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ADULT 1- Exam 2 > Urinary > Flashcards

Urinary Flashcards

1
Q

Urinary tract infection

Clinical Mx

A

dysuria, frequency, urgency, nocturia, nocturnal enuresis, foul smell, hematuria, suprapubic pain, cognitive impairment

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2
Q

Lower Urinary Tract Symptoms

A

post void dribbling, frequency, urinary retention, hesitancy, lower back pain, cloudy, foul smelling urine

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3
Q

UTI dx.

A

dipstick to identify presence of nitrites

Urine culture sensitivity- clean catch or mid stream

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4
Q

Uncomplicated UTI Collaborative Care

A

Septra, Bactrim-
make sure no allergies to sulfa drugs

Macrodantin, Macrobid-
usually given 7-10 days; May turn urine brown; May cause GI upset so take with meal; avoid sun exposure; do not take with antacids

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5
Q

Complicated UTI care

A

anti-fungal or antibiotics depending on what lab shows

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6
Q

UTI nursing Interventions

A

patient needs to wipe front to back
avoid unnecessary catheters
Catheter removal
Sterile procedure when putting in catheter
avoid bladder irritants
Avoid harsh soaps, bubble baths
Apply local heat; (pt can take warm bath)

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7
Q

Acute Pyelonephritis

onset

A

longterm use of catheters; colonization and infection of the lower urinary tract

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8
Q

Acute Pyelonephritis

Clinical MX

A 
CVA
hematuria
fever (102 or higher)
chills
mild fatigue to sudden onset of chills
mailase, vomiting, nausea
U/A will show hematuria, bacteria, WBC casts
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9
Q

Acute Pyelonephritis

Dx

A 
Urinary analysis
urine culture and sensitivity
blood cultures
no IVP or CT
diagnosis will show bacteria in urine and culture that is greater that 100,000 organisms
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10
Q

Acute Pyelonephritis

Collaborative Care

A 
same as UTI
antibiotic 14-21 days
NSAIDS for pain
fluid intake
can progress to chronic due to inflammation and scarring
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11
Q

Glomerulomphritis

Clinical Mx

A

result of acute Strep infection somewhere else in body

edema, hypertension, oliguria, smoky colored urine

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12
Q

Glomerulomphritis

DX

A

U/A- protein, hematuria, and urine more concentrated
WBS will be elevated
BUN and creatine is increases

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13
Q

Glomerulomphritis

Collaborative Care

A

increase fluid

diuretics

antihypertensives

sodium and fluid restriction

protein restriction but amount is based on how much kidney failure there is

daily weighs; if 2lb increase contact doctor

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14
Q

NEphrotic Syndrome

Clinical Mx

A 
hyperlipidemia
proteinuria
low albumin
low osmotic pressure--> peripheral edema
hypertension
elevated serum cholesterol and LDL 
Ascites and Anasarca
WEIGHT GAIN
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15
Q

NEphrotic Syndrome

Collaborative Care

A 
ACE inhibitors
 limit sodium (2-3gram diet) 
Limit protein (0.5-0.6)
find underlying cause
thiazide/loop diuretic
NO antibiotics
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16
Q

NEphrotic Syndrome

Nursing Interventions

A

daily weighs

I/Os

measure abdominal girth

cleanse edematous skin gently

avoid injury by monitoring while on diuretic

Patient at risk for malnutrition due to protein loss (protein is needed for wound healing)

Small frequent feeds

Pt. at risk for skin breakdown

17
Q

Urinary Tract Calculi

Risk Factors

A

o Abnormalities that result in increased urine levels of calcium, oxaturic acid, uric acid, citric acid
o WARM climates- that cause increased fluid loss
o LARGE intake of PROTEIN that increase uric acide, tea or fruit juices that elevate urinary oxalate
o LARGE intake of CALCIUM- only is susceptible
o LOW Fluid intake
o Family history, GOUT, renal acidosis
o Sendentary ocuupation, immobility, high sugar diets

18
Q

Urinary Tract Calculi

Causes

A
  • Calcium phosphate, calcium oxalate, uric acide, cysteine, struvite (magnesium ammonium phosphate)
  • 75% are composed of calcium phosphate or calcium oxalate
19
Q

Urinary Tract Calculi

Clinical Mx

A

PAIN
abdominal or flank pain
urinary obstruction

20
Q

Urinary Tract Calculi

DX

A
  • urinalysis- may or may not be normal; they may show blood or cyrstals
  • KUB: X-ray for kidney and bladder and reveal stones
  • No IVP bc of renal obstruction
  • Increased hydration will help kidney stones pass on their own
  • 90% are smaller than 5mm; if smaller they will pass on their own with hydration and/or diuretic
21
Q

Urinary Tract Calculi

Nursing Intervention

A
  • meds for pain: opiods, morphine (moderate- severe)
  • mild-moderate: NSAIDs
  • spams- antispamsatic drugs
  • encourage fluid intake;
  • pt will be sent home with strainer
  • If infection you need to administer antibiotics
  • Provide pre and post op teaching
  • If stone too big pt. will need surgical removal
  • Nutrition
22
Q

Urinary Tract Calculi

Treatment

A

• Cystoscopy
o Done to remove small stones from the bladder;
• Lithostripsy-
o Used for large stones
o stones are pulverized prior to removal (when home they will strain urine as well); hematuria is common after procedure; some require stents
• Percutaneous nephrolithomy-
o through skin from outside of body to get to kidney stones

23
Q

Urinary Tract Calculi

Nutrition

A

adequate fluids

avoid caffeine

ADULT 1- Exam 2 (1 decks)

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