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The bladder distends and its capacity increases: In older adults, the bladder wall becomes less elastic and more fibrous. This leads to a decrease in bladder capacity, not an increase. A smaller bladder capacity often results in increased frequency of urination and urgency.

Older adults ignore the need to void: This is a behavioral assumption rather than a physiological change. While some individuals with cognitive impairments like dementia may not recognize the sensation of a full bladder, it is not a normal physiological consequence of aging in a healthy adult. In fact, many older adults become more sensitive to the need to void due to reduced bladder capacity.

Urine becomes more concentrated: Aging affects the kidneys' ability to concentrate urine. Because there is a decrease in the number of functioning nephrons and a reduced response to antidiuretic hormone (ADH), the kidneys are actually less efficient at concentrating urine. This often leads to nocturia (waking up at night to urinate).

Stress urinary incontinence occurs when physical pressure is put on the bladder-such as coughing, sneezing, laughing, or lifting. It is caused by weak pelvic floor muscles.

Reflex urinary incontinence: This occurs at predictable intervals when the bladder reaches a specific volume. Crucially, the patient lacks the sensation or urge to void. This is common in patients with spinal cord injuries.

Functional urinary incontinence: This occurs when the patient has bladder control but cannot reach the toilet in time due to environmental or physical barriers (e.g., a broken hip, dementia, or being in restraints).

Decreased and highly dilute: This is a physiological contradiction. If urine volume is decreased because the body is holding onto water, the urine produced will be dark and concentrated (high specific gravity), not dilute.

Increased and concentrated: This is physically impossible under normal kidney function. To make urine concentrated, the kidneys must remove water; removing water naturally decreases the total volume of urine.

Increased and dilute: This occurs with high fluid intake or conditions like diabetes insipidus. In a client with fever and sweating, the body is trying to conserve fluid, not get rid of it.

Urgency is the sudden, strong, and often uncontrollable desire to void immediately. It is a sensory symptom, not an inability to empty the bladder.

Oliguria refers to decreased urine production by the kidneys (typically less than 400 mL in 24 hours). In the scenario, the kidneys are producing urine, so the problem is not oliguria.

Dysuria is the medical term for painful or difficult urination, often described as a burning sensation. While it may accompany a struggle to void, it does not define the inability to empty a full bladder.

Drinking more than 2,000 mL of fluid per day will cause fluid retention: For a healthy adult with normal heart and kidney function, 2,000 mL (about 2 liters) is actually the recommended target. The body maintains homeostasis by excreting excess fluid as urine; it does not cause retention unless there is an underlying pathology like heart failure or renal failure.

The healthy adult should drink four to six 8-ounce glasses of water per day: This amount is too low. The standard recommendation is eight to ten 8-ounce glasses (approx. 2,000–2,400 mL) per day to ensure adequate kidney flushing and to prevent constipation.

Children need fewer reminders to drink because of greater thirst sensitivity: Children are actually at higher risk for dehydration because they often get distracted by play and may not recognize or respond to thirst cues as quickly as adults. They require frequent reminders to hydrate.