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Dementia
Published in Henry J. Woodford, Essential Geriatrics, 2022
Dementia increases the risk of developing incontinence. Factors can include forgetting where the toilet is, mobility problems, disinhibition, not recognising the toilet, loss of the sensation of need, plus the other causes of incontinence (see page 257). Cholinesterase inhibitors can provoke urinary incontinence (see later) and anticholinergic drugs must be avoided. A toileting schedule can be tried. Diary monitoring might be used to establish the most useful times. Toilet reminders may help, i.e. ‘before you sit down…' Velcro or elasticated clothing can be easier to remove. Practical steps at home can include a waterproof mattress cover, washable covers and bin bags over the cushions on chairs. Containment pads might be accepted. Getting up at night for the toilet can be reduced by limiting fluids in the hours before bedtime. Nightlights (possibly motion-activated) can be put along the route to the toilet.
Meeting personal needs: elimination
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Jean should be encouraged to do this by herself as soon as possible following recovery from the effects of surgery. She should be supervised as she goes through the following steps: Encourage her to find the best position, such as sitting on the toilet or kneeling or standing beside it.Put toilet paper in the toilet bowl to avoid splashback.Open the tap/clip/Velcro end of the bag and drain into the toilet bowl.Squeeze out all the contents.Close and clean the tap/clip/Velcro on the outside to avoid staining clothing.Flush the toilet and wash her hands (Stoma Care 2007).
Fluid balance and continence care
Published in Barbara Smith, Linda Field, Nursing Care, 2019
Risk factors include: sex, age, cognitive impairment, Parkinson’s disease, dementia, cerebrovascular accident, heart failure and diabetes. Poor mobility/dexterity, failing eyesight, poorly fitting footwear, long toenails, breathlessness and environmental factors that can make it harder to use a toilet can also contribute to the problem (Yates, 2018a). This type of incontinence can also be associated with some practices carried out in healthcare facilities; this is called iatrogenic incontinence. The following are some examples (Stone, 1991): The patient is unable to locate the toiletThere is no access to a urinal or commode and the patient is unable to reach the toiletThere is a delayed response to the nurse-call bellThe use of certain medication, such as diuretics, sedatives, anticholinergics and anti-Parkinson drugs, which can lead to increased diuresis
Lichen sclerosus of the vulva
Published in Climacteric, 2021
An open trial of topical steroid followed by maintenance daily treatment (cold cream) showed that symptom relief was achieved. However, it was not certain whether the effect was that of the emollient or a long-term effect of steroid [36]. A randomized trial of topical vitamin E cream compared to emollient following an initial treatment with topical corticosteroid showed a similar relapse rate over a 1-year period, suggesting that vitamin E does not appear to have any advantage over an emollient [37]. Emollients may give symptom relief after an initial treatment with topical steroids. Women with LSV must be encouraged to use emollients. Of note, fewer symptoms are experienced by women with LSV by wearing silk rather than cotton panties [38]. When cleansing the genital area it is important to use little soap and not to harm the skin by over-washing or using abrasive towels. Moist toilet paper should also not be used. It should be pointed out that tight clothing and sports activities that stress the anogenital skin may function as a trigger. Soft bicycle saddles should be recommended. Some sports, notably horseback riding and bicycle riding, are only feasible to a limited extent because they strain the genital area too much. Tight clothing must be avoided as this can act as a trigger for pain.
Towards an “age-friendly-hospital”: Older persons’ perceptions of an age-friendly hospital environment in Nigeria.
Published in Cogent Medicine, 2020
Perpetua Lum Tanyi, André Pelser
The majority of the participants faced common problems related to the bathroom which was slippery, unhygienic, dirty and smelling. Further, patients—especially those who suffered from arthritis—also had problems using toilets. Few of the participants complained that bed covers and bed sheets were dirty and were not changed on time. Some of the participants explained it as follows: I am an asthma patient so I have difficulty in going to-and-from the toilet since it is very far from my bed. Also, having arthritis it is difficult for me to use the toilet because the toilet pot is too low and dirty.[In patient, 67 year, old man]Most of the older persons are from a village background so they don’t know how to use a western toilet properly. [Key Informant, 55year old, male].
MAGAM II – prospective observational multicentre poisons centres study on eye exposures caused by cleaning products
Published in Clinical Toxicology, 2019
Maren Hermanns-Clausen, Herbert Desel, Elke Färber, Carola Seidel, Angelika Holzer, Florian Eyer, Antje Engel, Dagmar Prasa, Erol Tutdibi, Andreas Stürer
Within the group of automatic dishwashing agent eye exposures, 5.6% of study cases showed moderate eye injuries comparable to 6.7% moderate cases within the group of hand dishwashing agents. At 25% the rate of moderate cases is remarkably high in the group of drain cleaners (1 of 4 cases). Other product groups with a relatively high rate of moderate chemical injury are toilet cleaners (18%), oven cleaners (15%), and automatic dishwashing rinse aids (14%). Because drain cleaners, as well as oven cleaners, commonly contain sodium hydroxide or potassium hydroxide, a high rate of chemical eye burns could be expected [4,9,14]. Hydrochloric acid or other acids (formic acid, acetic acid and other), or sodium hypochlorite are the main ingredients in toilet cleaners.