Chapter 28 Genitourinary Conditions Facilitating Genitourinary Health Good

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 • 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 p. H 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, (6 th ed. ). Philadelphia: Lippincott, Williams & Wilkins (ISBN 0 -7817 -4428 -8).