- History and physical exam - Laboratory tests Urinalysis (UA) Urine for C &S (Urine for C&S stands for urine culture and sensitivity) CBC with differential BC BLOOD CULTURE (means blood sample) if bacteremia suspected Ultrasound CT urogram

Urinary Tract Infections Retention, Reflux & Incontinence Flashcards by Jugurtha Kerchit

Urinary Tract Infections?

Most common reason of infections health care
Most common bacterial infection in women
Common site of acquired infection
May be caused by a variety of disorders including tuberculosis, fungal and parasitic infections
**Bacterial infection is most common
***Escherichia coli (E.coli) most common pathogen
-Counts of 10 5th CFU/mL or more indicate signs/symptoms are indicative of UTI
Counts as low as 10 2nd in a person with symptoms is indicative of UTI

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Classification of Urinary Tract InfectionsUpper versus lower

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Lower UTI?

Usually no systemic manifestations

**Cystitis –inflammation of the bladder
**Prostatitis
**Urethritis-inflammation of the urethra

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Upper UTI

Renal parenchyma, pelvis, and ureters
Typically causes fever, chills, flank pain

** Pyelonephritis: acute and chronic:

Inflammation of renal parenchyma and collecting system
Interstitial nephritis
Renal abscess and perirenal abscess

se refiere estrictamente a los rinones

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Classification of UTI. Urosepsis

UTI that has spread systemically
Life-threatening condition requiring emergent treatment
Can lead to septic shock and death

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Factors Contributing to UTI

Bacterial invasion of the urinary tract
Urethrovesical reflux, ureterovesical reflux
Uropathogenic bacteria
Shorter urethra in women
Risk factors

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Risk for Urinary Track Infection

Patients at Risk:

Immunosuppressed
Diabetic
Have kidney problems
Have undergone multiple antibiotic courses (build resistance)
Have traveled to developing countries: Travel to developing countries can increase the risk of urinary tract infections (UTIs) due to various factors such as poor sanitation, lack of access to clean water, and exposure to different strains of bacteria.

In developing countries, the risk of UTIs may be higher due to poor hygiene practices and limited access to proper medical care.

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Classification of UTI

Complicated versus uncomplicated
Uncomplicated
**Occurs in otherwise normal urinary tract: Like in someone like me who doesn’t have any other conditions like diabetes hbp etc
**Usually only involves the bladder

-Complicated
Coexists with presence of
**Obstruction or stones
**Indwelling urinary catheters or stents
**Urinary diversions
**Abnormal GU tract
**Diabetes/neurological disease
**Resistance to antibiotics
**Immunocompromised
**Pregnancy induced changes
***Recurrent infection

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Etiology & Pathophysiology of UTI

-Alteration of defense mechanisms increases risk for contracting UTI
**Compromising immune response factors
***Age, HIV, diabetes

-Predisposing factors:

**Factors increasing urinary stasis
**BPH, tumor, neurogenic bladder

**Foreign bodies
***Catheters, calculi, instrumentation

**Anatomic factors
***Obesity, congenital defects, fistula

**Functional disorders
***Constipation

**Other
***Pregnancy, multiple sex partners (women)

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Etiology & Pathophysiology

Organisms introduced via ascending route form urethra and originate in the perineum
**Gram-negative bacilli normally found in the GI tract are a common cause
**Urologic instrumentation allows bacteria to enter urethra and bladder
**Sexual intercourse promotes “milking” of bacteria from perineum and vagina
***May cause minor urethral trauma
Less common routes
**Bloodstream
**Lymphatic system

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Etiology & Pathophysiology 2.0 of a UTI

Rarely results via hematogenous route meaning trough an injury on your arm for example. Blood !!!
Kidney function occurring from hematogenous transmission always preceded by injury to urinary tract
**Obstruction of the ureter
**Damage form stones
**Renal scars

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Etiology & Pathophysiology 2.0

Rarely results via hematogenous route
Kidney function occurring from hematogenous transmission always preceded by injury to urinary tract
**Obstruction of the ureter
**Damage form stones
**Renal scars

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Etiology & Pathophysiology 3.0 of a UTI

Catheter-associated urinary tract infections (CAUTI) are the most common HAI
**Most are underrecognized and undertreated
***Often caused by E. coli and less frequently Pseudomonas species

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Clinical Manifestations of UTI

Range from painful urination in uncomplicated urethritis or cystitis
To severe systemic illness associated with abdominal or back /flank pain, fever, urosepsis, and decreased kidney function or AKI in some cases of pyelonephritis (upper urinary tract)

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Clinical Manifestations of UTI

Symptoms r/t either bladder storage or bladder emptying

Bladder storage
**Nocturia- waking up 2 or more times to void
**Nocturnal enuresis- loss of urine during sleep

