Renal And Urulogic Probs Flashcards
Renal and urologic probs j
UTIs
Glomuerulonephritis
Urolithiasis
Bladder cancer
Renal cancer
Incontinence
Urinary - renal trauma
Cystitis
Inflammation of bladder
Bladder irritability **
Nocturnal enuresis
Frequency
Urgency
Suprapubic pain
Dysuria
Hematuria
Fever
Confusion in older adults
Pyelonephritis
Inflammation of kidneys
Flank pain (costco angle pain)
Dysuria
Mild fatigue malaise
Chills , fever , vomiting
Sams s/s as cystitis
Urosepsis
Caused by UTI medical emergency
Decrease BP increase HR
Urititis
Inflammation of ureters
Most common bacterial infection is caused by
E. coli
CAUTI
Catheter caused. Most common hospital acquired infection
Less frequent caused of UTI
Pseudomonas
UTI where can it be?
Anywhere from the kidney to ureter
Types of UTI
Cystitis
Urethritis
Pyelonephritis
Risk factors of uti
Immunosuppressed
Diabetes
History of kidney probs
Antibiotics
Traveling to diff countries
Catheter
Cystoscopes exam
Occupation (nurses)
STI
Menopause
Dooshing
Females with multiple sex partners and people with poor hygenie
Higher risk of UTI
Lower tract UTI
Cystitis
Urethritis
No systemic manifestations
Unless cystitis turns into pyelonephritis
S/s or urethritis
Pain, burning/ difficult urination
Frequency (voiding more than every 2 hours )
Urgency
Males - clear mucous discharge
Females lower abdominal discomfort
Nocturia
S/s cysistitis
Everything from urethritis
Bladder irritability
Hesitancy
Suprapubic pain
Incontinence
Nocturnal enuresis (voiding while sleeping)
UA of uti
Nitrates WBC
Leukocyte esterase
If they feel like something else is going on besides UTI
Ultrasound or CT
Clean catch
Midstream clean void
Pee, clean and pee again, keep hand outside of cup
If you are drawing from a catheter
Clean port with alcohol before putting syringe on it
Upper tract
Fever, chills , flank pain
Pyelonephritis inflammation of renal parenchyma and collection system can lead to injury
Usually begins in lower UTI
Vesicoureteral reflux
CAUTI
Dysfunction of lower urinary tract that causes upper tract infections
obstruction of BPH
Structure
Urinary stone
Cauti
Vesicoureteral reflux
Backward movement of urine from lower to upper urinary tract
Chronic pyelonephritis
Reoccurring episodes lead to scarred and poorly functioning kidney and chronic
S/s of pyelonephritis
Fever, chills
N/v
Fatigue , malaise
Flank pain/pain at Costco vertebral angle
(May present with s/s of cystitis
Diagnosis pyelonephritis
History
UA
Urine culture and sensitivity
US, CT, Cystoscopy)
CBC
Blood culture(if they suspects systemic)
Percussion for flank pain (cva)
Why should we take pyelonephritis serious
Can easily turn into urosepsis
Urosepsis
UTI that has spread systematically
Life threatening condition
Requiring emergent treatment
(E coli)
UTI treatment/prevention
Antibiotics
Nsaids or antipyretic drug
Vitamin c
Urinary analgesics (phenazopyridine0
Fluids (iv, po , cranberry juice)
Why do we give vitamin c
Immunosuppression
Glomerulonephritis
Inflammation of glomeruli
Caused by bacterial infection (strep)
Focusing on acute
Risk factors of GN
Kidney infections
Nephrotoxic drugs
Immunocomprimised system
Systemic disease
Systemic disease example: if pt has lupus and they catch strep what can happen?
strep infection untreated that turns into GN tend to not have a good outcome (can lead to acute chronic kidney disease)
Acute GN s/s
General body edema
Decrease urine output
Oliguria, hematuria, protienuria
Hypertension
BUN/creatine
History of group A strep
Evidence of immune mediated response
In acute GN edema how will it start?
