A nurse is talking with a 65-year-old client who asks if she could discuss a pro

Question

A nurse is talking with a 65-year-old client who asks if she could discuss a problem that she is embarrassed to talk about with her physician. She states she has been having increasing problems with incontinence. She has noted that every time she coughs or sneezes, she notices a loss of urine. She has not had any fever or chills and has not pain with urination. She asks the nurse if she should tell her physician about the problem or does she think it is just a sign of getting older? What should the nurse say to the patient? What type of incontinence is likely present in this client and why? What is the underlying etiology of the type of incontinence you chose in the question above? What are three other types of incontinence? Compare and contrast the etiology and clinical manifestations. What specific change associated with aging may impact incontinence in this age group?

Explanation / Answer

1. The nurse sholud advise the patient to talk freely with the physician, as the physician should know the condition of the patient for her proper diagnosis and treatment.

2. Urinary incontinence (UI), is commonly known as involuntary urination, is the leakage of urine. It is a common problem and is twice as common in women as compared to men. Pregnancy, childbirth, and menopause are major risk factors for UI. It has been identified as an important issue in geriatric health care.

The type of urinary incontinence likely to be present in this patient are stress urinary incontinence beacuse people with stress incontinence may experience problems while they are laughing, coughing, sneezing, lifting, exercising or standing up.

3. The underlying etiology of this urinary incontinence is because after menopause, estrogen production decreases and in some women urethral tissue will demonstrate atrophy with the tissue of the urethra becoming weaker and thinner. Stress urinary incontinence is caused by loss of support of the urethra which is usually a consequence of damage to pelvic support structures as a result of childbirth. It is characterized by leaking of small amounts of urine with activities which increase abdominal pressure such as coughing, sneezing and lifting. Additionally, frequent exercise in high-impact activities can cause athletic incontinence to develop.

4. The three other types of incontinence are:

Treatments include pelvic floor muscle training, bladder training, and electrical stimulation, However, the benefit of medications is small and long term safety is unclear.

5. Changes associated with aging which impact incontinence are associated with menopause, decrease in estrogen production and in some women urethral tissue will demonstrate atrophy with the tissue of the urethra becoming weaker and thinner and may be due to loss of support of the urethra which is usually a consequence of damage to pelvic support structures as a result of childbirth.

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