Urinary Case Study Flashcards
Burning on urination
Urinary frequency
Lower abdominal pain – ask if tenderness – suprapubic area
Urinary urgency
High HR – indicates pain and discomfort
Long hours and short breaks – not voiding when need to
Recent marriage – not voiding after intercourse
bladder infection
Female gender – shorter urethra and Recent marriage put at risk
Older age – is risk factor; less protection of estrogen
Cystits
not being able to unload bladder frequently and stress; inflammation of the urethra: caused by STI’s
Urethritis
Obstruction
Stones (calculi)
Recent use of antibiotics
Increased age
Diabetes
Female gender
Vesicoureteral reflux
Urinary Tract Infection
Male gender - prostate
Complications of STD - scarring from inflammation
Trauma during catheterization
Urethral Strictures
Overweight
Family history
Calcium supplementation
Urolithiasis – kidney stones
Given the initial data obtained from the client, what further information is important to obtain at this time? Select all that apply
A. History of sexual activity
B. Birth control method – spermicide increased risk for infections
C. Intake of fiber
D. Exercise habits
E. Presence of flank pain
F. Presence of hematuria – infection getting worse
answer: A, B, E, F
Sara asks where the bathroom is because she has the urge to urinate. What is the best action to take at this time?
A. Provide the client with instructions and supplies for obtaining a midstream clean catch urine specimen
B. Show the client where the bathroom is quickly so she is not incontinent
C. Ask the client if she can refrain from going to the bathroom until she is examined by the nurse practitioner
D. Instruct the client to not empty her bladder so frequently
answer: A
Want as much sterile specimen; sterile not required for urinalysis – not risk contamination; suspect infection want sterile send off for culture
Anything that can irritate the bladder (caffeine, tomato juice) or dehydrate (alcohol)
What type of fluids should she avoid and why?
The nurse is providing education to the client after her diagnosis with cystitis. What should be included? Select all that apply
A. Drink 8-10 glasses of liquid per day
B. Take measures to prevent constipation
C. Empty bladder frequently
D. Void immediately after sexual intercourse
E. Consider changing to another method of contraception if spermicide is used
F. Notify the provider of any increase in symptoms
G. Avoid the use of tampons
answer: A, C, D, E, F
Tampons not affect risk UTI
Incomplete bladder emptying creates a continuous pool of urine in which bacteria can grow and ascend more easily up the urinary tract
Bacteria have a greater chance of multiplying the longer they remain in residual urine
Overdistention of the bladder damages the mucosa and allows bacteria to invade the bladder wall
Obstruction
Large stones can obstruct urine flow
The rough surface of a stone irritates mucosal surfaces and creates a spot where bacteria can establish and grow
Bacteria can live within stones and cause re-infection
Stones (calculi)
Bacteria-laden urine is forced backward from the bladder up into the ureters and kidneys, where pyelonephritis can develop.
Vesicoureteral reflux
Excess glucose in urine provides a rich medium for bacterial growth.
Peripheral neuropathy affects bladder innervation and leads to a flaccid bladder and incomplete bladder emptying.
Diabetes mellitus
Alkaline urine promotes bacterial growth.
Concentrated urine promotes bacterial growth.
Characteristics of urine
Use of douches, perfumed pads or toilet tissue, diaphragms, or spermicide in women can inflame periurethral tissue and contribute to colonization.
Bladder displacement during pregnancy predisposes women to cystitis and the development of pyelonephritis.
A diaphragm or pessary that is too large can obstruct urine flow or traumatize the urethra.
Women
