Question

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1. Show at least three ways nurses can collaborate with the interprofessional (PT/OT/ST) team to coordinate high quality care and promote urinary elimination in patients who have problems in the urinary tract.

2. Show at least three ways nurses can teach the patient and caregiver(s) how impaired elimination resulting from problems in the urinary tract affects home safety.

3. Show at least three community resources for patients requiring assistance with incontinence or any chronic urinary tract problem.

4. Show at least three ways nurses can teach adults how to decrease the risk for urinary tract infections.

5.Show at least three ways nurses can implement nursing interventions to help patients and families cope with the psychosocial impact caused by urinary incontinence or any other chronic problem of the urinary tract.

6. Show at least three ways nurses can apply knowledge of anatomy and physiology to assess patients with urinary problems affecting elimination.

7. Show at least three ways nurses can teach the patient and caregiver(s) about common drugs used for urinary tract problems, including pain control.

8.Show at least three nursing interventions that are directed toward prevention, detection, and management of urologic disorders.

Answer 1

Urinary Elimination problems :

Problems associated with urinary elimination and retention are Urinary incontinence and urinary retention. Nursing interventions can greatly help the patient to promote his urinary elimination pattern. Nurse can colllaborate with the interprofessional team such as Occupational therapists, Physical therapist etc for improving the patient's condition through many ways, such as:

* OT can assess the psychological and physical impact of Urinary incontinence.

* Along with nurses, they can provide patient education .

* Pelvic floor exercise training to strengthen pelvic floor muscles ( PT)

* Bladder control training and trans vaginal electric stimulation can gain the control or continence.

2. Nurses can teach the patient and the caregivers, that the problems associated with urinary elimination such as incontinence and retention can affect home safety.

* Teach the patient and care giver about incontinence or retention and it's effect on the quality of life and home safety.

Incontinence is the inability of the urinary bladder to control the voiding of urine. It may be of two types stress incontinence and urge incontinence.

*Instruct them that incontinence may increase the chance of falls and accidents at home.

* Home environment may become distorted as the rooms may have the bad odour due to incontinence of urine and the patient may fell hopelessness, irritability and depression.

3. Community resources for patients with incontinence and chronic urinary problems:

* Community Support groups for Incontinence patient: provides support to the patients andp provides contact of many people who are suffering the same problems.

* Urology Care Foundation provides the information and management ways for Incontinence and details regarding assistive devices that helps in continence.

* Many other organisations that help the clients with urinary problems, such as National association for continence( NAFC), Simon's Foundation for Continence etc.: These organizations provides assistance, informations, distribution of materials and devices such as catheters, absorbent pads, pessaries for women etc.

4. To decrease the risk for Urinary tract infection:

*Instruct the client to wipe from front to back to prevent the spread of bacteria.

* Instruct the clients/ care givers not to keep / remain in soiled materials for long time.

* As far as possible, keep the area dry, as moist environment may increase bacterial growth.

* Encourage the regular voiding in toilet in frequent intervals.

* Use breathable and soft incontinence products.

5. To cope with the psychosocial impact:

Nursing interventions:

* Teach them about the disease process and its causes and the homecare management of the urinary problems.

* Provide Psychological support to the patient and family. Offer open communication with active listening and encourage them to ventilate their feelings.

* Provide information and contact details of support groups and community resources that offer assistance to patient with urinary problems.

6. To assess patient with urinary problems:

* Nurse can assess the urinary system, that consist of kidney, ureters , urinary bladder and urethra . Anatomical and physiological problems associated with these structures can cause problems with Urinary Elimination.

* Reduced bladder capacity or weakened Urinary sphincters can be the main causes of urinary incontinence, especially in old age patients.

Urinary tract infection, pain on urination and enlarged prostrate gland ( in males) can cause Urinary retention, inability of the person to void the urine completely.

* Palpate the kidneys for any area of tenderness and masses and Urinary bladder for distention.

Inspect the urethra and surrounding tissue for any abnormalities, blood, pus or any lesions etc.

7. Common drugs for Urinary tract problems:

* Anticholinergic drugs to improve bladder control: eg. oxybutinin, trospium chloride , fesoterodine

* Botulinum toxin A ( BTX-A) to increase bladder compliance and capacity.

* To relieve pain : Phenazopyridine ( to reduce Urinary pain).

Acetaminophen, ibuprofen for UTI pain.

* Instruct the patient not to take alcohol or caffeine. It may increase urinary incontinence.