Cu Task 11 Urinary Problems

Case Scenario A:
Mrs. P is an 80-year-old retired school teacher who receives visits from a nursing agency for
congestive heart failure. Mrs. P was diagnosed with dementia 4 years ago. She lives with her
daughter, who is also her caregiver. In addition to dementia. Mrs. P has macular degeneration.
She is blind at her left eye and has significantly impaired vision in her right, she fell and
fractured her left hip 1 year ago. She walks with the assistance of a walker. She has a moderate
amount of ankle and foot edema bilaterally. She always suffered from frequent constipation. Her
current medication include; hydrochlorothiazide, a calcium channel blocker and a stool softener,
Mrs. P is able to get in and out bed by herself but requires assistance with all other ADLs. She
has been incontinent of urine for 2 years. Mrs. P voids but leaks urine before she gets to the
bathroom. Mrs. P wears incontinence undergarments. She also has enuresis and usually wet in
the morning
1. Enumerate and describe each different types of urinary incontinence.
 URGE INCONTINENCE
Involuntary loss of larger amount of urine accompanied by a strong urge to void - aka
overactive bladder.
 STRESS INCONTINENCE
Involuntary loss of small amounts of urine with increased intra-abdominal pressure. "loss
of less than 50 mL of urine" in the absence of an overactive bladder. pregnancy,
childbirth, obesity, chronic constipation, straining at stool. exercise, laughing, sneezing,
coughing and lifting all are activities that produce leakage of urine.
 MIXED INCONTINENCE Combination of urge and stress incontinence.
 OVERFLOW INCONTINENCE
The loss of urine in combination with a distended bladder. causes include fecal
impaction, neurological disorders and enlarged prostate.
 FUNCTIONAL INCONTINENCE
Untimely loss of urine when no urinary or neurological cause is involved. occurs because
of physical disability, immobility, pain, external obstacles or problems in thinking or
communicating that prevent a person from reaching a toilet. confusion, disorientation, or
mobility problems.
 TRANSIENT INCONTINENCE
Short-term incontinence that is expected to resolve spontaneously. UTI and meds
especially diuretics.
 UNCONSCIOUS (REFLEX) INCONTINENCE
Loss of urine when the person does not realize the bladder is full and has no urge to void.
CNS disorders and multisystem problem are common causes. tissue damage from
radiation, cystitis, bladder inflammation or radical pelvic surgery can trigger.
 ENURESIS
Familial. involuntary urination after about 5-6 years of age when control of bladder is
established stress, UTI, allergies, abnormal EEG patterns, sleep disorders, hearty
laughing, and small bladder.
 NOCTURNAL ENURESIS
Bedwetting. can persist until age 10 or later. familial. UTI, urinary obstruction, diabetes,
pressure on the bladder from extreme constipation, or neurological disorders of the spinal
cord.
2. Make a drug study of hydrochlorothiazide and stool softener

Drug Class :
Antihypertensive, diuretic
Pregnancy Category :-
Category B
Usage :
To manage hypertension
Dosage: Adults
12.5 mg daily
Dosage: Oral Solution

25 to 100 mg daily as a single dose or in divided doses b.i.d.
Dosage: Children over 6 Months

1 to 2 mg/kg daily as a single dose or in divided doses b.i.d.
Dosage: Children under 6 Months

