URINARY INCONTINENCE IN THE ELDERLY
Incontinence
has medical, emotional, social and economic consequences for older adults. It can
result in skin irritation or breakdown and can contribute to pressure ulcers.
Reversible
causes of incontinence:
- Delirium
- Infections
- Atrophic vaginitis
- Psychological causes (depression)
- Pharmaceutical agents
- Endocrine conditions (DM)
- Restricted mobility
- Stool impaction
Incontinence
can be reduces if there is a commitment to success rather than a defeatist
attitude. Stressing the benefits to the patient and identifying the benefits to
caregivers can help motivate the process. All member of the health care team
are essential to reduce incontinence.
Treatment:
General:
- The nurse should assess and apply analytical and urine culture.
- Correct precipitating factors favoring and incontinence
- One should look for proper voiding habit
- Constipation should be corrected
Residual
urine <100 ml:
- Pelvic floor exercises (Kegel)
Residual
urine> 100ml:
- Overflow: probe or reconstructive surgery
- Acontractile: modification techniques such as catheterization or incontinence pads.
The nurse
must assess elimination pattern, assess fluid intake patterns, explain measures
that help improve tone of the sphincter muscles, modify clothing to make
toileting easier, answer call signals promptly, initiate actions to maintain
skin integrity, insert catheter as prescribed by physician, discuss methods for
coping with incontinence…
In short, I
think that a nurse is very important to help the patient with urinary
incontinence. We must inform and explain to the patient the problems and how to
prevent it.
The incontinence
could produce pressure ulcers and we should clean the skin carefully to prevent
it.
A good
nurse must provide all necessary care to the patient for a better life.
1.
Gloria Hoffmann Wold.
Basic Geriatric Nursing. 5th ed. Milwaukee , Wisconsin :Elsevier;
2012
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