Presentation on theme: "How Can Your Nurse Advisor Help You? Presented by (insert name of presenter here)"— Presentation transcript:
How Can Your Nurse Advisor Help You? Presented by (insert name of presenter here)
Role of Nurses recogniseHelp to recognise patients who have problems maintaining continence helpadviceOffer help and advice to patients and relatives
How to Recognise Patients with an Overactive Bladder Symptom assessment Medical history Physical examination Urinalysis Bladder diary Pad test Referral for medical evaluation and treatment
Symptom Assessment In total, how many times do you go to the toilet in a 24-hour period? How often do you go to the toilet during the day? How often do you wake to go to the toilet during the night? How often do you feel a strong and sudden desire to urinate? If you fail to go to the toilet in time, how much urine do you usually leak? Do you leak urine when you laugh, cough, sneeze, jump or run?
Medical History Other questions that your doctor/nurse might ask: History of previous surgery or radiotherapy involving the pelvic region Medications currently taking Main symptoms (complaints) Duration of symptoms
Referral for Further Evaluation and Treatment Patients are considered for referral if: Symptoms do not respond to initial treatment within 2-3 months Blood in urine without infection on urine test
Referral for Further Evaluation and Treatment Symptoms suggestive of bladder obstruction Evidence of unexplained neurologic or metabolic disease (e.g. renal failure, diabetes insipidus)
Management of Overactive Bladder Drug therapy Bladder training Incontinence pads and protective devices Bladder self-catheterization Pelvic floor exercises Biofeedback Review diet and food intake Skin care and cleanliness Surgery
Bladder Training A behavioural approach to the treatment of the overactive bladder, which is often used in combination with drug therapy.
Bladder Training Aims: Increase the time intervals between bladder emptying. Increase bladder capacity by teaching patients to resist and suppress the urge to pass urine.
Incontinence Pads and Protective Equipment Absorbent pads Dribble pouch Reusable underpants designed to carry disposable absorbent pads All-in-one briefs Chair and bed pads
Incontinence Pads and Protective Equipment do not treat These do not treat the cause of the problem. At best, they are a passive form of management for only one of the symptoms (i.e. urge incontinence).
Incontinence Pads and Protective Equipment temporary supplementary Ideally, incontinence pads should be used only as a temporary or supplementary measure while the results of drug therapy or bladder training come into effect.
Bladder Catheterization will not be adequateFor some patients, drug therapy and bladder training will not be adequate to manage their symptoms. For example, patients with a spinal cord injury may be unable to empty their bladder completely.
Pelvic Floor Exercises Locate pelvic floor muscles Squeeze pelvic floor muscles as tightly as possible for a few seconds (maximum of 10 seconds) Relax completely for at least 10 seconds Repeat, as recommended by physician/ continence advisor
BiofeedbackBiofeedback Aim: Helps patient identify the correct muscle for performing Kegel exercises
Review Diet and Fluid Intake Some patients will try to reduce the risk of leakage by restricting their fluid intake.
Review Diet and Fluid Intake irritate the bladder However, drinking too little results in concentrated urine, which itself can irritate the bladder.
Review Diet and Fluid Intake Therefore, it is important that patients are encouraged to drink appropriate amount of fluids.
Review Diet and Fluid Intake Reduce Reduce consumption of: Caffeine (i.e. tea and coffee) Carbonated soft drinks Alcoholic drinks
Skin Care and Cleanliness Tips: The skin around the perineum and groin needs to be cleaned whenever the area becomes soiled with urine and faeces.
Skin Care and Cleanliness Tips: Do not over powder as this will cause caking.
Skin Care and Cleanliness Tips: Do not use alcohol based products which will cause over- drying of the skin.
Good Bladder Habits Step 1 Step 1: Maintain appropriate fluid intake Step 2 Step 2: Practice good toilet habits Step 3 Step 3: Maintain good bowel habits Step 4 Step 4: Exercise of pelvic floor muscles
Step 1 Maintain appropriate fluid intake 6 - 8 glasses of water per day, unless contrary to doctor’s advice. Limit intake of caffeine, i.e. coffee, soft drinks or tea Limit intake of alcohol as it increases urine production
Step 2 Practice good toilet habits Allow plenty of time to empty the bladder Ensure bladder is completely empty each time urine is passed Avoid going to the toilet “just in case” as this results in the bladder developing a smaller capacity
Step 3 Maintain good bowel habits Maintain regular bowel movements and avoid constipation
Step 4 Exercise pelvic floor muscles Exercise pelvic floor muscles regularly Keep weight down Obesity puts an additional stress on the pelvic floor muscles