Up to 3 mg/kg daily
Mechanism of Action :
A thiazide diuretic, hydrochlorothiazide promotes the movement of sodium (Na+),
chloride (Cl-), and water (H2O) from blood in the peritubular capillaries into the
nephron's distal convoluted tubule, as shown at right. Initially, hydrochlorothiazide may
decrease extracellular fluid volume, plasma volume, and cardiac output, which helps
explain blood pressure reduction. It also may reduce blood pressure by causing direct
dilation of arteries. After several weeks, extracellular fluid volume, plasma volume, and
cardiac output return to normal, and peripheral vascular resistance remains decreased.
Contraindications :
Anuria; hypersensitivity to hydrochlorothiazide, other thiazides, sulfonamide derivatives,
or their components; renal failure
Adverse Reactions :
CNS:
Dizziness, fever, headache, insomnia, paresthesia, vertigo, weakness
CV:
Hypotension, orthostatic hypotension, vasculitis
EENT:
Blurred vision, dry mouth
ENDO:
Hyperglycemia
GI:
Abdominal cramps, anorexia, constipation, diarrhea, indigestion, jaundice, nausea,
pancreatitis,
vomiting
GU:
Decreased libido, impotence, interstitial nephritis, nocturia, polyuria, renal failure
HEME:
Agranulocytosis, aplastic anemia, hemolytic anemia, leukopenia, neutropenia,
thrombocytopenia
MS:
Muscle spasms and weakness
SKIN:
Alopecia, cutaneous vasculitis, erythema multiforme, exfoliative dermatitis,
photosensitivity, purpura, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis,
urticaria
Other:
Anaphylaxis, dehydration, hypercalcemia, hyperuricemia, hypochloremia, hypokalemia,
hyponatremia, hypovolemia, metabolic alkalosis, weight loss
Nursing Considerations :
 Give hydrochlorothiazide in the morning and early in the evening to avoid
nocturia.
 Monitor fluid intake and output, daily weight, blood pressure, and serum levels of
electrolytes,
 especially potassium.
 Assess for signs of hypokalemia, such as muscle spasms and weakness.
 Monitor BUN and serum creatinine levels.
 Frequently monitor blood glucose level as ordered in diabetic patients, and expect
to increase
 antidiabetic drug dosage, as needed.
 If patient has gouty arthritis, expect an increased risk of gout attacks during
therapy.
#. Stool softeners: description
help form soft stool
Stool softeners: action
promote peristalsis
Stool softeners: therapeutic uses

Psyllium: decrease diarrhea.
Docustate: relieves constipation.
Bisacodyl: preprocedure for colon evactuation, it sttimulates.
Magnesium hydroxide or milk of magnesia (MOM): rapid stool evacuation
Stool softeners: drugs

psyllium, docustate, bisacodyl, magnesium hydroxide or milk of magnesia or M.O.M.
Stool softeners: adverse effects

bronchospasm, cramps, nausea
Stool softeners: contraindications

fecal impaction, obstructions. hypersensitivity, abdominal pain, dysphagia.
Stool softeners: med/ food interactions

decreased absoprtion of warfarin. caution with diet restricted clients.
Stool softeners: nursing interventions

monitor bowel finctions
Stool softeners: med administration

administer with water or juice. Shake solution well.
Stool softeners: evaluation of med effectiveness

soft forms stool and bowel function
Stool softeners: client education

educate regarding activities and moving. promote bowel elimination. Increased fluid and
fiber intake.
3. What is the common cause of urinary incontinence of Mrs. P?

Weak bladder muscles
Weak pelvic floor muscles
Damage to nerves that control the bladder
4. How can you stop incontinence in older adult?

Changing your way of life may help with bladder issues. Some bladder problems can be relieved
by losing weight, quitting smoking, saying "no" to alcohol, drinking water instead of other
drinks, and limiting drinks before bedtime. Preventing constipation and avoiding hard lifting
may
also aid in the treatment of incontinence. Pelvic muscle exercises (also known as Kegel
exercises) work the muscles that is used to stop also the urine incontinence.
5. Is incontinence a normal part of aging, explain?
In the elderly, urinary incontinence is a common and painful problem. Its reasons include
anatomical abnormalities in vesical muscle, reduced brain regulation, and alterations in the lower
urinary tract caused by aging. Incontinence can also be caused by medication. Urinary
incontinence is not normal, although it is frequent in older persons and can significantly reduce
quality of life and independence. A abrupt change in continence should prompt a search for
reversible disorders such as infection, constipation, or a side effect of medication.
SUBMITTED BY:
REYES, SHARRA MAY
PANGILINAN, SHERRILYN
PUNZALAN, ANGEL
TACDERAS, ALYSSA
TARUC, HAROLD
TIGLAO, AYEZA NICOLE
VALERIANO, JIMBO

Cu Task 11 Urinary Problems

Uploaded by

Copyright:

Available Formats

Cu Task 11 Urinary Problems

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Cu Task 11 Urinary Problems

Uploaded by

Copyright:

Available Formats

Case Scenario A:

2. Make a drug study of hydrochlorothiazide and stool softener

Dosage: Oral Solution

Dosage: Children over 6 Months

Dosage: Children under 6 Months

Stool softeners: therapeutic uses

Stool softeners: drugs

Stool softeners: adverse effects

Stool softeners: contraindications

Stool softeners: med/ food interactions

Stool softeners: nursing interventions

Stool softeners: med administration

Stool softeners: evaluation of med effectiveness

Stool softeners: client education

3. What is the common cause of urinary incontinence of Mrs. P?

4. How can you stop incontinence in older adult?

You might also like