This document discusses age-related changes to the urinary system and dysfunctions that can occur. It begins by outlining the objectives and functions of the urinary system. Key changes include decreased kidney function and loss of bladder control. Common urinary issues for older adults include incontinence, nocturia, benign hyperplasia, prostate cancer, pyelonephritis, kidney stones. Nursing interventions are provided for each issue to help patients manage symptoms and promote continence.

1. Prepared by: Group 7
Age Related
Changes to the
Urinary System
Care of the Older Adult - NCM 114
Verallo, Clarise Jean Policarpio, Jeanny
Traya, Princess Yutuc, Khaile

2. Objectives
Recall the
functions of
Urinary
System
Understand the
age related
changes in the
kidneys,
bladder, and
urethra
Identify the
age related
dysfunctions
of the urinary
system
Determine the
causes of
each
dysfucntions
of the urinary
system
Apply and
provide full
uderstanding
of the nursing
interventions

3. The urinary system, also known as
the urinary tract or renal system,
consists of the kidneys, ureters,
bladder, and the urethra. The
purpose of the urinary system is to
eliminate waste from the body,
regulate blood volume and blood
pressure, control levels of
electrolytes and metabolites, and
regulate blood pH.
Function of
Urinary System

4. Age Related Changes
• Loss of renal mass due to less of glomeruli
• Decreased glomerular filtration rate
• Altered permeability = proteinuria
• Degenaration and loss of nephrons
• Diminished blood flow through kidneys
• Decreased ability to handle body pH level
1. Kidneys

5. Age Related Changes
• Loss of muscle tone and elasticity
• Loss of awareness to urinate
• Increased frequency especially at night
• Loss of muscle tone in pelvic floor (stress
incontinence)
2. Bladder and urethra

6. Age Related
Dysfunctions
of the Urinary
System

7. 1. Urinary Incontinence
- It is the involuntary
passing of urine through
the urethra. Between 30 to
50 % of elderly people
suffer from this. U.I is
caused by weakening of
the urethral sphincters and
the muscles of the pelvic
floor.

8. 8 types of U.I.
- it is the most
common form
of incontinence
in women and it
is treatable.
Stress
Incontinence
01
- it isinvoluntary loss
of urine occuring for
no apparent reason
while suddenly feeling
the need to urinate.
Urge
Incontinence
02
- it is when the
bladder is always full
so that it frequently
leaks urine, weak
bladder muscle can
cause this type of
incontinence.
Overflow
Incontinence
03
- it means you have
more than one type
of incontinence, it is
usually combination
of stress and urge
incontinence.
Mixed
Inconvinience
04

9. 8 types of U.I.
- people who have this
may have problems in
thinking, moving or
community that
prevent them to
reaching a toilet.
Functional
Incontinence
05
- t is episodic I.U
while asleep and it is
normal for young
children, but
sometimes adult
can also have it.
Bed Wetting
06
- it is a temporary
version of
incontinence, it can
be triggered by
medication.
Transient
Incontinence
07
- it is an involuntary
response to
laughing, it is
usually affects
children.
Giggle
Incontinence
08

10. *Instruct the patient to limit fluid intake 2 to 3 hours before bedtime.
*Assess the patients ability to get to a toileting facility.
*Monitor elderly patients for dehydration in the long term care facility.
*Explain to the patient the rationale behind and implementation of a toileting
program.
*Educate family members about the importance of responding immediately to the
patients request for assistance with voiding.
*Advise the patient about the benefits of using disposable or reusable pads.
Nursing Interventions

11. 2. Nocturia
- It is defined as excessive
urination at night, while
having to urinate multiple
times in the night is can
contribute insomnia.
Between 60 to 80 % of the
age 65 experience
nocturia.

