factors affecting voiding

1. DEVELOPMENTAL FACTORS

1.1. INFANT

1.1.1. graduallyincreasesto250-500mL/day

1.1.2. Unable to concentrate urine very effectively (immature kidneys)

1.1.3. No urinary control (develops 2-5 years of age)Control during the daytime precedes night-time control

1.2. PRESCHOOLER

1.2.1. Independent responsibility for independent toileting

1.2.2. Parents need to realize: accident occurs, and the child should never be punished.

1.3. SCHOOL-AGE CHILDREN

1.3.1. ENURESIS-involuntary passing of urine when control should be established (5 years of age)

1.3.2. NOCTURNAL ENURESIS- (bed wetting), involuntary passing of urine during sleep

1.3.3. SECONDARY ENURESIS- appears after the child has achieved dryness for a period of 6 consecutive months

1.4. OLDER ADULTS

1.4.1. Excretory function diminishes with age, but usually not significantly below normal levels unless a disease process intervenes

1.4.2. Common complaints : urinary urgency & urinary frequency REASON: MALE- enlarged prostate gland FEMALE- weakened muscles supporting the bladder or weakness of urethral sphincter

2. High in sodium decrease fluid output, water is retained to maintain normal concentration of electrolytes

3. PSYCHOSOCIAL FACTORS

3.1. Set of condition helps in the stimulation of micturition reflex: privacy, normal position, sufficient time, and, occasionally, running water.

4. FLUID & FOOD INTAKE

4.1. Healthy body-maintains balance I & O

4.2. Some fluid increase fluid output, inhibiting the production of anti-diuretic hormone Alcohol Caffeine (coffee, tea, cola)

5. MEDICATION

5.1. Diuretics- increase urine formation by preventing re-absorption of water and electrolytes from the tubules of the kidney into the bloodstream.

5.2. Some medication- change color of urine

6. MUSCLE TONE

6.1. good muscle tone is important to maintain the stretch and contractility of the detrusor muscle so the bladder can fill adequately & empty completely.

6.2. pelvic muscle tone also contributes to the ability to store and empty urine

7. PATHOLOGIC CONDITION

7.1. Affects the formation & excretion of urine

7.2. Disease of kidney- affect nephrons to produce urine

7.3. Heart disease/hypertension- affect blood flow to kidneys

7.4. Abnormal amount of fluid is loss (fever/vomiting)- water is retained in the kidneys & urinary output falls.

8. SURGICAL & DIAGNOSTIC PROCEDURE

8.1. Anesthesia:Decrease awareness to void

8.2. Surgery can cause: Swelling of urethra and Postoperative bleeding