Management of pts with urinary disorders ch 49 Flashcards
CAUTIs account for ____% of all hospital acquired infections
50
Lower UTIs
___________ (bladder)
__________ (Prostate)
__________ (urethra)
cystitis
prostatitis
urethritis
Upper UTI
_______________: acute or chronic
Interstitial ____________
________abscess & _______ abscess
Pyelonephritis
nephritis
Renal , Prerenal
What are ways that bacteria can get into the urinary tract ?
*Reflux from urethra back into the bladder
* Bladder refluxes into the ureters
Mia comes into urgent care and is complaining of the urgency and frequency to urinate, burning while urinating , and cloudy and foul smelling urine. What is she most likely to be diagnosed with?
Cystitis
What is some nursing management for cystitis?
* encourage _____
* Send urine for _________
* administer ____ and bladder ________ (pyridium)
*Teach pts to drink __________ juice to increase urine ________
*Teach female pts to void after ___________
* Teach females to wipe _________ to _________
fluids
culture
ABX, analgesics
cranberry, acidity
intercourse
front,back
What are some complications of UTIs?
Sepsis
Acute kidney injury (can increase BUN and Creatinine)
Chronic kidney disease
What kind of things should you look for during the assessment for someone with pyelonephritis?
Chills
fever
general malaise
urinary frequency
dysuria
flank pain
CVA tenderness
How do you manage pyelonephritis?
__________ therapy, antiseptics, ___________
increase fluid intake to ________ml / day
May have periodic blood tests to look at ______ (checking infection)
May have urine _________ done to see response to therapy
ABX, analgesics
3000
WBCs
culture
If you have a kidney stone in the urinary tract , it is called a _________
urolithiasis
If you have a kidney stone in the kidney ______________
nephrolithiasis
Kidney stones can be caused by anything that increases __________ concentration in the blood or urine
calcium
Kidney stones are also known as
urinary tract calculi
How to you diagnose a pt with a kidney stone?
CT
Urine sample
Stone analysis
Cystoscopy
Stones usually form from:
Calcium oxalate
Calcium phosphate
uric acid
Kidney stone treatment
* ____________ Therapy
* _____ Management
Nutritional
Pain
Interventional procedures for kidney stones
Ureteroscopy
Lithotripsy : shockwaves shatter the stones
Surgical management of kidney stones
Stent
Nephrostomy
Why is urinary incontinence so underreported?
Embarrassment
what are the types of incontinence ?
stress - leaking during physical activity or exertion
urge - sudden , intense urge to urinate followed by involuntary loss of urine
functional - (can’t reach the bathroom)
overflow - bladder is too full and leaks
interventions for incontinence
* ___________ training
* _______ exercises
* _________ Sling
* _________ caths, incontinence. pads
bladder
pelvic
bladder
condom
urinary retention is the inability of the _________ to ______ completely
bladder , empty
________ urine is the amount of urine left in the bladder after voiding
residual
Causes of urinary retention
Post op
DM, prostatic _________, urethral pathology, trauma, pregnancy, neurological disorder (MS or parkinson’s)
Meds
Cancer
Calculi (____________)
enlargement
kidney stones
signs and symptoms of urinary retention
* voiding ___________ but in ______ amounts
* ___________ discomfort (maybe)
* Appropriate ____________ w/o urinary output for >6hrs
* ________ specific gravity level in urine
frequently, small
suprapubic
hydration
high
What are some questions to ask a patient with urinary incontinence.
“when was the last time you urinated and how much was there?”
“Are you urinating small amounts or urine frequently?”
“are you dribbling urine”
“Are you in any pain or discomfort of lower abdomen”
why would a pt with urinary incontinence be a fall risk?
they are more likely to be rushing to the bathroom
complications of retention
* _________ of bladder
* _________ or sepsis
* build up of _______ in the blood (BUN)
* ________ damaged around bladder
* Kidney ________
rupture
infection
urea
nerves
stones
What are the criteria for indwelling foley are :
* accurate ______ for critical ill pts
* severe urinary ___________
* incontinent pt with _________ wounds
* Use in the ___
* Comfort for _______
I&Os
retention
sacral
OR
end-of-life
UTIs occur when _________ gains entrance to the __________
bacteria
bladder
Bacteria reaches the bladder by:
________ from urethra back into the ________
______ refluxes into the ureters
refluxes, bladder
bladder
Why are females more prone to UTIs than males are?
Women have much shorter urethras than men
What is pyelonephritis?
kidney infection
Signs and symptoms on pyelonephritis
chills
fever
malaise
urinary frequency
dysuria
flank pain
CVA tenderness
How is pyelonephritis treated?
ABX therapy, antiseptics, analgesics
Increase fluids to 3000ml a day if not contraindicated
WBCs tests
urine culture to see response to therapy
what are some interventions for urinary retention?
- Encourage normal ___________ patterns
- Apply warmth to relax ___________
- Utilization of trigger techniques
- utilizing __________ scanning to check for __________
voiding
sphincters
bladder, distension
