Early sign of UTI in the elderly, urgency or confusion?

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This was a test question, I went with urgency because to me that would happen before confusion. Another question was asking what is the most accurate way to assess hydration status, I&O, daily weights, or skin turgor. I went with I&O, but curious what someone else may believe. Thanks!

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This was a test question, I went with urgency because to me that would happen before confusion. Another question was asking what is the most accurate way to assess hydration status, I&O, daily weights, or skin turgor. I went with I&O, but curious what someone else may believe. Thanks!

I would go with confusion and turgor. Most of the elderly people I work with have incontinence/frequency/urgency issues to start out with. For the second one, I'd always look at the actual patient to assess- not the charting.

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Specializes in Public Health, TB.

I second confusion for question #1.

But for question #2 I would go with daily weights, using the same scale at the same time of day. This is the standard practice for kidney and cardiac patients. It's pretty difficulty to monitor I and O, what with incontinence, failure to measure, and various means of receiving fluids.

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I second confusion for question #1.

But for question #2 I would go with daily weights, using the same scale at the same time of day. This is the standard practice for kidney and cardiac patients. It's pretty difficulty to monitor I and O, what with incontinence, failure to measure, and various means of receiving fluids.

Daily weights definitely have uses if the daily weights are accurate (good luck with that!), but I'm not sure assessment of hydration status is one of them. A dialysis patient can lose a few pounds after dialysis, but it doesn't mean they're dehydrated. You still have to actually look at the patient.

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Specializes in Hematology-oncology.

I agree with SourLemon. Daily weights are useful for monitoring fluid overload, and the therapeutic effects of diuretics (or the lack thereof)...but I agree that patient assessment (including skin turgor) is better when assessing hydration. Vital signs trends, I/O trends, weight trends, and lab trends are all tools to *augment* or supplement the assessment.

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I agree with SourLemon. Daily weights are useful for monitoring fluid overload, and the therapeutic effects of diuretics (or the lack thereof)...but I agree that patient assessment (including skin turgor) is better when assessing hydration. Vital signs trends, I/O trends, weight trends, and lab trends are all tools to *augment* or supplement the assessment.

This is the thing I dislike about NCLEX-style questions. The reality is that we use all of our tools when making assessments, not a single "BEST" one.

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Look at it this way:

PT A has what looks like adequate I&O,and target daily weights, but poor skin turgor.

PT B has inadequate I&O, and is not meeting target weights, and has great skin turgor.

Which of these patients has clinical signs of dehydration?

Part of taking tests involves understanding the question.

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