Urinary Function Flashcards
Cystitis
Inflammation of the bladder
Can also occur without an infection present
Interstitial Cystitis
Inflammation of the bladder with no known cause
What is the most common factor placing patients at risk for UTIs in the hospital and long-term care settings?
Catheters
Urosepsis
Spread of infection from the urinary tract to the bloodstream
Prostatits
Inflammation of the prostate
Urethritis
Inflammation of the urethra
What can happen if you leave a UTI untreated?
Can lead to pyelonephritis and urosepsis, which can eventually lead to death
Risk Factors for UTIs in Females
- Short urethra
- Sexual intercourse
- Frequent use of feminine hygiene sprays, tampons, sanitary napkins, and spermicidal jellies
- Pregnancy
- Wet bathing suits
- Frequent submersion into baths or hot tubs
Signs and Symptoms of UTIs
- Lower back or lower abdominal discomfort and tenderness over the bladder area
- Nausea or Vomiting
- Urinary frequency and urgency
- Dysuria, bladder cramping, spasms
- Feeling of incomplete bladder emptying or retention of urine
- Perineal itching
- Hematuria
- Pyuria (greater than 4 WBC in urine sample)
- Fever
- Nocturia
- Voiding in small amounts
- Cloudy or foul-smelling urine
Older Adult Clinical Manifestations of UTIs
- Mental confusion
- Incontinence
- Loss of appetite
- Nocturia and dysuria
- Hypotension, tachycardia, tachypnea, and fever (signs of urosepsis)
Complications from a UTI
- Urethral obstruction
- Pyelonephritis
- Chronic kidney disease
- Urosepsis
- Septic shock
- Death
A nurse is caring for a client who has a urinary tract infection. The client reports pain and a burning sensation upon urination, and cloudy urine with an odor. which of the following is the priority intervention by the nurse?
A. Offer a warm sitz bath
B. Recommend drinking cranberry juice
C. Encourage increased fluids
D. Administer an antibiotic
D. Administer an antibiotic
Rationale: The greatest risk to the client is injury to the renal system from the UTI. Therefore, the priority intervention is to administer antibiotics.
A nurse is reviewing information with a female client who has frequent urinary tract infections. Which of the following information should the nurse include? (Select all that apply)
A. Avoid sitting in a wet bathing suit
B. Wipe the perineal area back to front following elimination
C. Empty the bladder when there is an urge to void
D. Wear synthetic fabric underwear
E. Take a tub bath daily
A and C
ATI page 593 - PN Book
A nurse is reviewing the laboratory findings for a urinalysis (UA) of a client who reports urgency and nocturia. Which of the following findings should the nurse report to the provider?
A. Positive for casts
B. Positive for leukoctye esterase
C. Positive for epithelial cells
D. Positive for crystals
B. Positive leukocyte esterase
Rationale: The client who has a positive leukoctye esterase indicates 68% - 88% positive urine for URI, and the nurse should report this finding to the provider.
Expected Findings on a UA from a Patient with a UTI
Bacteria, sediment, WBC, and RBC
Positive leukocyte esterase and nitrates
Hematuria
Blood in the urine
Pyuria
Presence of WBC (pus) in the urine
Anuria
Complete lack of urine output
Scant amount
Urethral strictures
Narrowed areas of the urethra
Treated surgically
Manifestations of Urethritis
Burning or difficulty urinating and a discharge from the urethral meatus
What is the most common cause of urethritis in males?
STDs
Urethral Strictures
Narrowed areas of the urethra
Overflow Incontinence
Involuntary loss of urine when the bladder is overdistended
Continence
Control over the time and place of urination
Incontinence
Involuntary loss of urine severe enough to cause social of hygienic problems
Stress Incontinence
Loss of small amounts of urine during coughing, sneezing, jogging, or lifting.
Most common type
Urge Incontinence
Perception of an urgent need to urinate as a result of bladder contractions regardless of the urine volume in the bladder
Also known as overactive bladder
Mixed Incontinence
Presence of more than one type of incontinence - usually both urge and stress
Very common in older women
Overflow Incontinence
Occurs when the detrusor muscle fails to contract and the bladder becomes overdistended
Also known as underactive bladder
Functional Incontinence
Occurs as a result of factors other than the abnormal function of the bladder and urethra
A common factor is the loss of cognitive function in patients affected by dementia.
What exercise can you teach women when they have stress incontinence?
Pelvic floor (Kegel) exercises
Pyridium
Analgesic
It can relieve symptoms caused by urinary tract infections and other urinary problems.
Makes urine a bright orange color
Renal Calculi
- Too much calcium in the body
- Increased risk with family history
- Painful
- Encourage patient to drink lots of water to decrease the chance of them reoccuring
How do you develop bacterial cystitis? (UTI)
- E. coli
- Improper perineal care
- Catheter that may not be properly cared for
- Not using the restroom when you need to go
- Low estrogen count can increase risk for UTI
If a patient is post-menopausal has complained about having two UTIs in the last 6 months, what would you explain to the patient?
Low estrogen levels caused by menopause can increase the risk of developing a UTI
If someone has a fungal urinary tract infection, what would the nurse do? Select all that apply.
A. Get a list of medications B. Ask if they have visited any foreign places recently C. Palpate the kidney and bladder D. Look at current medical history E. Bladder scan for post void residual
A. Get a list of medications
D. Look at current medical history
E. Bladder scan for post void residual
Risk Factors for Gastritis
- NSAIDs
- H. pylori
- Caffeine
- Alcoho
- Corticosteroids
If a patient in a nursing home keeps having several falls, what should the nurse do first?
Obtain a urine sample to determine if the patient has a UTI - which can cause issues such as impaired balance, confusion, or agitation.
For a young women of childbearing age has a UTI and a doctor gives them an antibiotic, what can happen?
If the patient is on an oral contraceptive, the antibiotic can make the pill ineffective which can lead to unwanted pregnancy
What are some different reasons that an indwelling catheter might be inserted?
- Patient may have a neurogenic bladder
- Completely incontinent (increased risk of UTI with Foley catheter)
- Urinary retention
- Surgery
