NURSE-UN 1243 Adult and Elder Nursing 3 WEEK 9 – Urinary Incontinence
Learning Objectives
By the end of this week, the learners will be able to :
• Differentiate types of urinary incontinence.
• Implement collaborative management (assessment and treatment) of urinary incontinence in the...
nurse un 1243 adult and elder nursing 3 week 9 – urinary incontinence
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NURSE-UN 1243 Adult and Elder Nursing 3 WEEK 9 – Urinary
Incontinence
Learning Objectives
By the end of this week, the learners will be able to :
• Differentiate types of urinary incontinence.
• Implement collaborative management (assessment and
treatment) of urinary incontinence in the older adult.
• Discuss sexual health and sexually transmitted infection risk in the
older adult population.
• Describe the components of a sexual health assessment for an older adult.
Urinary Incontinence (UI) - viewed as a social and hygienic problem but it is not; it
does affect the quality of life.
● Involuntary leakage of urine
o More prevalent with older adults (women more than men) but
not a naturalconsequence of aging.
o Gender differences
▪ Men—common with BPH (Benign prostatic hyperplasia - also
called prostate gland enlargement) or prostate cancer;
overflow incontinence from urinary retention related to BPH -
urine can back up into the ureters
→ Hydronephrosis - the swelling of a kidney due to a build-up of urine
▪ Women—stress and urge incontinence
o Transient or “new onset”
o Chronic
o occurs when the bladder pressure is greater than sphincter control
o DRIP - causes of UI
▪ D - dehydration, delirium, depression
▪ R - restricted mobility, rectal impaction
▪ I - infection, inflammation, impaction
▪ P - polyuria (pee a lot), polypharmacy
Incontinence
● Types of Incontinence
o Stress
o Urge
o Overflow
, o Functional
o Mixed
o (May have more than 1 type)
● Risk Factors
o Weak bladder muscles
o Overactive bladder muscles
o Weak pelvic floor muscles - teach pt kegel exercises -
▪ to perform exercise; Make sure your bladder is empty, then sit or lie down
, ▪ Tighten your pelvic floor muscles. Hold tight and count 3 to 5 seconds.
▪ Relax the muscles and count 3 to 5 seconds.
▪ Repeat 10 times, 3 times a day (morning, afternoon,
and night).o Debility - physical weakness, especially as a
result of illness.
o Arthritis
o Pelvic organ prolapse - happens when the muscles or connective
tissues ofthe pelvis do not work as they should. The most
common risk factors are: Vaginal childbirth, which can stretch and
strain the pelvic floor. Multiple vaginal childbirths raise your risk for
pelvic organ prolapse later in life.
o BPH/Prostatitis
o Infection
New Onset Incontinence: What to do?
● Always a nursing priority - same as DRIP - look for the underlying causes
○ Delirium - new onset of confusion - there is always a reason****
○ Infection--urinary (symptomatic) - UTI: urge/ frequency
○ Atrophic urethritis (urethra vulvar tissue thinning) and vaginitis (an
inflammation of the vagina)
○ Pharmaceuticals - antihypertensive, diuretics
○ Psychologic disorders, especially depression - causing not to want
to get out of bed
○ Excessive urine output (e.g., heart failure or hyperglycemia (polyuria,
polydipsia, polyphagia - big with a new onset of diabetes))
○ Restricted mobility - Pt may have arthritis, causing them to move
slowly - this is a functional problem; pt cant get to the bathroom fast
enough, end up dribbling.
○ Stool impaction
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