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Chapter 28 Genitourinary Conditions. Facilitating Genitourinary Health. Good fluid intake Maintenance of an acidic urine Activity Frequent toileting Annual GYN exam for older women and annual PSA testing for older men Testicular self-examination for men. Types of Urinary Incontinence.
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Facilitating Genitourinary Health • Good fluid intake • Maintenance of an acidic urine • Activity • Frequent toileting • Annual GYN exam for older women and annual PSA testing for older men • Testicular self-examination for men
Types of Urinary Incontinence • Stress • Urgency • Neurogenic • Functional • Mixed
Factors to Assess for Incontinence • Medical history • Medications • Functional status • Cognition • Neuromuscular function in lower extremity • Urinary control and retention • Bladder fullness and pain
Factors to Assess for Incontinence (cont.) • Elimination pattern • Fecal impaction • Symptoms • Diet • Reactions to incontinence
Measures to Improve Urinary Functioning • Stress Incontinence • Kegel exercises, biofeedback, and medications (e.g., estrogen, anticholinergics) • Urgency Incontinence • Adherence to a toileting schedule, Kegel exercises, biofeedback, and medications (e.g., anticholinergics, adrenergic antagonists)
Measures to Improve Urinary Functioning (cont.) • Overflow Incontinence • Adherence to a toileting schedule, the use of the Crede method, intermittent catheterization, and medications (e.g., parasympathomimetics) • Functional Incontinence • Improvement of mobility; provision of a bedside commode
Risk Factors and Symptoms of Bladder Cancer • Risk Factors • Bladder irritation • Cigarette smoking • Symptoms • Painless hematuria • Frequency
Risk Factors for Renal Calculi • Immobility • Infection • Dehydration • Hypercalcemia
Symptoms of Renal Calculi • Pain • Hematuria • Symptoms of UTI
Symptoms of Glomerulonephritis • Fever • Headache • Altered mental status • Anorexia • Edema
Treatment of Glomerulonephritis • Antibiotics • Restricted sodium and protein diet • Close attention to fluid intake and output
Treatment of Valvulitis • Treat and manage any underlying cause. • Maintain good nutritional status helps improve the condition. • Use sitz baths and local applications of saline compresses or steroid creams. • Keep the incontinent patient clean and dry as much as possible.
Postmenopausal Changes Affecting the Vaginal Canal • Reduction in collagen and adipose tissue • Shortening and narrowing of the vaginal canal • Decreased elasticity • Less vaginal lubrication • A more alkaline vaginal pH as a result of lower estrogen levels
Symptoms and Treatment of Cervical Cancer • Symptoms • Vaginal bleeding • Leukorrhea • Pain does not usually occur. • Urinary retention or incontinence, fecal incontinence, and uremia • Treatment • Radium or surgery
Factors Influencing the Incidence of Cancer of the Endometrium • Obesity • Diabetes • Hypertension
Symptoms of Problems of Fallopian Tubes and Ovaries • Early symptoms are nonspecific. • Later symptoms include: • Bleeding • Ascites • Masses
Common Types of Herniation • Cystocele • Rectocele • Prolapse of the uterus
Symptoms of Benign Prostatic Hyperplasia • Dysuria • Hesitancy • Frequency • Nocturia • Poor urinary control
Late Symptoms of Prostate Cancer • Back pain • Anemia • Weakness • Weight loss
Palliative Treatment of Prostate Cancer • Irradiation • Transurethral surgery • Orchiectomy • Estrogens
Source • Eliopoulos, C. (2005). Gerontological Nursing, (6th ed.). Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).