Management of Incontinence in the Geriatric Client
Pertinent Positives
- History of mild alcohol consumption
- History of persistent post-birth urinary incontinence with or without activity
- Family history of hypertension
- History of UTI and vitamin D deficiency and constipation
- History of hypothyroidism (a risk factor for Multiple sclerosis) and Hypocalcemia
- Sexual inactivity/menopause, divorced, and lives alone
Pertinent Negatives
- Normal vaginal deliveries without pre and post-birth complications
- History of normal Menarche experienced at the age of 12 years
- Normal chest exam, normal cardiovascular, and no previous history of EKG
- No history of cigarette smoking and use of other illicit drugs
- No known food or environmental allergies
- No history of major trauma and no recent surgical operation
Missing Information
There is no comprehensive psychological examination to assess the client’s emotional variability. As noted by Spencer, McManus & Sabourin (2017), incontinence is prevalent among older people due to psychological changes that come with aging. Social and mobility information about the client is not incomplete. The patient lives alone, and information about her mobility capability is missing. Decreased mobility due to old age exacerbates incontinence in adults (Bedretdinova, Fritel, Zins & Ringa, 2016). The missing information makes it difficult to make a more accurate diagnosis. Also, the patient assessment does not provide the client’s ethnic and dietary information, which is critical in the diagnosis.
Differential and Actual Diagnosis
Based on the subjective and objective of the patient under examination, possible differential diagnoses include the following: Multiple Sclerosis, Vaginitis, Urinary Tract Infection, Prostatitis, Spinal Epidural Abscess, and Uterine Prolapse in Emergency Procedures. Based on the provided information, the actual diagnosis for the patient is vaginitis.
Plan for Priority Diagnosis
The primary aim of managing vaginitis is to stop the condition from worsening and prevent risk factors that may increase severity. The patient should first stop her thyroid medication. Avoid sprays and heavily perfumed soaps when cleaning the vaginal area. Besides, the patient will be prescribed metronidazole and clotrimazole to manage suspected urinary tract infections. Finally, the patient is advised to maintain high levels of hygiene.
References
Bedretdinova, D., Fritel, X., Zins, M., & Ringa, V. (2016). The Effect of Urinary Incontinence on Health-Related Quality of Life: Is it Similar in Men and Women? Urology, 91, 83-89.
Spencer, M., McManus, K., & Sabourin, J. (2017). Incontinence in Older Adults: The Role of the Geriatric Multidisciplinary Team. British Columbia, Medical Journal, 59(2): 99-105. Retrieved from https://www.bcmj.org/articles/incontinence-older-adults-role-geriatric-multidisciplinary-team
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Question
Management of Incontinence in the Geriatric Client
NU 627 DT 8 Instructions
Unit 8 Discussion – Management of Incontinence in the Geriatric Client
Instructions
It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format.
Discussion Prompt [Due Wednesday]

Management of Incontinence in the Geriatric Client
The topic for unit 8 is the management of incontinence and constipation in the geriatric client. Despite what you may think, urinary incontinence is not normal for aging. However, as a society, we think it is because it is a common complaint. Identifying the exact cause of the incontinence may be difficult since medications and changes in cognitive function could be contributing factors (Spencer, McManus, Sabourin, 2017). As nurse practitioners, what can we do to improve the quality of life for individuals who suffer these complaints?
Spencer, M., McManus, K., & Sabourin, J. (2017). Incontinence in older adults: The role of the geriatric multidisciplinary team. British Columbia, Medical Journal, 59(2): 99-105. Retrieved from https://www.bcmj.org/articles/incontinence-older-adults-role-geriatric-multidisciplinary-team
Initial Post Instructions:
- Please critically evaluate the subjective and objective information provided to you in the attached file below.
The first part of the discussion board is to identify all pertinent positive and negative information and list missing information. - Then create a differential diagnosis list with at least 3 possible actual diagnoses based on your findings.
The second part is to create a plan utilizing clinical practice guidelines for the priority diagnosis. - Be sure to utilize the template and in-text citations and provide full reference citations at the end of the discussion.
