Chapter 34: Urinary Elimination; Factors Influencing Urinary Elimination

Question 1

Factors Influencing Urinary Elimination

Answer 1

Growth and Development
Sociocultural Factors
Psychological Factors
Personal Habits
Fluid Intake
Pathological Conditions
Surgical Procedures
Medications
Diagnostic Examiniation

Question 2

Growth and Development

Answer 2

• Children- cannot control voiding until 18-24 months, toilet training
• Older adults- decrease in bladder capacity, unable to to hold urine causes the initial desire to void and an urgent need to void, also increased risk for incontinence as a result of chronic illnesses, and mobility

Question 3

Sociocultural Factors

Answer 3

• Privacy vs.. communal
• Acceptable to assist in elimination practices
• Social expectations, can interfere with timely voiding

Question 4

Psychological Factors

Answer 4

• Anxiety and stress- sense of urgency

* Depression- decrease desire for urinary continence

Question 5

Personal Habits

Answer 5

Privacy and time

Question 6

Fluid Intake

Answer 6

Fluid- increase or decrease output depending on intake
Alcohol- decreases anti-diuretic hormones, increase urine production
Caffeine- prompt bladder contractions, which increase frequency, urgency, and incontinence

Question 7

Pathological Conditions

Answer 7

• Diabetes, MS, and stroke- alter bladder contractility and the ability to sense bladder filling; causing either bladder overactivity or deficient bladder emptying
• Arthritis, Parkinson’s, Dementia and chronic pain- interfere with timely access to a toilet
• Spinal Cord injury- loss of urine control because of bladder overactivity and impaired coordination between the contracting bladder and urinary sphincter
• Prostatic Enlargement- obstruction of bladder outlet, leading to urinary retention

Question 8

Surgical Procedures

Answer 8

Indwelling urinary catheter

Anesthetics- decrease bladder contractility and/or sensation of bladder fullness, causes retention

Question 9

Medications

Answer 9

Diuretics- Increase output
Some drugs- change color of urine
Aniticholinergics- urinary retention by inhibiting bladder contractility
Hypnotics and sedatives- reduce ability to recognize and act on the urge to void

Question 10

Diagnostic Examinations

Answer 10

Cystoscopy- localized trauma of urethra

-UTIs