DETAILED ANSWERS|LATEST
Explain the functions of the kidney. - ANSWER 1. Filtration
2. Fluid balance (ADH and Aldosterone)
3. Erythropoietin production when sats are low
4. Acid/base balance (use of Bicarb)
5. Bone health (conversion of vitamin D to active form)
6. Blood pressure regulation (RAAS)
Explain the different kinds of incontinence. - ANSWER Stress- involuntary loss r/t
incompetent sphincter
Urge- "gotta go and I have to go now" r/t overactive detrusor muscle, contracts before it's
supposed to
Mixed- Urge and stress
Overflow= r/t obstruction, urine leaks AROUND obstruction
Incomplete= does not empty all the way
Functional= R/t something outside the kidney (i.e. immobility, AMS)
Transient= involuntary loss of urine that comes and goes with various conditions (severe
constipation, pregnancy)
1
, Explain medications used to treat incontinence. - ANSWER Hormones= estrogen; may
increase blood flow and nerve conduction to the urinary tract
Anticholinergics= suppress involuntary bladder contraction (Tolteridone, Oxybutynin, etc.)
Alpha adrenergic agonists= increases contractile force of sphincter, increased resistance to
urine outflow (Midodrine)
Beta 3 Agonists= Relax detrusor muscle to increase badder capacity and urine storage
(Mirabegron)
Antidepressants= Increase norepi and serotonin which is thought to strengthen the urinary
sphincter (Imipramine, Amitriptyline)
Explain bladder training. - ANSWER For pt's who are A/O
Assess pt's CURRENT voiding patterns (i.e. 45 min intervals between peeing) and consistently
increase intervals between urination by 15 minutes
Goal is to increase intervals to Q 3-4
If incontinent, reduce intervals by 15 min
Explain habit training. - ANSWER FOR COGNITIVELY IMPAIRED
Offer bedpan or toilet every 2 hours (Adjusted schedule for each pt)
If incontinent, reduce intervals by 30 min until continent
Explain factors that contribute to UTI's and why. - ANSWER Obstruction prevents
complete emptying, creating a continuous pool of urine where bacteria grow.
Stones can cause obstruction and their rough surface causes mucosal damage, creating an
ideal spot for bacteria to grow.
2
Explain the functions of the kidney. - ANSWER 1. Filtration
2. Fluid balance (ADH and Aldosterone)
3. Erythropoietin production when sats are low
4. Acid/base balance (use of Bicarb)
5. Bone health (conversion of vitamin D to active form)
6. Blood pressure regulation (RAAS)
Explain the different kinds of incontinence. - ANSWER Stress- involuntary loss r/t
incompetent sphincter
Urge- "gotta go and I have to go now" r/t overactive detrusor muscle, contracts before it's
supposed to
Mixed- Urge and stress
Overflow= r/t obstruction, urine leaks AROUND obstruction
Incomplete= does not empty all the way
Functional= R/t something outside the kidney (i.e. immobility, AMS)
Transient= involuntary loss of urine that comes and goes with various conditions (severe
constipation, pregnancy)
1
, Explain medications used to treat incontinence. - ANSWER Hormones= estrogen; may
increase blood flow and nerve conduction to the urinary tract
Anticholinergics= suppress involuntary bladder contraction (Tolteridone, Oxybutynin, etc.)
Alpha adrenergic agonists= increases contractile force of sphincter, increased resistance to
urine outflow (Midodrine)
Beta 3 Agonists= Relax detrusor muscle to increase badder capacity and urine storage
(Mirabegron)
Antidepressants= Increase norepi and serotonin which is thought to strengthen the urinary
sphincter (Imipramine, Amitriptyline)
Explain bladder training. - ANSWER For pt's who are A/O
Assess pt's CURRENT voiding patterns (i.e. 45 min intervals between peeing) and consistently
increase intervals between urination by 15 minutes
Goal is to increase intervals to Q 3-4
If incontinent, reduce intervals by 15 min
Explain habit training. - ANSWER FOR COGNITIVELY IMPAIRED
Offer bedpan or toilet every 2 hours (Adjusted schedule for each pt)
If incontinent, reduce intervals by 30 min until continent
Explain factors that contribute to UTI's and why. - ANSWER Obstruction prevents
complete emptying, creating a continuous pool of urine where bacteria grow.
Stones can cause obstruction and their rough surface causes mucosal damage, creating an
ideal spot for bacteria to grow.
2
