Quiz 48: Urinary Elimination
Mr. John Baker is an aged 66 year old client who is diagnosed with hematuria, urinary retention and fever. He is also experiencing frequent urinations during the night time, difficulty in the starting of urinations and also experiences dribbling afterwards. All these symptoms clearly depicts that he is suffering from impaired urinary elimination. It may also be caused by obstruction of the bladder neck in case of enlargement of the prostate gland. Also in old people the bladder muscle tone diminishes, which causes increase in the frequency of urination and nocturia. Also with increasing age the ability of the kidney to concentrate urine also reduces. Diminished contractibility and bladder muscle tone also results in retention of urine in the bladder after voiding or incomplete voiding. Mobility problems and neurologic impairments may also cause urinary incontinence.
With age, significant changes occur in the urinary bladder. In healthy older adults, the bladder capacity increases with age, and the ability to completely empty the bladder gets diminished. Older adults may have difficulty in getting to the toilet at the time of the urge of urination, but they do not ignore the urge to urinate. With age, the ability to produce concentrated urine by the kidney gets diminished. The kidney functioning gets reduced with age, which can be due to several reasons such as a decrease in the number of nephrons which are the functional unit of the kidney and are primarily involved in filtering of urine. Hence, the options 1, 2 and 3 are incorrect. In healthy older adults, even though the capacity of the bladder increases, still the bladder muscle tone and its contractibility get diminished. This results in increasing the retention of the urine in the bladder after voiding. This also increases the risk of encountering bacterial infection Hence, the correct answer is the option .
Mr. John Baker is an aged 66 year old client who is diagnosed with hematuria, urinary retention and fever. He is also experiencing frequent urinations during the night time, difficulty in the starting of urinations and also experiences dribbling afterwards. All these symptoms clearly depicts that he is suffering from impaired urinary elimination along with obstruction of the bladder neck due to enlargement of the prostate gland. The client is being recommended for a surgery by the primary care provider. The nurse needs to validate the client and his relatives of the surgery. The nurse should explain the need of surgery to the client and his relatives. Some of the important points that should be mentioned are as follows: 1. Decreased contractibility and bladder muscle tone results in retention of urine in the bladder after voiding or incomplete voiding. This is one of the major factors that increase the risk of bacterial growth and infection in such people. Hence, in order to avoid such complications, it is beneficial to go for surgery in the initial stages. 2. It is also essential to treat impaired urinary functioning as early as possible as this increases the risk for excess fluid volume or deficient fluid volume. It is also required because incontinence can be emotionally and physically distressing to the client as this is socially unacceptable. 3. It is also required as incontinence can also increase the risk for impaired skin integrity, which can occur due to saturation of bed linens and clothes with urinate, which may macerate the skin of the client.