Question

The nurse working at the senior center notices

Mrs Jones,a78-year old crying. The nurse approach Mrs Jones and asks if she needs help. Mrs Jones stars “ I am so embarrassed. I had another accident and my pants are all wet. It’s like I’m a baby. I never should have come to the senior center.

Qn.1: Whar factors may be contributing to urinary incontinence?

Q 2: How should the nurse respond to Mrs Jones?

Answer 1

Urinary incontinence means a person leaks urine by accident.It can happen to anyone, urinary incontinence is more common in elderly people. When the muscles of urinary bladder don't work the way they should, urine can leak. Urine incontinence typically occur if the bladder muscles relax without warning.

Urinary incontinence isn't a disease it is a symptom caused by a person's daily routine.

Caffeine, Chocolate, alcohol, large doses of vitamin C, artificial sweeteners and chili peppers stimulates urinary bladder and can cause temporary urine incontinence.

? Causes of urinary incontinence:-

• Urine incontinence problem for short period of time may be caused by Urinary tract infection, vaginal infection, constipation.

• Incontinence lasts longer it may be due to

-- Weak bladder muscles

-- Overactive bladder muscles

-- Disease such as multiple sclerosis, diabetes, Parkinson's disease can damage nerves that control the bladder.

-- Pelvic organ prolapse, which is when pelvic organ shift out of normal place

Most of the male urinary incontinence is caused by prostate gland.

#Prostatitis- inflammation of prostate gland, it is a painful condition.

#Injury or damage to nerves or muscles

#Benign prostate Hyperplasia

? Types of Urinary Incontinence:-

1. Stress incontinence:- Urine leaks when a person exert pressure on bladder during excersice, laughing, sneezing.

2. Functional incontinence:- Physical or mental impairment keeps the person making it to the toilet on time.

3. Overflow incontinence:- Frequent urge to urinate due to the bladder that doesn't empty completely.

4. Urge incontinence:- Sudden urge to urinate followed by an involuntary loss of urine.

5. Mixed incontinence:- When a person experience more than one types of incontinence.

TREATMENT FOR URINE INCONTINENCE

# Surgery is sometimes performed to remove a blockage in bladder or urethra that is causing overflow incontinence or shift the position of bladder to remove pressure that is causing stress incontinence.

# Sacral nerve stimulation is sometimes used to treat overactive bladder.

# Incontinence Medication:- The drug given to a urine incontinence patient to relax bladder muscles to stop abnormal contractions.

1. Levbid

2. Santura

3. Cystospaz

4. Detrol

5 . ProBanthine

# Alpha adrenergic antagonists:- These drug relaxes smooth muscles of bladder to improve urine flow. This class of drug is effective for men with urge incontinence. These include Hytrin, Uroxatral, Flomax.

# In stress incontinence the alpha adrenergic agonist drug are heplful because they strenghten the muscles that open and closes urinary sphincter.

# Tricyclic antidepressants:- The neurotransmitters serotonin and noradrenaline play a role in urination and urge and stress incontinence. Example are Janimine, Nortriptyline, doxenin.

The Nurse should ask Mr. Jones to relax and stop crying as it is a common old age problem and their is nothing to get embarrassed in it.

The nurse shoud ask Mr. Jones about his daily routine and his medical history. If Mr. Jones uses tobacco the nurse should ask him to not to use tobacco as it is a contributing factor in Incontinence.

The nurse should go for some test like Urine sample, test of bladder emptying and filling as the result from these test would be helpful in understanding the incontinence and give proper medicine for it.