Urinary Flashcards
What is the most common type of uti
E Coli
/what are risk factors for UTIS
Urinary stasis
Therefore: completely & repeatedly empty bladder
Foreign bodies (calculi)
Anatomical abnormalities
kinks in ureter
Bladder compression
constipation, pregnancy
Vesicoureteral Reflux
flow of bladder urine into the ureters
How is uti diagnosed
clean catch and culture
What is used if we keep getting them for diagnosis of UTI’s
intravenous pyelogram (IVP) or scans to identify anatomic abnormalities contributing to UTI or kidney changes from recurrent infection
What is hydronephrosis
back up of fluid into the kidney
What are manifestations for hydronephrosis
back pain
Match these Chordee (e) 2. Epispadias ( c) 3. Hydrocele (a) 4. Hypospadias (f) 5. Inguinal hernia (d) 6. Phimosis (b)
A. fluid in scrotum
B. narrowing (stenosis) of preputial opening
C. dorsal meatal opening
D. abdominal contents through inguinal canal
E. ventral penis curvature
F. urethral opening anywhere along ventral surface
What are some symptoms of UTI’s I havent memorized
Lethargy
Low grade fever
Hematuria
Abdominal flank pain/tenderness (if upper UTI))
Enuresis (urinary incontinence may be intentional or involuntary, not due to a physical disorder).
Nocturia (excessive urination at night)
Pyuria
What is a big sign that indicates a UTI in children
new urinary incontinence
What are some nursing interventions for UTI
Force fluids (Up to 3000 ml/day)
Monitor intake and output
Assess urine for odor, hematuria & sediment.
Administer medications
Monitor S/S of yeast inf in women (cheesy discharge, perineal itching & swelling)
Avoid bubble baths & tight clothing.
Provide a warm sitz bath for comfort
pyridium
What are the teaching points for UTI’s
Stress the importance of adequate hydration.
voiding (q 2 – 3 hrs)
Voiding after sexual intercourse
Need for F/U urine cultures to determine recovery
Explain the importance of completing the entire course of antibiotic therapy (from 7 to 10 days),
Pyridium- decreases spasms will cause bright orange colored urine.
What are the S/S of cystitis
Pain during sex
Pain worsening during menstruation
What is pylonephritis
an inflammation of the renal pelvis and renal tissues
What is a common prob before gettign pyelonephritis
cystitis from E Coli
What is Glomerulonephritis
an allergic rx
antigen-antibody rx
What is glomneph usually from
strep
What is an acute tubular necrosis
usu from a lack of perfusion so think of an MI
What are the signs and symps of pyeloneph
all of general UTI’s
plus pain Costovertebral Angle
possible systemic complications
What is a complciated UTI
involves kidney
What viruses can cause glomeruloneph
Hep B
Rubella (measles)
Who is more likely to get glomeruloneph
6-7yr old boys
About how long does the glomeruloneph lasts, what is likely given, and what is the nurse doing
14 days of antibiotics for strep inf
watching the patients conditions, reacting to changes
What is a differnce between pyeloneph and glomneph
glom affects both kidneys from the start and pyelo will start with only one in the beginning
What are the signs and symps of Glomneph
Possible abdominal/flank pain Oliguria ↑ urine specific gravity Dark colored urine Proteinuria Hematuria Complement - the pieces of damaged tissue Azotemia like ↑ serum BUN and creatinine ↓H & H (depending on blood loss) Edema of the face & peri-orbital area (hallmark sign) secondary to oliguria Hypertension Headache Weight Gain Fever- Low Grade Lethargy/Malaise/Fatigue
What can pyelo and glom end with
acute tubular necrosis
What are some data to assess for in glom
precipitating streptococcal infection
drugs, virus, hepatitis, other infections
What are some infection and conditions increase the risk of glom
upper respiratory infection or impetigo
lupus
What are some prevention tips for glom
Seek prompt treatment of a strep infection causing a sore throat or impetigo.
Prevent infections like HIV and hepatitis,
Follow safe sex guidelines and avoid intravenous drug use.
If Diabetic, controlling your blood sugar
If hypertensive, controlling your BP
What is a late sign of glom
oliguria
What are some things that increase the risk for nephrotic syndrome
Diabetes, heart failure, NSAIDs, Clots, lupus, infections from strep syphilis HIV hepatitis malaria
leukemia’s
What does nephrotic syn cause
increased glomerular permeability to proteins and other things
What are the S/S of nephrotic syn
massive, progressive edema
Hyperlipidemia
Hypercoagulability
What is nephrotic syn likely from
strep
What is a test for nephrotic syn
antistreptolysin titer
What do we do for nephrotic syn
same as glom
treat the cause and react to changes
What is an intrinsic obst uropathy
strictures (a kink)
What are extrinsic obst uorpathy
stones
Who is more likely to get stones
men, white, age 20-55, familial predisposition
What are the predisposing factors for calcium oxalate stoens
Idiopathic hypercalciuria, hyperoxaluria, independent of urinary pH, family history
What are the treatments for cl ox stones
Increase hydration
Reduce dietary oxalate
Give thiazide diuretics
Give cellulose phosphate to chelate calcium and prevent GI absorption.
Give potassium citrate for alkaline urine.
Give cholestyramine to bind oxalate.
Give calcium lactate to
precipitate oxalate in GI tract. Reduce daily sodium intake.
What are the predisposing factors of cal phos stones
Alkaline urine,
primary hyperparathyroidism
What isthe treatment for cal phos stones
treat underlying cause
What are the predisposing factors of struvite stones
urinary tract inf usu proteus
What are the treatment s for struvite stones
Administer antimicrobial agents and acetohydroxamic acid.
surgucal removal
acidify urine.
What are the predisposing factors for uric acid stones
gout
acidic urine
inheirited condition
What is the treatment for uric acid stones
Reduce urinary concentration of uric acid.
Alkalinize urine with potassium citrate.
Administer allopurinol. Reduce dietary purines
What are the predisposing factros for cystine stones
acidic urine
What is the treatment for cystine stones
Increase hydration.
Give α-penicillamine and tiopronin to prevent cystine crystallization.
Potassium citrate for alkaline urine.
What is a dietary recommenation for food for purine stones
reduce intake of
Sardines, herring, mussels, liver, kidney, goose, venison, meat soups,
sweetbreads
Chicken, salmon, crab, veal, mutton, bacon, pork, beef, ham
What are the dietary recommendations for food for calcium stoens
reduce intake of
dairy products; all beans (except
green beans), lentils; fish with fine bones (e.g., sardines, kippers, herring,
salmon); dried fruits, nuts; chocolate
What are the dietary recs for foods for oxalate stones
Decrease intake of
Dark roughage, spinach, rhubarb, asparagus, cabbage, tomatoes, beets, nuts,
celery, parsley, runner beans; chocolate, instant coffee, tea;
Worcestershire sauce
What is the treatment for all urinary tract calculi
treat pain with narcotics and antispasmodics like ditropan
increase fluids
If the calculi is over 4mm what will the likely treatment be
Transurethral lithotripsy
ESWL
