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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
• 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).