An elderly resident of a long-term care facility frequently wakes up to urinate during the night. What physiological change associated with normal aging could be the cause of this?
Reduced kidney ability to concentrate urine.
Lower fluid intake during daytime hours.
Enhanced bladder contractility leading to urinary stasis.
Increased bladder muscle tone leading to frequent urination.
The Correct Answer is A
Choice A rationale:
Reduced kidney ability to concentrate urine is a common physiological change associated with normal aging. This is due to several factors, including:
Decreased glomerular filtration rate (GFR): The kidneys filter waste products from the blood. As we age, the number of functioning nephrons (filtering units) in the kidneys decreases, leading to a decline in GFR. This means that the kidneys are less able to filter waste products and concentrate urine.
Decreased renal blood flow: Blood flow to the kidneys also decreases with age. This further reduces the kidneys' ability to filter waste products and concentrate urine.
Decreased tubular function: The tubules in the kidneys are responsible for reabsorbing water and electrolytes from the urine. As we age, the function of the tubules also declines, leading to a decrease in the ability to concentrate urine.
As a result of these changes, older adults often produce more urine, even at night. This can lead to nocturia, which is the need to wake up to urinate two or more times per night.
Choice B rationale:
Lower fluid intake during daytime hours can also contribute to nocturia, but it is not a direct physiological change associated with normal aging. Older adults may drink less fluids during the day for a variety of reasons, such as decreased thirst sensation, fear of incontinence, or limited access to fluids. However, even if they maintain adequate fluid intake during the day, they may still experience nocturia due to the reduced ability of their kidneys to concentrate urine.
Choice C rationale:
Enhanced bladder contractility leading to urinary stasis is not a typical physiological change associated with normal aging. In fact, bladder contractility often decreases with age, which can lead to difficulty emptying the bladder completely. This can contribute to urinary frequency and urgency, but it is not typically a cause of nocturia.
Choice D rationale:
Increased bladder muscle tone leading to frequent urination is also not a typical physiological change associated with normal aging. Bladder muscle tone may decrease with age, which can lead to difficulty emptying the bladder completely. However, it is not typically a cause of nocturia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Sims' position is a side-lying position with the lower leg flexed and the upper leg extended. It is not ideal for bladder scanning because it can compress the bladder and make it difficult to obtain an accurate reading.
Additionally, in Sims' position, the bladder may not be fully accessible to the scanner, as it may be partially obscured by the upper thigh.
Choice B rationale:
Dorsal recumbent position is the optimal position for bladder scanning. In this position, the client lies flat on their back with their knees bent and their feet flat on the bed. This position allows for:
Full exposure of the bladder, making it easily accessible to the scanner.
Relaxation of the abdominal muscles, which can help to ensure an accurate reading.
A comfortable position for the client, promoting cooperation and reducing the likelihood of movement that could interfere with the scan.
Choice C rationale:
Supine position is a similar position to dorsal recumbent, but with the legs fully extended. While it is possible to perform a bladder scan in this position, it is not as ideal as dorsal recumbent because:
The extended legs can place some tension on the abdominal muscles, potentially affecting bladder position and the scan's accuracy.
The client may find this position less comfortable, leading to restlessness and potential movement that could interfere with the scan.
Choice D rationale:
High Fowler's position is a semi-sitting position with the head of the bed elevated at a 45- to 60-degree angle. This position is not suitable for bladder scanning because:
Gravity can pull the bladder downwards, making it difficult to visualize and measure accurately.
It can be challenging to maintain proper positioning of the scanner on the abdomen in this position, potentially leading to inaccurate readings.
Correct Answer is D
Explanation
Choice A rationale:
Episodic urinary incompetence is not a recognized medical term. It's important to use accurate terminology in healthcare to ensure effective communication and understanding.
Choice B rationale:
Episodic normal micturition refers to occasional instances of normal urination. It does not describe the involuntary leakage of urine that occurs with sneezing.
Choice C rationale:
Episodic uncontrolled anuria refers to a temporary absence of urine production. This is a serious condition that requires immediate medical attention, as it can lead to kidney failure. It is not consistent with the client's report of involuntary urine leakage upon sneezing.
Choice D rationale:
Episodic urinary incontinence is the involuntary loss of urine that occurs at specific times or events, such as sneezing, coughing, laughing, or exercising. This is the most accurate description of the client's symptoms.
Key points about episodic urinary incontinence:
It is a common condition, affecting millions of people worldwide.
It can be caused by a variety of factors, including weakened pelvic floor muscles, overactive bladder, urinary tract infections, and neurological conditions.
It can have a significant impact on a person's quality of life, causing embarrassment, social isolation, and anxiety. There are a number of treatment options available, including behavioral therapies, medications, and surgery.
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