: urinary tract changes in older adult

7/30/2019 : Urinary Tract Changes in Older Adult

1/14

Urinary Tract Changes inOlder Adults

Presented by: Group 6


2/14

Although bladder disorders are common

among the elderly population, bladderdisorders are not a normal part of aging

or of being in an institution. Therefore,

when properly assessed and treated,

bladder function can be corrected in

about 30% of residents of extended care

facilities and suitably managed and

controlled in the rest.


3/14

Muscle tone decreases

decrease theelasticity of the ureters, bladder, and

urethraamount of urine the bladder can hold

is reduced (bladder capacity decreases)

elderly person will not be aware of the need to

void until their bladder is almost full

Frequency(the need to urinate

often),Urgency(an immediate need to urinate ),Nocturia( waking at night to

urinate),Incontinence(inability to hold urine )

Alterations:


4/14

The sensory nerve tracts from the

bladder (through the spinal cord) to

the brain often wear out, creatingbreaks in the neural pathway.

Consequently, there is a short-

circuiting of nerve firing andmessages from the urinary system

may not completely reach the brain.

In general, the nervous system takes

longer to respond to sensory stimuli.

This causes the bladder urge

sensation (telling the person to void)

to be delayed.


5/14

Due to an incomplete nerve

pathway there is an increase in

bladder spasms or bladder

overactivity small frequent

contractions that create the urge to

void before the bladder is fullThese

bladder contractions cause urine

leakage (urinary urge incontinence)


6/14

The bladder does not empty

completelycapacity of the bladderis decreasedneed to void often in

small amountsThe urine that

remains in the bladder after the

person has voided (post-void residual,

or PVR) may become infected with

bacteriaincreased incidence of

urinary tract infection.


7/14

Immobility incomplete emptying of

the urine from the bladder andkidneysurine is retained too long as

with any fluid standing stillbegins to

grow bacteriaresulting in infection

and development of kidney stones

(calculi).


8/14

the pelvic floor muscles normally get

weakened with age(especially in

womenthese pelvic muscles

sometimes grow so weak that the

bladder and urethra prolapse, or fall

into the vaginaolder women maybecome incontinent, or lose urine

involuntarily.


9/14

Urine flow can also be blocked by an

enlarged prostate gland in men(BPH,and is

common in aging men)

Tissue artophy

Reduced ability of the tubule cells toselectively secrete and reabsorb fluid and

electrolytes alterationDecreased

GFRmaybe due to multiple

medicationsincrerased risk of adverse

drug affects and drug - drug interaction.


10/14

Decreasedtheir thirst stimulation

already diminished fluid volumedeficit prone to develop

hypernatremia.


11/14

Nursing Management:

Prevent urinary stasis by:

- encourage liberal fluid intake (The

fluid intake and output must be accurately

measured for all patients with any urinary

related issues. Unless a patient is on fluid

restrictions they should be offered fluids

frequently and have them fresh and

readily available at their bedside. Fluidsshould include a variety of juices, tea,

soups and most of all water.


12/14

Adequate hydration keeps the urinary

system clean and prevents urine from

becoming concentrated. The fluidintake should be no less then 2500 cc

every day. Unless fluids are being lost

through excessive perspiration,vomiting or diarrhea the output

should be approximately 2000 cc ( if

their intake was 2500cc).

- encourage frequent change in

position

- encourage ambulation


13/14

Prevent skin breakdown by thorough

cleansing.

Keep the patient covered up with a

call light in reach espacially if patient is

experiencing nocturia

Early recognition of urinary tract

infection and other renal diorders.

Promptly respond to call for bathroom

or bed pan (If you have a mobile

patient it is best to have a hat in the

commode to catch the urine.)


14/14

: urinary tract changes in older adult

Documents