An elderly female patient tells the nurse that she is having trouble "holding her water" and doesn't want to drink fluids anymore. How should the nurse interpret this statement?
1. The patient has a urinary tract infection.
2. The patient needs estrogen cream.
3. The patient has a reduced thirst reflex.
4. The patient is experiencing incontinence.
4
Rationale 1: There is not enough evidence to suggest a urinary tract infection.
Rationale 2: The use of estrogen cream would be indicated for atrophic vaginitis or a decrease of estrogen in the vaginal tissues. Those conditions are not indicated by the patient's statement.
Rationale 3: The patient states that she does not want to drink fluids, which would not support a reduced thirst reflex.
Rationale 4: One common disorder seen in the genitourinary tract of the elderly is incontinence—stress incontinence, urge incontinence, overflow incontinence, or any combination of the three.
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