Urinary Misc. (UTI, Pyelonephritis, Nephrolithiasis, Urinary Diversion Devicies) Flashcards
Define CAUTI
Catheter-acquired urinary tract infection
What is an “Upper UTI”?
involves parenchyma, pelvis or ureters
accompanied by fever, chills and flank Pain
What is another name for Flank Pain?
CVA tenderness or costovertebral angel tenderness
What is a Lower UTI?
associated with cystitis, no systemic manifestations
What is Pyelonephritis?
inflammation (usually r/t infection) of renal parenchyma and collecting system
What is Cystitis
inflammation of bladder wall
Define Urosepsis
UTI that has spread to systemic circulation, can be life threatening
What predisposes someone to UTI’s?
- neurogenic bladder
- kidney stones
- female urethra
- aging, DM
- constipation
- pregnancy
- poor hygiene
- habitual delay in urination (nurse’s bladder)
What are clinical manifestations of UTI’s
- Bladder emptying symptoms: hesitancy, intermittency, post void dribbling, urinary retention/ incomplete emptying, dysuria
- Bladder storage symptoms: urinary frequency, urgency, incontinence, nocturia, nocturnal enuresis
What is the most common bacterial infection and type of bacterial found in women?
UTI’s and gram negative bacteria (E-coli)
How would an older adult present with a UTI?
non-localized abdominal discomfort
cognitive impairment or generalized clinical deterioration
What diagnostic test are used for UTI’s
urinalysis
- quick dipstick
- microscopic urinalysis
- urine culture
What will you expect to see on a urinalysis
Leukocytes, Glucose, Ketone (Acetoacetic acid), Bilirubin, Blood, Specific Gravity, Protein, Urobilinogen, Nitrite, Ascorbic Acid, and pH.
What are some risk factor Reductions for UTI’s
patient teaching, empty bladder regularly and completely, wipe perineal area from front to back, drink adequate amounts of fluid daily (2-3 liter daily)
sexually active females should urinate prior to and following sexual intercourse
Risk Factor Reductions for Nosocomial/HAI UTI
- avoid or early removal of urinary catheterization
- careful aseptic technique w/ urinary tract instrumentation
- excellent hand washing and glove wearing when giving perineal care
- Avoid incontinence episodes
What are interventions for UTI’s
- adequate fluid intake (water is best)
- Pain relief ( warm bath, no bubbles), local heat to area
- ABX ( take full course, seek follow up care if symptoms do not resolve)
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How will the patient diagnosed with pyelonephritis present?
mild fatigue to sudden onset of chills, fever, vomiting and flank pain (CVA tenderness)
what additional diagnostic test will you perform for pyelonephritis
WBC w diff
imaging tests
Blood culture
How do you manage Mild symptoms of pyelonephritis?
adequate fluid intake
NSAIDs or antipyretic
follow up urine culture and imaging studies
How do you manage severe symptoms of Pyelonephritis?
Hopitalization
-adequate fluid intake (parenterally initially; switch to oral when N/V/dehydration subside)
-NSAID’s or antipyretic drugs
-follow up urine culture and imaging studies
Parenteral ABX- switch to oral when tolerates intake