Geriatric Trauma Book: Urologic Trauma

Chapter

Abstract

Minimal research has been done on urologic injuries in the geriatric trauma population. A number of preexisting conditions may be seen and should be considered in the care of the older adult patient with urologic trauma. With aging, there is a loss of functional glomeruli and tubules as well as a reduction in blood flow, due to the decrease in mass of the kidney [1]. This impacts the ability of the kidneys to excrete medications that rely on renal clearance, therefore increasing the risk of adverse drug reactions [2]. Decreased functional reserve in the older adult also increases the risk of renal failure [3]. Nursing care must include a thorough physical assessment that incorporates the location of pain, assessment for patterns of bruising or lacerations, as well as consideration for associated injury [4]. Hematuria, flank pain/bruising, and abdominal pain have all been associated with assessment of renal injury [4]. There should be a high suspicion of renal injury with rib fractures or spinal process fractures [4]. Hemodynamic stabilization of the patient and treatment of concomitant injuries are critical components of immediate nursing care [4]. Many older adults are currently taking anticoagulants, which can profoundly impact the care of older adult patient with a renal injury. It is critical to complete a thorough review of medications and preexisting comorbidities on admission.

References

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Transitional Trauma UnitLehigh Valley Health NetworkAllentownUSA

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