Urinary and Renal problems Flashcards
What is difference between complicated and uncomplicated UTIs?
Uncomplicated means have normal urinary tract and only involves bladder
Complicated means something else is going on (diabetes, pregnancy, catheter, renal calculi, etc.)
What is first choice (4 of them) of abxs for UTI?
Bactrim (trimethoprim/sulfamethoxazole)
Macrobid (nitrofurantoin)
Keflex (cephalexin)
Fosfomycin
What are some other abxs that are given for UTIs?
Ampicillin
Amoxicillin
Cephalosporins
Fluoroquinolones
What is a common anti fungal given for UTIs?
Diflucan (fluconazole)
What is the name of common urinary analgesic?
Pyridium (phenAZOpyridine)
Azo
What bacteria is commonly the cause of CAUTIs and UTIs?
E. coli
What is the big clinical manifestation DIFFERENCE between upper and lower UTIs?
Flank pain, fever, chills with upper
—Remember upper will have more systemic s/sx—
—Lower will have more s/sx related to bladder storage and emptying–
What diagnostic tests will be ordered for suspected UTI?
UA
Urine for C/S
CBC with Diff
Blood culture (if bacteremia suspected)
Ultrasound
CT
What are common risk factors/causes of glomerulonephritis?
Diabetes
HTN
Glomerulosclerosis
Post-strep
Illegal drug use
Lupus (SLE)
Scleroderma
What are s/sx of post-strep glomerulonephritis?
1-6 weeks post strep infection
Edema
HTN
Oliguria
Hematuria
Proteinuria
Periorbital edema
Red/brown urine
Abdominal/Flank Pain
—History is important here!!–
What is nephrotic syndrome?
Glomeruli too permeable, especially to plasma proteins.
Causes MASSIVE proteinuria»>low plasma albumin and edema
Will have fat in urine (makes urine foamy)
Will be at risk of infection and risk for blood clots (hypercoagulability)
What is nursing focus on with nephrotic syndrome?
Managing edema
What is the most common composition of renal calculi?
Calcium oxalate (70-80%)
What medication causes smooth muscle of ureter to relax?
Flomax (tamulosin)
–Given to help pass kidney stone–
What are some common diagnostic studies done in renal calculi?
UA
CT
Ultrasound
Measuring urine pH can be helpful
Retrieval and stone analysis
What is priority nursing done in renal calculi?
Pain management
Secondary:
Strain urine, Hydration,
Ambulation
Teaching for kidney stones.
Hydration!!!!
Dietary changes
Sodium restrictions
What is a urethral stricture?
Narrowing (usually at UPJ or UVJ)
Could be from trauma, urethritis, surgery, congenital defect.
S/sx of urethral stricture?
Straining to void
Poor stream
Dribbling
Tx of urethral stricture.
Dilation
Temporary stent
Urethroplasty
What is nephrosclerosis?
Inadequate blood flow to kidneys leads to ischemia and necrosis
What is aim of treatment for nephrosclerosis?
Restore perfusion to kidney ASAP
What is renal vein thrombosis?
Treatment?
Thrombi in renal vein
Treatment aimed at busting clot and restoring perfusion
Cause of polycystic kidney disease?
Genetic disorder
Cystic enlarged kidneys
–There is an acquired type that can happen after a pt is on dialysis for long time–
What other organs can polycystic kidney disease affect?
Liver
Heart
Intestines
Blood vessels
Brain
Treatment of polycystic KD?
No cure
Prevent/tx of UTI
Nephrectomy
Dialysis
Transplant
Med called Tolvaptam that can slow cyst growth
What is procedure to break up kidney stones called?
Lithotripsy
Many different types like laser, ultrasonic, shock wave, etc.
What is procedure to surgically remove stones?
—lithotomy
nephrolithotomy (kidney)
Ureterolithotomy
Pyelolithotomy (renal pelvis)
Depending on where incision is made to remove stone.
What is aim at treating renal artery stenosis?
Control BP and restore kidney perfusion
What is Tolvaptan used for?
Polycystic Kidney Disease
–slows progression–
Risk factors for bladder cancer.
Smoking
White
Male
Obesity
What is the most common cancer of the urinary system?
Bladder
First s/sx of bladder cancer.
Painless hematuria
Bladder irritability with dysuria, frequency, urgency.
First s/sx of kidney cancer.
Flank pain
Hematuria
–Presents with upper UTI symptoms-
What are some common meds given to relax urethra and improve urine flow?
–these are classed as Alpha adrenergic blockers–
Flomax (tamulosin)
(All other meds in this class end in
—osin or zosin)
Examples:
alfuzosin
doxazosin
prazosin
silodosin
terazosin
What med reduces prostate size?
finasteride (Proscar)
What are some common meds for overactive bladder?
–classed as anticholinergics–
oxybutynin
tolterodine
fesoterodine
In urinary retention, what is the normal amount of urine left in bladder? How much is a cause of concern?
50 ml=normal
200 ml=concerning
