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6200 Adult /Older Adult II > Renal and Urologic Problems > Flashcards

Renal and Urologic Problems Flashcards

1
Q

UTI General Symptoms?

A

dysuria, frequency, urgency, supra-pubic discomfort/pressure, hematuria/cloudy urine

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2
Q

UTI Symptoms in an older adult?

A

non-localized abd pain and cognitive changes

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3
Q

Diagnostics for a UTI?

A
  • UA to identify presence of nitrites, WBC’s and leukocyte esterase
  • CNS study
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4
Q

UTI tx?

A

hydrate, antibiotics, teaching (hygiene…)

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5
Q

UTI Preventive measures?

A
  • regular bowel movements
  • bladder emptying
  • adequate hydration
  • cranberry juice/tabs
  • void b4 sex and after sex
  • good catheter care
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6
Q

Most common cause of UTI?

A

E. Coli

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7
Q

Pyelonephritis

A
  • Inflammation of the renal parenchyma (Upper UTI) and collecting system, including the renal pelvis
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8
Q

Cause of Pyelonephritis?

A

Usually a lower urinary infection that has ascended

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9
Q

Pyelonephritis symptoms?

A
  • fatigue, fever, chills, vomiting, malaise, flank pain
  • lower UTI symptoms,
    Costovertebral angle tenderness
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10
Q

Acute treatment of Pyelonephritis?

A

Antibiotics and fluids

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11
Q

Cystitis

A

Inflammation of the bladder lower UTI

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12
Q

Inflammation of the bladder (lower UTI)

A

Cystitis

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13
Q

Cystitis risk factors?

A

female and catheter is inserted

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14
Q

Cystitis S/S?

A

urgency, frequency, cloudy/foul smelling urine

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15
Q

Cystitis Tx?

A
  • Urine acidifiers (cranberry juice)

- Urinary tract analgesic

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16
Q

Glomerulonephritis Signs/Symptoms

A

hematuria, proteinuria, uremia, pyuria, edema, hypertension

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17
Q

What diagnostic test would you do if Glomerulonephritis is suspected?

A
  • UA
  • blood study (BUN, WBC, creatinine)
  • Abd or kidney US/CT
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18
Q

Glomerulonephritis Treatment?

A
  • Manage symptoms (HTN, edema, and UTI)
  • Low protein, low NA diet
  • fluid restriction, I&O, weigh daily
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19
Q

diet restrictions for glomerulonephritis?

A

Low protein, low NA

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20
Q

Pt teaching: glomerulonephritis?

A
  • Decrease dietary protein if high BUN

- Daily weight

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21
Q

Medical term for stone?

A

Calculus

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22
Q

What is the most common type of Urinary Calculi?

A

calcium oxalate

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23
Q

Medical term for stone formation

A

Lithiasis

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24
Q

Urolithiasis

A

Urinary stone

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25
Q

Nephrolithiasis

A

Kidney stone

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26
Q

Urinary Calculi Risk Factors?

A
  • men > women
  • age 20-55
  • White > AA
  • Family history
  • UTI
  • dehydration
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27
Q

Urinary Calculi Signs/symptoms?

A
  • decreased UO
  • abd or flank pain
  • hematuria
  • N/V
  • fever/chills
  • kidney stone dance (a.k.a. renal colic)
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28
Q

Diagnostic for Urinary Calculi?

A
  • CT
  • US
  • UA
  • Kidney Ureter Bladder (KUB) x-ray
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29
Q

Urinary Calculi Acute Attack Treatment?

A
  • Treat pain, infection, obstruction
  • Hydration
  • Medication to relax smooth muscle
  • Strain all urine
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30
Q

Medication to relax smooth muscle used to treat Urinary Calculi?

A

Tamsulosin or terazosin

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31
Q

Pt Teaching - Urinary Calculi?

A
  • Adequate hydration
  • Diet-based on cause
  • Pain management
  • Lithotripsy, surgical removal
32
Q

Uncontrolled leakage of urine?

A

Urinary Incontinence

33
Q

Urinary Incontinence is caused by?

A

“DRIP”

  • Delirium/Drugs
  • Retention
  • Immobility, Inflammation or Impaction of feces
  • Polyuria
34
Q

Type of Urinary Incontinence?

A

“SOUR”

  • Stress
  • Overflow
  • Urge
  • Reflux
35
Q

Type of Urinary Incontinence caused by lifting, sneezing, laughing?

A

Stress

36
Q

Type of Urinary Incontinence caused by BPH or uterine prolapse and the patient complains of “constant dribbling”?

A

Overflow

37
Q

Involuntary urination without warning

A

Reflux incontinence

38
Q

Type of Urinary Incontinence caused a spinal cord injury (SCI) or MS?

A

Reflux incontinence

39
Q

Urinary Incontinence complications?

A

infection, skin break down and embarrassment

40
Q

Pt teaching- Urinary Incontinence?

