Name that Urinary Disorder Flashcards
Generally caused by complications of an STD, trauma during catheterization, urologic procedures, or childbirth, a third of cases have unknown causes
Occurs more often in men
Most common symptom: obstruction of urine flow
Treatment is usually surgical dilation or urethroplasty - go in and open urethra
Is the narrowing
Urethral stricture
This is the most common type of nosocomial infection
Causes include: strictures, reflux, catheter use, being female, antibiotic use, sexual intercourse, urolithiasis, diabetes, etc.
Symptoms include: frequency, urgency, dysuria (painful urination), etc.
Treatment: resolve underlying cause and antibiotics: Prevention is key!
Urinary tract infection
When in doubt, take it out (after getting an order from your provider)
Hand hygiene
Catheters only for appropriate use: Assess daily
Sterile technique for insertion
Smallest size catheter needed
Keep tubing patent
Keep collection bag below level of bladder
No dependent loops
Secure catheter
Daily catheter care
Empty collection bag when moving - not backflow
CAUTI prevention strategies
Symptoms include urinary frequency, urgency and dysuria; low back pain; nocturia, incontinence, hematuria, pyuria, suprapubic tenderness
Could potentially lead to urosepsis
Inflammatory condition of the bladder
Best to prevent with increase fluid, good perineal care, don’t delay urination, some nutritional supplements (cranberry, vinegar, estrogen)
Cystitis
Antibiotics: For bacterial
Antiseptics: Relieves local symptoms
Analgesics: Reduces bladder pain and burning; Phenazypyidine will turn urine orange
Antispasmodics: Decrease bladder spasms
Increase fluid intake
Void after sex
Hydrated
Void when need to
Avoid foods that irritate the bladder: Caffeine, carbonation, and tomato products
Cystitis interventions
Your postmenopausal patient reports dysuria, urgency, lower abdominal pain, and vaginal discharge.
She mentions that she and her sexual partner both are being treated for chlamydia. He is reporting similar symptoms.
UA results may show a high WBC count without presence of bacteria.
Urethritis
A 50-year old man presents to the ED with “the worst pain I’ve ever had”. You can barely get an assessment in as he is doubled over and guarding his lower abdomen.
He is admitted to the floor on IV narcotics after a confirmatory KUB and US
Common symptoms include severe pain, hematuria, N&V, pallor, diaphoresis
Urolithiasis (kidney stones)
Pain management
Infection prevention
Obstruction prevention
Nursing outcomes for client with urolithiasis
Opioids, NSAIDS (ketorolac)-Give scheduled
Antispasmodics
Tamulosin and nifedipine (relax the urethra and aid in expulsion)
Pain management - Nursing outcomes for client with urolithiasis
Encourage increase fluid intake
Antibiotics if needed
Urinalysis and C&S
Infection prevention - Nursing outcomes for client with urolithiasis
Encourage increase fluid intake
I &O
Encourage activity - increase circ to pass it
Strain all urine - analyze if recurrent
Lithotripsy/Stent placement
Obstruction prevention - Nursing outcomes for client with urolithiasis
Strain urine to monitor the passage of stone fragments
Bruising may occur on the flank of the affected side after procedure (expected)
May have blood in urine after procedure
Monitor for increase pain, fever, chills, difficulty with urination
Lithotripsy/Stent placement
Causes vary and can be temporary or permanent.
25-45 % of all women report this issue in their lifetime
Involuntary loss of urine severe enough to cause social or hygienic problems
Types include: functional, stress, urge, overflow, and mixed form.
Urinary incontinence
What is the most common type of incontinence?
Stress - kegal good way to manage
This problem can occur in the bladder, kidney, or renal pelvis
Hematuria is often the first major sign
Dysuria, frequency, and urgency occur when infection or obstruction are present
Diagnosed with urinalysis, cystoscopy, biopsy, cystoureterography, CT, US, and/or MRI
Treatment ranges from prophylactic immunotherapy to removal of bladder and surrounding tissues
Urothelial cancer
