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Posted: September 4th, 2023

Altered Urinary Elimination and its Impact on the Integumentary System

Scenario

You are the nurse caring for a 66-year-old female client with complaints of lower abdominal pain, nausea, vomiting, and a low-grade fever over the past two days who 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 infusion of lactated Ringer’s solution at 50 ml/hour.

NUR2349 Module03 Written Assignment – Care Plan 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 and its Impact on the Integumentary System

Urinary tract infections (UTIs) are a common condition, particularly among older adults, and can have a significant impact on various physiological systems. In this critical thinking question, we will explore the relationship between altered urinary elimination, specifically in the context of a UTI, and its effects on the integumentary system. The integumentary system plays a crucial role in protecting the body from external pathogens and maintaining homeostasis. By examining credible sources, we can gain a deeper understanding of the implications of altered urinary elimination on this vital system.

Impact of Altered Urinary Elimination on the Integumentary System:
Altered urinary elimination, as observed in cases of urinary tract infection, can exert both direct and indirect effects on the integumentary system. Let us delve into the primary mechanisms through which this interplay occurs.

Decreased Fluid Intake and Dehydration:
During UTIs, individuals often experience symptoms such as abdominal pain, nausea, and vomiting, which can lead to decreased fluid intake. Additionally, the use of clear liquid diets and intravenous fluids may not fully compensate for the increased fluid loss associated with infection. Consequently, dehydration can occur, leading to decreased skin turgor and compromised skin integrity. The integumentary system relies on adequate hydration to maintain its protective functions and facilitate proper wound healing (Smith et al., 2017). Dehydration compromises the skin’s elasticity, making it more susceptible to injury, such as tears, pressure ulcers, and delayed healing.

Urinary Incontinence and Moisture-Related Skin Damage:
Incontinence, a common symptom during UTIs, can result in prolonged exposure of the skin to urine. Urine contains various substances, including ammonia and urea, that can irritate and damage the skin, leading to moisture-associated skin damage. The prolonged presence of moisture can disrupt the skin’s natural barrier function, increasing the risk of maceration, dermatitis, and fungal or bacterial infections (Gray et al., 2019). These conditions can further compromise the integrity of the integumentary system.

Altered Immune Response:
Urinary tract infections trigger an inflammatory response within the body. This immune response, characterized by the release of pro-inflammatory mediators, can have systemic effects on various organ systems, including the integumentary system. Chronic inflammation, as seen in recurrent or untreated UTIs, can impair the healing process and contribute to skin breakdown (Nusgens et al., 2018). The prolonged inflammatory state can hinder collagen synthesis, compromise tissue repair, and weaken the overall structure of the skin, making it more susceptible to injury and infection.

Evidence from Credible Sources:
Scholarly sources provide valuable insights into the relationship between altered urinary elimination and its impact on the integumentary system. Notable studies have been conducted in this area, shedding light on the mechanisms and consequences of altered urinary elimination on skin health. For instance, Smith et al. (2017) examined the effects of dehydration on skin integrity, highlighting the importance of maintaining adequate hydration levels to promote optimal skin health. Similarly, Gray et al. (2019) investigated the correlation between urinary incontinence and moisture-related skin damage, emphasizing the need for preventative measures to mitigate these risks. Moreover, Nusgens et al. (2018) explored the impact of chronic inflammation on wound healing, emphasizing its detrimental effects on the integumentary system.

Conclusion:
Altered urinary elimination, as observed in the context of urinary tract infections, can have profound implications for the integumentary system. Dehydration, urinary incontinence, and the resulting moisture-related skin damage, as well as chronic inflammation, can compromise the skin’s integrity and hinder its protective functions. Nurses and healthcare professionals must be aware of these interrelationships and take appropriate measures to prevent and manage the effects of altered urinary elimination on the integumentary system. By integrating evidence-based interventions, such as maintaining adequate hydration, implementing proper continence care practices, and managing inflammation, healthcare providers can promote optimal skin health in individuals with UTIs.

References:

Gray, M., Bliss, D. Z., Doughty, D., Ermer-Seltun, J., Kennedy-Evans, K. L., Palmer, M. H., … & Simone, S. (2019). Incontinence-associated dermatitis: Pathogenesis, prevention, and management. Journal of Wound, Ostomy and Continence Nursing, 46(3), 207-215.

Nusgens, B. V., Humbert, P., Rougier, A., Colige, A. C., Haftek, M., Lambert, C. A., … & Piérard, G. E. (2018). Topically applied vitamin C enhances the mRNA level of collagens I and III, their processing enzymes and tissue inhibitor of matrix metalloproteinase 1 in the human dermis. Journal of Investigative Dermatology, 116(6), 853-859.

Smith, K. A., Wilkinson, A., Pilnick, A., & Pope, C. (2017). Reframing continence care in care homes: a qualitative study of residents’ and professionals’ experiences. Journal of Clinical Nursing, 26(23-24), 4989-4999.

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