Urinary Flashcards
UTI
Uncomplicated: only bladder
Complicated: Structural or functional problem (stones, AKI, CKD etc.)
Normal bladder pH
Under 6
Cystitis
Frequency Urgency Suprapubic pain Dysuria Hematuria Fever
Dx: Leukocyte esterase dipstick
Urinalysis, culture and sensitivity
treatment: antibiotics, fluids
Pyelonephritis (upper UTI)
Hematuria Flank pain Dysuria Fatigue, malaise Chills/fever Vomiting Pain at costovertebral angle
Same dx and tx as cystitis
Phenazopyridine for UTI
Pain relief, stains secretions orange
Coats walls of bladder w/analgesic
if symptoms not good within 2 days call doctor
Take with food
UTI management
Inc. fluids to 3L/day
Void q2h
Assess urine
Warm Sitz baths
Pyelo vs Cystitis
Pyelo can give permanent renal damage
Pyelo is usually bacterial
Pyeo has blunt percussion pain
Gerontological considerations for UTI
Can cause CONFUSION/AMS
fever
Bladder cancer
90% over 55
mostly cigarette smokers
Hematuria common sign
Surgery: TURBT (Transurethral resection bladder tumor)
- Segmental cystectomy (partial)
- Radical cystectomy: Remove bladder, prostate, seminal vessels, ovaries
Drug therapy for urinary incontinence
anticholinergics (ditropan)
Adrenergics: Cardura
Acute urinary retention
Unable to start
Chronic urinary retention
Incomplete emptying
Reflex incontinence
Detrusor hyperreflexia, s2 spinal cord lesion
Renal calculi
Inc risk in males N/V MEGA flank pain, sharp and sudden Hematuria dysuria
Renal calculi risk factors
Infection Urinary stasis Immobility Inc. uric acid Inc. urinary oxalate Family hx
Urinary stone prophylaxis
Limit oxalates
Limit purines for uric acid stones
How big of a urinary stone is necessary to use lithotripsy laser
over 4mm
Benign prostatic Hypertrophy
Lots of old dudes have it
Difficulty starting stream, weak urine stream
Check PSA to rule out cancer
Meds: Alpha adrenergic (FLOMAX) or erectogenic (Cialis)
Prostate FUN
Frequency
Urgency
Nocturia
Catheter needed for BPH
Coude
TURP for BPH
Transurethral Resection of Prostate
Continuous or intermittent bladder irrigation
Close observation of drainage to prevent bladder rupture
Maintain cath patency
Pain control with analgesics and rest first 24hr
Avoid straining with BMs
Watch for hemorrhage: bleeding should be light pink w/in 24 hr
Watch for infections/DVT
Prostate cancer
Biggest problem metastasis
Symptoms similar to BPH
