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urinary disorders Flashcards

1
Q

what are the two classifications of UTIs

A
  • complicated (UTI tat doesnt respond to usual treatment)
  • uncomplicated
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2
Q

what are some upper UTIs

A
  • pyelonephritis = inflammation of the renal pelvis
  • nephritis = inflammation of the kidney
  • renal abscess

these are usually complicated

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3
Q

name some lower UTIs

A
  • cystitis = inflammation of the urinary bladder
  • prostatitis = inflammation of the prostate
  • urethritis = inflammation of the urethra
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4
Q

describe pyelonephritis

A
  • bacterial infection of the renal pelvis, tubules, and interstitial tissues in the kidneys of one or both kidneys
  • acute or chronic
  • associated ith abscesses, obstructions, and tumors
  • nephrons replaced by scar tissue in chronic infection
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5
Q

what are some common causes of pyelonephritis

A
  • ecoli infection (usually comes from shit getting into the urethra)
  • renal calculi
  • malignancy
  • catheter/cystoscopy
  • BPH
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6
Q

what are some acute symptoms of pyelonephritis

A
  • high fever/chills
  • leukocytosis
  • bacteriuria
  • pyuria
  • low back/flank pain
  • cloud/blood, foul smelling urine
  • painful urination
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7
Q

what are soem chronic symptoms of pyelonephritis

A
  • may have no symptoms
  • may have fatigue, headache,poor appetite, polyuria, excessive thirst, and weight loss
  • less painful
  • discovered when HTN being evaluated
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8
Q

what tests are used in the diagnosis of pyelonephritis

A
  • symptoms
  • labs (increased WBCs)
  • UA/C&S (bacteria in urine, gross urine, culture b4 antibiotics)
  • radiology (find root cause)
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9
Q

what are some nursing interventions for pyelonephritis

A
  • vital signs (hgih risk of sepsis)
  • I+O
  • maintain fluid balance and electrolyte balance
  • antibiotic therapy
  • analgesics
  • antispasmodics
  • increase fluid intake (3-4L/day)
  • renal diet
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10
Q

describe cystitis

A
  • inflamamtion in the lining of the urinary tract caused by bacteria
  • “bladder infection”
  • most common type of UTI
  • most common bacteria: ecoli
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11
Q

what are some risk factors for cystitis

A
  • inability to empty bladder completely
  • obstructed urinary flow
  • instrumentation of the urinary tract
  • inflammation or abrasion of the urethral mucosa
  • poor hygiene practices
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12
Q

what ae some symptoms of cystitis

A
  • pain
  • burning
  • bladder spasms
  • frequency
  • atypical for elderly
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13
Q

what are some diagnostic tools for cystitis

A
  • UA/C&S
  • CT scan
  • US
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14
Q

what are some nursing interventions for cystitis

A
  • strict aseptic technique for catheter insertion
  • instruct on proper perineal hygiene
  • I+Os
  • force fluids (3-4L/day)
  • educate (take all antibiotics)
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15
Q

a patient returns to the doctor after finishing her antibiotic course continuing to complain of uti symptoms. what classification of uti is this?

A

complication

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16
Q

name some types of urinary incontinence

A
  • stress
  • urge
  • functional
  • iatrogenic
  • mixed urinary
  • overflow
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17
Q

what are some gerontologic considerations for urinary incontinence

A
  • not a normal part of aging
  • decrease ability to maintain independence
  • transient episodes with abrupt onset
  • possible causes include UTI, constipation, meds, decreased estrogen levels, diabetes
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18
Q

what are some diagnostic tools for urinary incontinence

A
  • history
  • I+O
  • radiologic tests
  • residual urine checks
  • UA/C&S
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19
Q

what are some treatments/interventions for urinary incontinence

A
  • electrical stimulation
  • meds
  • bladder training/timed voided
  • kegal exercises
  • surgery
  • fluid and dietary changes
  • decrease caffiene and alcohol intake
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20
Q

describe urolithiasis/nephrolithiasis

A
  • presence of a stone anywhere in the urinary tract/kidney. stones may be composed of calcium oxalate, calcium phosphate, or uric acid
  • 75% of stones are calcium based
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21
Q

what are some risk factors for urolithiasis/nephrolithiasis

A

dehydration and meds like calcium supplements

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22
Q

what are sme signs and symptoms of urolithiasis/nephrolithiasis

A
  • pain in flank area
  • hematuria
  • urine retention, frequency, urgency
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23
Q

whats used in diagnosis of urolithiasis/nephrolithiasis

A
  • UA
  • radiologic testing
  • ct
  • ivp
24
Q

what are some interventions are used for urolithiasis/nephrolithiasis

A
  • analgesics and NSAIDs
  • I+O
  • strain urine (catch any stone passed for lab)
  • increase fluid intake
25
Q

what are some procedures for urolithiasis/nephrolithiasis

A
  • stent placement
  • percutaneous lithotripsy
  • extracorporeal shock wave lithotripsy
  • open removal (rare)
26
Q

describe percutaneous lithotripsy

A

small puncture in flank, gets stone out

good for bigger stones

27
Q

describe extracorporeal shock wave lithotripsy

A
  • most common one
  • shocks and breaks up the stone
  • no incision but may be bruising
28
Q

what are some post procedural interventions for urolithiasis/nephrolithiasis

A
  • manage pain and fluid and elctrolyte balance
  • monitor signs and symtpoms of infection
  • monitor kidney function
  • assess urine and strain
  • educated on possibility of bruising in the flank area for ESWL
29
Q

describe nephrostomy

A

bypasses all lower urinary tract, needs to be flushed

30
Q

what are risk factors for urolithiasis? choose all that apply

1) diet high in alcohol and organ meats
2) calcium supplements
3) smoking
4) urinary stasis

