: urinary tract changes in older adult
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Urinary Tract Changes inOlder Adults
Presented by: Group 6
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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.
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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:
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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.
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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)
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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.
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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).
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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.
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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.
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Decreasedtheir thirst stimulation
already diminished fluid volumedeficit prone to develop
hypernatremia.
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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.
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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
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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.)
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