Disorders of the urinary system Flashcards
Classification of Urinary Tract Infection (UTI)
1. Upper Urinary Tract Infection (UTI): Pyelonephritis 2. Lower Urinary Tract Infection (UTI): Cystitis UTIs are the most common hospital-acquired infection
Lower UTI causes
- BPH
- Calculi
- Urethral strictures
- Tumors
- Sexual intercourse
- Blood born infection
Upper UTI causes
- Calculi
- Trauma
- Tumor
- Aneurysm
- Congenital anomaly
Other causes
- Noninfectious :
- Chemical exposure: Drugs: Cyclophosphamide (Cytoxan) - Radiation therapy
- Foreign bodies
- Urinary calculi
- Indwelling catheter - Factor compromising Immune response
- HIV
- Diabetes - Hematogenous route
- Complications
- Pyelonephritis
UTI: Cystitis : manifestations
- Dysuria
- Urinary: Frequency; Urgency; Hesitancy
- Suprapubic: Pain; Discomfort; Pressure
- Hematuria
- Pyuria (WBC)
- Urethral discharge : Cloudy/foul smelling urine
- Perineal itching
- Mental status changes
- Hydronephrosis
UTI: Cystitis: TX
- Drugs - aim to reduce bacteria in urinary tract / pain: Bactrim, Lexaquin, Amoxil, Macrobid, Cipro
- Education about antibiotics: take entire prescribed dose;
- Prevention of recurrence
- Sensitivity to those with anxiety/ embarrassment.
Preventing a UTI
- Drink 2-3 L every day - 8-10 glasses
- Sleep, rest, nutrition
- W: clean from front to back; avoid bubble bath, nylon underwear; scented tissues; wear cotton underwear ! empty before and after intercourse.
- Empty as soon as feel urge (every 4 hr)
- Home therapies: cranberries juice, apple cider vinegar, vitamin C to acidify the urine!!
- prevent recurrence: complete antibiotics ;follow appointment ;
Pyelonephritis
Bacterial infection in the kidney and renal pelvis.
Could be:
- Acute pyelonephritis
- Chronic pyelonephritis
Usually begins with ascending infections from the lower tract into the renal pelvis and
parenchyma
Blood borne infections
Acute Pyelonephritis: appearance
kidney is swollen with multiple abscesses (yellowish gray streaks)
Acute Pyelonephritis: manifestations
Chills Fever Nausea/Vomiting Malaise Flank, back pain !!!! Nocturia
Acute Pyelonephritis: complications
Chronic Pyelonephritis
Temporary altered kidney function
Rarely progresses to renal failure
Chronic Pyelonephritis: manifestations
Hypertension
Inability to conserve sodium
Decreased urine concentrating ability/Nocturia
Hyperkalemia and acidosis
Chronic Pyelonephritis: complications
Scar tissue
Hypertension
Renal failure
Urinalysis: Color
dark amber; very pale; dark red
Urinalysis: Odor
foul smell: possible infection
Urinalysis: Turbidity
Cloudy urine: urinary protein; infection
Urinalysis: spesific gravity
1.005-1.030
Urinalysis: pH
average: 6 : range: 4.6-8
Urinalysis: Protein
0.8 mg/dL
Urinalysis: RBC
0-2 per high power field