Возрастные изменения мочевыделительной системы

With age, all systems and organs, irreversible structural and functional changes. They determine the activity of human body and human life.Aging of the urinary system of man, especially the kidneys, begins very early - after 30 years. Early aging kidneys due to the high functional activity of this organ.  
 

With aging there is a decrease in the number of nephrons in the kidneys and a decrease in the blood supply that adversely affect the functioning of the urinary system. The kidneys become less efficient in concentrating a diluting urine. (The renal threshold for glucose is elevated, and individuals tested for high blood glucose will not show elevated levels in the urine. Excretion of drugs is altered, and the elderly must be closely observed for signs of drug toxity. The smooth muscle and elastic tissue of the bladder is replaced with fibrous connective tissue. This results in decreased bladder capacity and increased frequency of urination. The elderly also experience more nocturia. There is a decrease in the force of the stream, and some may experience stress incontinence. For these reasons many elderly may limit their appearance in publiс or long trips. Some decrease their fluid intake to avoid embarrassment. Bladder outlet changes may cause obstruction in the male and incontinence in the female.

Assessment;

Assessment of the urinary system is done indirectly by asking the elderly about their urinary habits. The kidneys themselves are rarely palpated. If there is a severe kidney infection, the individual can have flank tenderness. The amount, color, and odor of urineis one way to assess the urinary system. The external meatus of both men and women should be inspected and kept clean to prevent infections. If the urinary bladder is overfilled with urine, it can be palpated above the pubic bone.

Common  pathologic  conditions

Decrease in the function of the urinary system causes certain pathologic conditions to be regularly seen among the elderly. The diminished efficiency of the kidheys may result in acute and chronic renal failure. Bladder problems such as urinary retention, urinary tract infections, and cancer of the bladder appear. Urinary incontinence is especially troublesome in women, while benign prostatic hypertrophy and prostate cancer affect men.

Violations of urodynamics and renal blood flow aggravated by an older man diseases: atherosclerosis, hypertension, diabetes, kidney stones, gout, BPH, etc., as well as drugs that are taken in abundance elderly. Particularly important drugs that reduce the tone of smooth muscles (eg, nitrates, korinfar, baralgin) or affect the operation of the renal tubules (primarily painkillers: Analgin, indomethacin, voltaren, ibuprofen, etc., as well as antibiotics).

Nursing   interventions

The elderly may feel uncomfortable talking about a genitourinary problem. The understanding nurse will appreciate these feelings and will provide a private, gentle, and sensitive environment to assist

the individual. Nursing interventions should be focused on maintaining normal functioning of the urinary system. Maintaining adequate fluid intake is essential for bladder functioning, and good personal hygiene is important to decrease the incidence of infection and to control odor. Exercises can be taught to decrease incontinence (Kegel exercises)•