Final answer:
The nurse should first establish normal voiding patterns for the patient when diagnosing altered urinary elimination. Considering physical and neurological challenges in the elderly is crucial as these can impact their ability to urinate regularly. Conditions like UTIs, benign prostatic hypertrophy, and kidney stones, as well as medication and decreased kidney function, can also alter urinary elimination.
Step-by-step explanation:
When establishing a diagnosis of altered urinary elimination, the first step for the nurse should be to establish normal voiding patterns for the patient. This involves understanding the individual's typical urinary frequency, volume, and any recent changes in habits or symptoms that may signal an underlying issue. Monitoring the patient's fluid intake and voiding attempts is part of this assessment, but it's important not to encourage excessive fluid intake as it may aggravate certain conditions and not all patients can tolerate increased fluids due to various medical conditions or fluid restrictions. Instead, a comprehensive assessment that includes reviewing medical history, observing current signs and symptoms, and evaluating results from diagnostic tests such as a urinalysis or a urine culture if an infection is suspected.
Physical and neurological challenges in elderly patients, like difficulty with mobility or cognitive issues from conditions such as Alzheimer's or Parkinson's disease, can impact their ability to maintain regular voiding patterns. Conditions like urinary tract infections (UTIs), benign prostatic hypertrophy, or obstructions like kidney stones can alter urinary elimination. Medications, abdominal malignancies, and decreased kidney function can also affect micturition. Therefore, tailored interventions and close monitoring are essential for these patients.