A 66-year-old female client presents to the ER with c/o lower abdominal pain, nausea, vomiting, and a low-grade fever over the past two days. She is admitted to the medical-surgical unit with the diagnosis of urinary tract infection (UTI). The client’s family reported the client was confused and incontinent with urine that had a “strong odor.” The client is on a clear liquid diet and has an intravenous fluids running (Lactated Ringer’s) at 50 mL/hour.
Instructions
Using the information from the scenario, create a care plan using the attached template.
Student Name: __________________________
Date: ______________________
Client Gender: ____________ Client Age: ________
Client Diagnosis: __________________________________________________________________________________________________
| Assessment data for Nursing Diagnosis | Nursing Diagnosis (3) | Expected Outcomes with Indicators
(1 per Nursing Diagnosis) |
Nursing Interventions
(2 per Expected Outcome) |
Evidence-based Rationale for each Nursing Intervention (Cited/referenced) | Evaluation
(How do you know it worked?) |
Respond to this critical thinking question:
Describe how altered urinary elimination can affect the integumentary system?
Support your response with evidence from credible sources.
Altered urinary elimination can have a significant impact on the integumentary system. The integumentary system comprises the skin and its accessory structures, such as hair, nails, and glands. The skin acts as a protective barrier against environmental factors, regulates body temperature, and helps in the elimination of waste products through sweating. However, when urinary elimination is altered, it can affect the skin’s integrity and lead to skin breakdown, infections, and other complications.
One of the most common ways that altered urinary elimination affects the integumentary system is through the development of pressure ulcers. Pressure ulcers, also known as bedsores, are caused by prolonged pressure on the skin, leading to decreased blood flow and tissue damage. When a patient is incontinent, urine can cause prolonged moisture on the skin, leading to maceration, or softening of the skin, and skin breakdown. The combination of moisture and pressure can accelerate the development of pressure ulcers, leading to pain, discomfort, and further complications.
Furthermore, urinary incontinence can also increase the risk of urinary tract infections (UTIs), which can affect the skin around the perineum and lead to skin breakdown and irritation. UTIs are common in patients with altered urinary elimination, and the risk increases with age. The bacteria responsible for UTIs can spread to the skin, leading to infections, which can further compromise the skin’s integrity and increase the risk of complications.
In conclusion, altered urinary elimination can have a significant impact on the integumentary system, leading to skin breakdown, pressure ulcers, infections, and other complications. Nurses should be vigilant in assessing and managing urinary elimination in their patients to prevent skin-related complications and improve patient outcomes.
References:
- National Institute on Aging. (2017). Urinary incontinence in older adults. https://www.nia.nih.gov/health/urinary-incontinence-older-adults
- National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, & Pan Pacific Pressure Injury Alliance. (2019). Prevention and treatment of pressure ulcers/bedsores: Clinical practice guideline. https://www.internationalguideline.com/static/pdfs/NPIAP-EPUAP-PPPIA-CPG-2019.pdf