A

1) diet high in alcohol and organ meats
2) calcium supplements
4) urinary stasis

31
Q

what are soem risk factors for bladder cancers

A
  • tobacco use
  • toxins
  • family history
32
Q

what are some signs and symptoms of bladder cancer

A
  • painless hematuria
  • frquency, urgency, and dysuria
  • changes in voiding patterns
33
Q

whats used for diagnosis of bladder cancer

A
  • radiologic
  • biopsy
34
Q

whats included in the treatment of bladder cancer

A
  • cystectomy (complete removal of bladder)
  • radiation therapy
  • chemotherapy
  • may be a combo
35
Q

name some urinary diversions

A
  • illeal conduit
  • cutaneous ureterostomy
  • continent urostomy
36
Q

describe illeal conduit

A
  • most common, permanent
  • urine flows freely through stoma to a pouch
37
Q

describe cutaneous ureterostomy

A

ureters are brough out to skin in one or more stomas

38
Q

describe continent urostomy

A
  • ureters drain into reservoir that has a valved stoma
  • the stoma is cathed to remove urine
39
Q

describe pre op care for urinary diversion

A

patient education of expectations post surgery
- changes in body image
- show stoma pouches
- activities
- exercise, diet, and clothing
- discuss site of ostomy

40
Q

describe post op care/patient education for urinary diversion

A
  • assess stoma site
  • monitor I+O
  • monitor for S/S of stoma obstruction
  • education
  • ostomy nurse
41
Q

what are some complications of urinary diversion

A
  • stoma ischemia/necrosis
  • infection
  • stoma - irritation - yeast infection
  • skin breakdwon
42
Q

describe BPH

A
  • enlargment of prostate gland
  • men primarily over 40 years
  • prostate size increases with age
  • yearly exams
43
Q

what are some signs and symptoms of BPH

A
  • frequency/hesitancy
  • hematuria
  • inability to empty the bladder fully
  • post void dribbling
  • anuria
  • bladder distention
  • enlarged, firm, non elastic feeling upon digital exam
  • elevated PSA
44
Q

what are some diagnostic tools for BPH

A
  • digital rectal exam
  • PSA (not super accurate)
  • transrectal ultrasonography (TRUS)
  • CT/MRI
  • cystoscopy
45
Q

describe treatment for BPH

A
  • watchful waiting
  • meds like alpha1 adrenergic blockers or alpha reductase inhibitors
  • surgery (transurethral resection of the prostate and prostatectomy)
  • minimally invasive procedures (transurethral heat ablation, TULIP, prostatic stent)
46
Q

is prostate cancer deadly

A

yep
2nd in death rate only to lung cancer

47
Q

what are some risk factors for prostate cancer

A
  • increases with age (60s)
  • african american men - higher risk
  • family hx
  • diet high is saturated animal fat
  • vit D deficiency
  • occupational risks
  • high levels of testosterone
48
Q

describe prevention and screening for prostate cancer

A
  • annual DRE
  • PSA (starting at age 50)
  • ultrasound guided TRUS
49
Q

what are some signs ans symptoms of prostate cancer

A
  • dysuria, nocturia, hematuria
  • frquency
  • abnormal prostate on digital exam
  • bone pain, pack pain, nerve pain
  • bowel and bladder dysfunction
  • weight loss
  • fatigue
50
Q

whats used for the diagnosis of prostate cancer

A
  • subjective S/S
  • prostate specific antigen, DRE
  • TRUS exam
  • tissue biopsy
51
Q

what are some treatments of prostate cancer

A
  • hormone deprovation (ADT therapy) (not curative but can slow growth)
  • orchiectomy (cut those balls off, castration)
  • surgery
  • radiation (external or internal)
52
Q

what are some complications to prostate cancer treatment

A
  • hemorrhage
  • infection
  • venous thromboembolism
  • catheter issues
  • erectile dysfunction
  • urinary incontinence
  • urethral stricture
53
Q

what does TURP do

A

scrapes and sucks prostate tissue out

54
Q

what is the goal of continuous bladder irrigation (CBI)

A

prevent and remove blood clots in the bladder

55
Q

describe continuous bladder irrigation (CBI)

A
  • adjust flow rate to keep urine light pink/peach color
  • decrease flow rate if urine clear
  • increase flow rate if urine bloody
  • may need order for manual irrigation for large clots
56
Q

what test will diagnose prostate cancer?

A

biopsy

57
Q

true or false?
is it normal to see mucous threads in a urostomy pouch?

A

true

adults (51 decks)

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