12. 3 types of Nocturia
- those people who
have polyuria is
estimated to urinate
3,000 ml in 24 hours. It
is usually caused by
there being too much
water filtered by the
kidneys.
Polyuria
01
- people who have it
will experience a high
urine volume only at
night, and their urine
volume during
daytime is normal.
Nocturnal
Polyuria
02
- if you have this, you
may urinate in small
amounts or urinate
more frequently. This
usually due to an
inability of the bladder
to fully empty.
Nocturnal Urinary
Frequency
03

13. *Restrict the patients fluid intake in the evening.
*Elevate the legs of the patient to prevent fluid accumulation.
*Encourage the patient to take afternoon naps.
*Instruct the patient to take diuretic medication 6 hours before bedtime.
Nursing Interventions

14. 3. Benign Hyperplasia
- is defined as the enlargement
of the prostate gland. The
prostate gland is an organ of the
male reproductive system. When
it enlarges the prostate gland
puts pressure on the urethra.
Over time the increased
pressure on the urethra makes it
difficult for the bladder to be
fully evacuated. In sever cases
urine can back up into the
ureters and interfere with kidney
functioning.

15. *Maintain fluid balance.
*Have patient document time and amount of each voiding.
*Assess for dressing
*Provide instruction. Before the surgery
Nursing Interventions

16. 4. Carcinoma of the
Prostate
- is the most common cancer in older men. Over
50% of men over 70 years of age show signs of
prostate cancer. According to the Centers for
Disease Control and Prevention (CDC), prostate
cancer is the second most common cancer in
men. However, some forms of prostate cancer
grow very slowly and thus may not ever require
treatment. Aggressive forms of prostate cancer, in
contrast, involve metastasis to vulnerable organs
like the lungs and brain. There is no link between
BPH and prostate cancer, but the symptoms are
similar. Prostate cancer is detected by a medical
history, a blood test, and a rectal exam that allows
physicians to palpate the prostate and check for
unusual masses. If a mass is detected, the cancer
diagnosis is confirmed by biopsy of the cells.

17. *Assist patient to assume normal position when voiding.
*Regularly check the dressing, incision and drainage for
excessive bleeding.
*Record time, amount of voiding, and size of stream after
catheter is removed
.*Monitor Vital signs
*Observe wound leakage surrounding the suprapubic
catheter
Nursing Interventions

18. 5. Pyelonephritis
- is an inflammation of the kidney
caused by a bacterial infection or
viral infection. The initial infection
may be caused by a urinary tract
infection, or travel to the kidney in
the blood or lymph. While the
infections are generally easily
treatable with antibiotics repeated
infections can cause permanent
scarring of the kidney tissue. This
affects the kidney function and can
cause kidney failure.

19. *Encourage to drink fluid, especially water
*Urinate as you need to
*Empty the bladder after sexual intercourse
*Wipe carefully
*Avoid using products in the genital area.
*Educate the patient about the disease process, prognosis,
and treatment regimen.
Nursing Interventions

20. 6. Renal Calculi
- also know as kidney stones,
become progressively more
common with age. The presence of
stones in the kidney do not typically
cause problems severe enough to be
detected. However, the passage of
renal calculi from the kidney through
the ureters, bladder, and urethra can
be extremely painful. Additionally the
stones may become lodged in the
ureter or cause ulcerations in the
lining of the urinary tract.

21. *Encourage patient to follow a regimen to avoid further stone
formation, including maintaining a high fluid intake to assist
passage of stone fragments.
*Encourage to take sufficient fluids in the evening to prevent
urine from becoming too concentrated at night.
*Encourage to stay hydrated
*Eat less Sodium.
Nursing Interventions

22. References
Cleveland Clinic. (2022). Proteinuria. Retrieved from:
https://my.clevelandclinic.org/health/diseases/16428-
proteinuria#:~:text=Proteinuria%20is%20high%20levels%20of,can%20help%20you%
20manage%20it.
Jessica, K. (2016). Age Related Changes to the Urinary System. Retrieved from:
https://courses.lumenlearning.com/atd-herkimer-biologyofaging/chapter/age-
related-changes-to-the-urinary-system/

23. “The greatest wealth is health.”
Virgil
Thank you!