Facial and neck edema first
Then as it progresses it will turn into general
Nursing management acute GN
Daily weights& I&O
Measure of abdominal girth
Medication
Diet
What medications do acute GN pt take?
Antihypertensives
Diuretics
Corticosteriods
what special diet should acute GN take?
Low sodium low to moderate protein / fluid restriction
Nursing management GN
Teaching
Disease process
Meds
Follow up appointment
Avoid infections
Rest
HAD STREP
Hypertension
AS0 tiger (+) this is a test for strep
Decreased GFR
Swelling face/eyes
Tea colored urine
Recent strep infection
Elevated BUN creatine
Protienuria
What do we teach on GN?
The severity and how important to receive treatment because it can lead to disease
Urinary tract calculus -urolithiasis
Kidney stones
More common in men
20-55 years old
White
Family history of stone formation
Personal history
Summer months
Clinical manifestations of stones (renal calculus)
Pain
Sweaty
N/v urinalysis
+RBC
UTI like symptoms
Diagnosis of renal calculi
Ultrasound to see if its passing
Ct scan IVP
Renal stone analysis retrograde pyelogram
Cystoscopy
Measure urine PH
Nursing management renal calculi
Narcotics(morphine) and nsaids
Antiemetic
Alpha-adrenergic blockers
(Helps pass stone)
lab functions to monitor for renal calculi
Increase BUN /creatine
UA
CBC
Nursing management renal calculi 2
Vital signs
(BP , pulse elevated =pain)
Fluid management
I&O
Teaching
(Strain urine
Symptoms of infection/obstruction
Prevention)
In the future what can we teach pt about prevention of renal calculi?
Avoid diet high in uric acid
Mushrooms , shell fish , beats, oxalate,tea,coffee chocolate
How much hematuria is a goal for pt to have in renal calculi
Maintain free flow of urine with minimal hematuria
What is important after teaching pt about renal calculi?
Make sure they verbalize understanding of disease process and measures to prevent recurrence
Also make sure pt report satisfactory pain relief
Bladder cancer patho
Tumor formation
4th most common cancer in men
8th most common in women
Smoking is the most important risk factor
Clinical manifestations of bladder cancer
Painless hematuria
Urine cytology
Lab looking for tumor markers
Cystoscopy ( check in bladder)
Imaging
When are tumor markers typically found in bladder cancer?
By accident because they are usually looking for something else
Nursing management for bladder cancer
Vital signs
Medication (chemo , immunotherapy)
Continuos bladder irrigation
I&O
Murphy 3 way catheter
If pt is bleeding
Strict I&O is important and watch bags to make sure they wont dry
Superficial or low grade bladder cancers
Consist of excision or removal through fulguration or laser ablation
invasive bladder cancer
Radical cystectomy
Combined w neoadjuvant or adjuvant chemotherapy
Renal cancer
Usually found in the cortex or pelvis of the kidney
Clinical manifestations of renal cancer
Initially asymptomatic (found by mistake)
Classics triad (flank mass, flank pain and hematuria )
Weight loss(unexpected)
Hypertension
Fever
Anemia
Kidneys are effected not perfusing well.
Diagnostic test of renal cancer
IVP (if kidneys are functional)
Ultrasound
Ct/mri
Urine cytology
Treatment
Biological immunotherapy or cytokinesis
Radical nephrectomy
Nursing management renal cancer
Pain management
Iv hydration
Post op (bleeding incision latency of tubes /catheters
I&O
Incontinence
H&P
Labs UA ,renal function imaging KUB IVP cystometrogram
Goals for incontinence
Treatment is to prevent or stop urinary leakage
Nursing management incontinence
Teaching
Meds
Kegel excercises
Skin care
Voiding diary
Emotional support
Urinary renal trauma
Can range from confusion or hematoma to shattered kidney
Boxers, mma
What do females experience in urethritis
Lower abdominal discomfort
Why do males experience clear mucous like discharge in urethritis
Cause by STI
