts of urine
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What is the name of the pelvic floor exercise used as an intervention to urinary incontinence?
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Kegel exercises
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What is the group of drugs used to reduce bladder spasms?
Give four examples. |
anticholinergics
Ditropan, Detrol, Urispas, Vesicare |
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What is the drug group used to treat bladder irritation secondary to UTI?
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sulfonamides
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What drug is used as a treatment for stress incontinence?
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estrogen
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What is the name of the drug used to stimulate complete bladder emptying?
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Prostigmine
(Used in OB & after general surgery also. Helps stimulate urge to go) Treats Urinary Retention |
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These drugs (group name and two examples) help to relax muscle tissue and are used in BPH.
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Alphablockers
(Hytrin, Flomax) |
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These drugs shrink the prostate.
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5 Alpha Reductase Inhibitors
Proscar, Avodart |
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Why would you use an antidepressant to treat BPH?
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Imipramine is a tricyclic antidepressant used to relax bladder and thus causing muscles at bladder neck to contract.
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This class of drugs is used to treat BPH and Urinary Incontience.
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Anticholinergics/Antispasmodics
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