Fundamentals of Nursing Q 571

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Immobility impairs bladder elimination, resulting in such disorders as:

  

     A. Increased urine acidity and relaxation of the perineal muscles, causing incontinence

     B. Urine retention, bladder distention, and infection

     C. Diuresis, natriuresis, and decreased urine specific gravity

     D. Decreased calcium and phosphate levels in the urine

    

    

Correct Answer: B. Urine retention, bladder distention, and infection

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The immobilized patient commonly suffers from urine retention caused by decreased muscle tone in the perineum. This leads to bladder distention and urine stagnation, which provide an excellent medium for bacterial growth leading to infection.

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Option A: Urea is the main nitrogenous waste product resulting from protein breakdown (catabolism) and is rapidly eliminated in the urine by the kidneys. During bed rest, the concentration of urea in the blood increases, and the kidneys eliminate larger amounts of urea.

Option C: As food intake usually decreases during bed rest, it is speculated that these higher concentrations of urea in blood and urine can only come from the catabolic breakdown of endogenous protein sources, such as muscle and other lean tissues (Bilancio et al, 2014). This correlates with the reduction in lean tissue mass and sarcopenia that are characteristic of prolonged immobility.

Option D: Immobility is independently associated with the development of a series of complications, including pressure ulcer, deep vein thrombosis (DVT), pneumonia, and urinary tract infection (UTI) Immobility also results in more alkaline urine with excessive amounts of calcium, sodium, and phosphate, a gradual decrease in urine production, and increased specific gravity.

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