Al

gor
it
hm #1Gener
alAs
ses
smentofBl
adder
Ri
skf
act
orsf
orur
inar
ydys
funct
ion
-
Cogni t
iveimpai rment/memor yimpai rment- -del er
ium/ dement i
a/dis
ori
entationorconf usionorforgetful
nes-li
mit
edmobi l
i
ty
L
-imi
tedmobi l
ity--weaknes sorcompl etel
yi mmobi l
ei noneormor eli
mbs( requir
ings t
abili
zi
ngas si
st
ancewhenoutofbed)
-
Hist
oryofur ologicalconditi
onspr iortohos pit
alizati
on- -previousincontinence,BPH,r etentionorotherpr oblems
Hi
- st
oryofcons t
ipati
onforlongert han3days- -refertoAl gorithm #4and#5
-
Presenceorr ecentr emovalofi ndwel li
ngcat het eri
nt hel ast3days
T
-herapeuticmedi cat
ionswithadver s
es i
deef f
ect s-
-( di
ruet i
cs,choli
nergicsandadr energicmedi cati
ons )
-
Neur ol
ogicalimpai rment--(rel
atedt ostr
oke,t r
aumat icbr aininj
ury,multi
plescl
er osi
s,Parki
nsonsdis
eas e,spinal
cor
dinjury)
-
Diabetes--wi thelevatedbloodgl ucoser eadingscons is
tent l
yabove200mg/ dLandorhi st
oryofporgl ycemi ccont
rol
-
Obes it
y--BMI>30
-
Women- -his
toryofhys t
erectomy,t r
aumat icchi l
dbirth,mul ti
parus,post-
menopaus als
tate,vaginalatrophy

Pr
oceedwi
thScr
eeni
ngQues
ti
onsf
orBl
adderDyf
unct
ion
Ur
gency: Doyoufr
equentlyhaveas tr
ongurgetouri
nate?
St
res
s: Doyouexperi
enceal ossofuri
newhenyous neeze,coughorlaugh?
Fr
equency:
Doyouuri
natemor eoftenthanyouthi
nkyous houl
d?
Doyougot othebathroom sooft
enthati
tint
erfer
eswithyourr
egulardai
l
yact
ivi
ti
es?

Noct
uri
a: Ar
eyoubot
her
edbywaki
ngupatni
ghtt
ogot
othebat
hroom?

Ur
gency: Doyouhaveuncont
rol
labl
eur
gestour
inatet
hats
omet
imesr
est
ulsi
nwet
ti
ngacci
dent
s?
w/LeakageDoyoul
eakur
ineonthewaytot
hebat hr
oom?

Cons
ti
pat
ion:Hasi
tbeent
hreeormor
edayss
inceyourl
astbowel
movement
?

YESt
oanyoft
hes
eques
ti
onswi
l
lneedcl
osemanagementands
uppor
tbynur
si
ngcar
etoi
mpr
oveur
inar
ycont
inence.

CollectData
-
Postafrequency-vol
umechar tint hepatientsr
oom orbat hroom tot r
ackur i
narypatt
erns
-
Notelastvol
umeofur i
nevoi
ded,odor ,color,evi
denceofs edi
mentandt i
mes i
ncelastvoi
d
-
Coll
ectpos t
-voi
dr es
idual
(PVRs )withi
n20mi nutesoft heeachvoi cef oratleastt
wocons ecuti
vevoids
-
Uri
nal
ysiswit
hrefl
extocultur
e- -identi
fyuri
nar yt
ractinfecti
on;seekphys i
ciansupportf
ortreat
ment
-
Notelastbowelmovement( cons t
ipati
onal t
ersregularuri
narypatterns)seeAlgori
thm#4Bowel Ass
essment
-
Compl eteamedi cationr
eview:eval uateformedi cationscontr
ibuti
ngt obladderorbowel dysf
uncti
on

ConductPhys
icalAs
ses
sment
Oral/
Swallow:Evaluat epatientfors
afetol
er anceoft hinl
i
quids,pati
entswithPEG t
ubesatincreasedri
skofdehydrati
on
NeuroExam: As s
es sori
entati
on,commandf oll
owing,recall
ofinfor
mat i
onands ust
ainedattenti
on
Abdomi nal: Palpat ethebl adderabovet hepubi csymphas i
sfordist
ensi
onorspacticit
y
Peri
nealSkin: I
nspectper i
neum andgeni tali
af orr
ash,excori
ation,i
nconti
nence/moisturer
elat
edder mati
ti
sorfungalgr
owth
Uret
hralMeatus:Assessforerythema,obs
truct i
on,orti
ssueerosi
onr el
atedtoprevi
ousindwell
ingorInt
ermit
tentcathet
eruse.

F
unct
ionalAs
ses
sment
:Eval
uat
ethepat
ient
smobi
l
it
yst
atus
,st
andi
ngbal
anceandf
all
ri
skr
elat
edt
otoi
l
ett
rans
fer
s.

I
dent
if
yPr
imar
yBl
adderS
ympt
omsandI
nit
iat
eaPl
anofCar
e

F
orpati
ent
swi
thur
inar
yincont
inence F
orpat
ient
swi
thr
etent
ions
ympt
oms
: F
orpat
ient
swi
thf
unct
ional
sympt
oms
:
s
ymptoms:
I
ndicat edby: -
communi cat i
ondef i
cit
s(aphas i
a,
I
ndicatedby: -
PVRs>150af ter2cons ecutivevoids verbalapraxia,et c)
-
uri
naryurgency,fr
equency -
uri
nar yhes i
tency -
mobi l
i
ty/motori mpai r
mentr equiri
nga
-
leakageofs mall
orlargeamounts -
weakorpul sati
ngur i
nes t
ream deviceorper sonal assi
st
ance
withurgency -
str
ainingt ovoid -
cogniti
veimpai rment
-
painwi t
huri
nati
on -
MENwi t
henl argepr ost
ate/BPH -
envir
onment al/phys i
calbarriersto
-
nocturiawit
hnoct ur
nalpol
yur
ia -
Womenwi t
hpel vicorganpr olapseor propertoil
eti
ng
-
str
ess-
inducedleakagewithcough cystocel e,pelvi
cf l
oordys f
unct i
on -
emot i
onal orps ychologi
cal unwi l
li
ng-
ormovement -
pos t
-voiddr i
bbl i
ng nesstocooper ate(ie.depres i
on)
-
sensat i
onofi ncompl etebladder -
bladderirr
it
atingmedi cati
ons
empt ying
-
leakagewi thaf ullbl
adder

Fol
l
ow Fol
l
ow Fol
l
ow
Al
gor
it
hm #2:Ur
inar
yIncont
inence Al
gor
it
hm #3:Ur
inar
yRet
ent
ion Al
gor
it
hm #2:Ur
inar
yIncont
inence