A
  • hydration
  • scheduled void or cath
  • pelvic floor exercises
    double voiding
  • incontinence pads
  • meds
41
Q

Which category of drug is used for urinary incontinence and why?

A

anticholinergics to relax the bladder muscle

42
Q

Causes of Urinary Retention?

A

Bladder outlet obstruction and ↓ detrusor muscle contraction

43
Q

S/S of Urinary Retention?

A

frequent small urination, suprapubic distension or pain, elevated specific gravity

44
Q

Pt teaching-Urinary Retention?

A
  • Double/scheduled - Voiding
  • Catheter if indicated
  • Diet
  • Medications
  • Surgery for obstruction
45
Q

Complications of Urinary Retention?

A

rupture, infection, uremia

46
Q

Indication for a Urinary Diversion?

A

cancer, neurogenic bladder, trauma, strictures

47
Q

most common Urinary Diversion?

A

Ileal conduit

48
Q

Ileal conduit

A

ureters are implanted in part of the ileum, with stoma

49
Q

Types of Urinary Diversions?

A
  • Ileal conduit,
  • Cutaneous Ureterostomy
  • Nephrostomy
50
Q

Cutaneous Ureterostomy

A

ureters brought to the abdominal wall, with stoma

51
Q

Nephrostomy

A

catheter inserted into renal pelvis of the kidney (temp or permanent)

52
Q

Which types of Urinary Diversions have stomas?

A

Ileal conduit and cutaneous ureterostomy

53
Q

S/S of Benign Prostatic Hyperplasia?

A

retention, hesitancy, frequency, urgency, dysuria, nocturia, hematuria, difficulty initiating/stopping, dribbling

54
Q

Diagnostics for BPH?

A
  • H&P
  • Digital exam
  • Urine Culture
  • Prostate-Specific Antigen (PSA)
  • Transrectal Ultrasound
  • Cystoscopy
55
Q

BPH teaching Management?

A
  • med information
  • Avoid things that increase symptoms
    • alcohol, caffeine, cold medicine
  • Limit evening fluids
  • Urinate every 2-3 hours (decrease retention)
56
Q

In a patient with BPH, the below increase the risk of?

1) dehydration
2) overhydration

A

1) infection

2) distention

57
Q

5 alpha reductase inhibitors MOA and does what in a patient with BPH?

A
  • inhibits 5-alpha reductase, preventing the production of DHT from testosterone
  • causes regression of hyperplasia
58
Q

Alpha adrenergic receptor blockers

do what in a patient with BPH and take how to be effective?

A
  • Promotes smooth muscle relaxation

- 2-3 wks

59
Q

What does TURP stand for?

A

Transurethral Resection of the Prostate

60
Q

TURP (Transurethral Resection of the Prostate) Post-surgical Care?

A

Antibiotics
Pain management
Assess dressing/drainage

61
Q

TURP Post-op complications ?

A
  • Hemorrhage (assess urine and vitals frequently)
  • Bladder spasm
  • Urinary incontinence
  • Infection
62
Q

During a continuous bladder irrigation, the urine may be bright red for how long?

A

up to 12 hrs

63
Q

How to determine the flow to be use during a continuous bladder irrigation?

A

titrate for urine flow to be light pink/clear, no clots

64
Q

Why must the bag never be allowed to run dry during a continuous bladder irrigation?

A

may increase clotting in the catheter and cause pain

65
Q

UTI risk factors?

A

prego, menopause, habitual delay of urination, foleys, sex

66
Q

Meds to tx uncomplicated or initial UTIs?

A
  • Trimethoprim-sulfamethoxazole (TMO-SMX)

- nitrofurantoin (macrodantin)

67
Q

What is pyruria?

A

increased number WBC’s in the urine

68
Q

Acute Poststreptococcal Glomerulonephritis is caused by?

A

infection of the tonsils, pharynx, or skin by nephrotoxic strains of group A-hemolytic streptococci

69
Q

How long after an infection by group A-hemolytic streptocci will APSGN develop?

A

5-21 days

70
Q

Manifestations of APSGN?

A
  • generalized body edema
  • HTN
  • oliguria
  • hematuria with a smoky or rusty appearance
  • proteinuria
71
Q

ASPGN management?

A
  • rest
  • edema and HTN management
  • dietary protein restriction if an increase in nitrogenous wastes is present
72
Q

What are the five major categories of stones?

A
  • calcium phosphate
  • calcium oxalate
  • uric acid
  • cysteine
  • struvite
73
Q

What is the medical term for the regular reflex of urination?

A

micturition

74
Q

Complications of an indwelling catheter (> 30 days)

A

bladder spasm, periurethral abscess, pain, and urosepsis

75
Q

Initial and conservative tx of BPH?

A
  • Meds: 5 alpha reductase inhibitors and a-adrenergic blockers
  • watch and wait for asymptomatic or minor symptom presentation

6200 Adult /Older Adult II (17 decks)

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