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Med Surg > Urinary > Flashcards

Urinary Flashcards

1
Q

What is the most common type of uti

A

E Coli

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2
Q

/what are risk factors for UTIS

A

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

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3
Q

How is uti diagnosed

A

clean catch and culture

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4
Q

What is used if we keep getting them for diagnosis of UTI’s

A

intravenous pyelogram (IVP) or scans to identify anatomic abnormalities contributing to UTI or kidney changes from recurrent infection

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5
Q

What is hydronephrosis

A

back up of fluid into the kidney

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6
Q

What are manifestations for hydronephrosis

A

back pain

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7
Q 
Match these
Chordee (e)
2.  Epispadias ( c)
3.  Hydrocele (a)
4.  Hypospadias (f)
5.  Inguinal hernia (d)
6.  Phimosis (b)
A

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

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8
Q

What are some symptoms of UTI’s I havent memorized

A

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

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9
Q

What is a big sign that indicates a UTI in children

A

new urinary incontinence

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10
Q

What are some nursing interventions for UTI

A

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

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11
Q

What are the teaching points for UTI’s

A

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.

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12
Q

What are the S/S of cystitis

A

Pain during sex

Pain worsening during menstruation

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13
Q

What is pylonephritis

A

an inflammation of the renal pelvis and renal tissues

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14
Q

What is a common prob before gettign pyelonephritis

A

cystitis from E Coli

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15
Q

What is Glomerulonephritis

A

an allergic rx

antigen-antibody rx

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16
Q

What is glomneph usually from

A

strep

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17
Q

What is an acute tubular necrosis

A

usu from a lack of perfusion so think of an MI

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18
Q

What are the signs and symps of pyeloneph

A

all of general UTI’s
plus pain Costovertebral Angle
possible systemic complications

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19
Q

What is a complciated UTI

A

involves kidney

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20
Q

What viruses can cause glomeruloneph

A

Hep B

Rubella (measles)

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21
Q

Who is more likely to get glomeruloneph

A

6-7yr old boys

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22
Q

About how long does the glomeruloneph lasts, what is likely given, and what is the nurse doing

A

14 days of antibiotics for strep inf

watching the patients conditions, reacting to changes

23
Q

What is a differnce between pyeloneph and glomneph

A

glom affects both kidneys from the start and pyelo will start with only one in the beginning

24
Q

What are the signs and symps of Glomneph

A 
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
25
Q

What can pyelo and glom end with

A

acute tubular necrosis

26
Q

What are some data to assess for in glom

A

precipitating streptococcal infection

drugs, virus, hepatitis, other infections

27
Q

What are some infection and conditions increase the risk of glom

A

upper respiratory infection or impetigo

lupus

28
Q

What are some prevention tips for glom

A

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

29
Q

What is a late sign of glom

A

oliguria

30
Q

What are some things that increase the risk for nephrotic syndrome

A

Diabetes, heart failure, NSAIDs, Clots, lupus, infections from strep syphilis HIV hepatitis malaria
leukemia’s

31
Q

What does nephrotic syn cause

A

increased glomerular permeability to proteins and other things

32
Q

What are the S/S of nephrotic syn

A

massive, progressive edema
Hyperlipidemia
Hypercoagulability

33
Q

What is nephrotic syn likely from

A

strep

34
Q

What is a test for nephrotic syn

A

antistreptolysin titer

35
Q

What do we do for nephrotic syn

A

same as glom

treat the cause and react to changes

36
Q

What is an intrinsic obst uropathy

A

strictures (a kink)

37
Q

What are extrinsic obst uorpathy

A

stones

38
Q

Who is more likely to get stones

A

men, white, age 20-55, familial predisposition

39
Q

What are the predisposing factors for calcium oxalate stoens

A 
Idiopathic
hypercalciuria,
hyperoxaluria,
independent of urinary
pH, family history
40
Q

What are the treatments for cl ox stones

A

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.

41
Q

What are the predisposing factors of cal phos stones

A

Alkaline urine,

primary hyperparathyroidism

42
Q

What isthe treatment for cal phos stones

A

treat underlying cause

43
Q

What are the predisposing factors of struvite stones

A

urinary tract inf usu proteus

44
Q

What are the treatment s for struvite stones

A

Administer antimicrobial agents and acetohydroxamic acid.
surgucal removal
acidify urine.

45
Q

What are the predisposing factors for uric acid stones

A

gout
acidic urine
inheirited condition

46
Q

What is the treatment for uric acid stones

A

Reduce urinary concentration of uric acid.
Alkalinize urine with potassium citrate.
Administer allopurinol. Reduce dietary purines

47
Q

What are the predisposing factros for cystine stones

A

acidic urine

48
Q

What is the treatment for cystine stones

A

Increase hydration.
Give α-penicillamine and tiopronin to prevent cystine crystallization.
Potassium citrate for alkaline urine.

49
Q

What is a dietary recommenation for food for purine stones

A

reduce intake of
Sardines, herring, mussels, liver, kidney, goose, venison, meat soups,
sweetbreads
Chicken, salmon, crab, veal, mutton, bacon, pork, beef, ham

50
Q

What are the dietary recommendations for food for calcium stoens

A

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

51
Q

What are the dietary recs for foods for oxalate stones

A

Decrease intake of
Dark roughage, spinach, rhubarb, asparagus, cabbage, tomatoes, beets, nuts,
celery, parsley, runner beans; chocolate, instant coffee, tea;
Worcestershire sauce

52
Q

What is the treatment for all urinary tract calculi

A

treat pain with narcotics and antispasmodics like ditropan

increase fluids

53
Q

If the calculi is over 4mm what will the likely treatment be

A

Transurethral lithotripsy

ESWL

Med Surg (35 decks)

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