Bladder emptying
**Weak stream
**Hesitancy – difficulty starting the urine stream
**Intermittency – interruption of the urinary stream during voiding
**Postvoid dribbling – urine loss after completion of voiding
**Urinary retention – inability to empty urine from the bladder
**Dysuria –painful or difficult voiding

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Clinical Manifestations 2.0

Older adults

**Symptoms often absent
**Non localized abdominal discomfort rather than dysuria
**Cognitive impairment possible
**Change in behavior, confusion or agitation possible
**Fever less likely

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UTI Diagnostic Studies

History & physical examination
Dipstick urinalysis
**Identify presence of nitrites, WBCs, and leukocyte esterase
Urine culture & sensitivity (if indicated)
**Clean-catch sample preferred
**Specimen by catheterization or supra needle aspiration more accurate
**Determine bacteria susceptibility to antibiotics
-Ultrasound
-CT scan (CT urogram)

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UTI Interprofessional Care

Drug therapy with antibiotics
Uncomplicated UTI – short term course (typically 3 days)
**Trimethoprim/sulfamethoxazole – inexpensive, taken twice daily
**Nitrofurantoin (Macrodantin) -3-4 x /day or Macrobid (long acting) 2x/day
***Ampicillin, amoxicillin, cephalosporins
-Complicated UTI – long term treatment (7-14 days or more)
**Fluoroquinolones –Ciprofloxacin (Cipro)

-Other
**Antifungals –amphotericin or fluconazole
**Urinary analgesic –used in conjunction with antibiotics; provides soothing effect on urinary tract mucosa; stain s urine reddish orange
**Prophylactic or suppressive antibiotics

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Nursing Management of a UTI

Health history
**previous UTI, calculi, stasis, retention, pregnancy, STIs;
**antibiotics, anticholinergics, antispasmotics;
**instrumentation, (instruments/tools used in the past to diagnose or treat this pt ex iodine, insertion of a catheter)
urinary hygiene
**ANV, chills, nocturia, frequency, urgency
*Suprapubic/LBP lower back pain, bladder spasms, dysuria, burning with urination
Objective
**Fever
**Hematuria, foul smelling urine, tender/enlarged kidney
**Leukocytosis, + bacteria, WBCs, RBCs, pyuria, ultrasound, CT scan, IVP

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Nursing Management 2.0 of a UTI

Acute care

**Adequate fluid intake
**Avoid caffeine, alcohol, citrus, chocolate, spicey foods
**Application of local heat (warm pack)
**Instruct patient about drug therapy and SE; full course
**Monitor for signs of improvement and cessation of symptoms
**Report onset of flank pain, persistence of symptoms, fever
**Educate patient about voiding after intercourse, temporality d/c contraceptive diaphragm, regular voiding (3-4 hours), f/u care

Health Promotion
**Cranberry juice or tablets may reduce # of UTIs
**Avoid unnecessary catheterization; early removal of indwelling catheters

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Acute Pyelonephritis

AFECTA 3 PARTES

Inflammation of 1 renal parenchyma and
2colleting system (including 3 the renal pelvis)
Most common cause is bacterial infection

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Etiology and Pathophysiology Pyelonephritis

Preexisting factor usually present
Commonly starts in the renal medulla and spreads to adjacent cortex
Recurrent episodes lead to scarred, poorly functioning kidney and chronic pyelonephritis
**Vesicoureteral reflux –retrograde (backward) movement of urine for the lower to the upper urinary tract
**Dysfunction of the lower urinary tract –obstruction from BPH; stricture, stone
**CAUTI

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Clinical Manifestations Acute Pyelonephritis

Mild fatigue, chills, fever, vomiting, malaise, flank pain
LUTS characteristic of cystitis
**Dysuria, urgency, frequency
Costovertebral tenderness to percussion on affected side
Manifestations may subside in a few days, even without therapy
**Bacteriuria and pyuria still persist

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Diagnostics

History and physical exam
Laboratory tests
**Urinalysis (UA)
**Urine for C &S (Urine for C&S stands for urine culture and sensitivity)
**CBC with differential
**BC BLOOD CULTURE (means blood sample) if bacteremia suspected
**Ultrasound
**CT urogram

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Interprofessional Care Acute Pyelonephritis

- Hospitalization for patients with severe infections and complications **N/V with dehydration _Improve with treatment after 48-72 hours -Antibiotics (IV then oral) -NSAIDs or antipyretic drugs for fever or discomfort -Urinary analgesics -Relapses are treated with 6 weeks of antibiotics

Nursing Process: The Care of the Patient With a UTI—Assessment

- Pain, burning upon urination, frequency, nocturia, incontinence, hematuria - About half are asymptomatic - Association of symptoms with sexual intercourse, contraceptive practices, and personal hygiene - Gerontologic considerations - Assessment of urine, urinalysis, and urine cultures - Other diagnostic tests

Nursing Process: The Care of the Patient With a UTI—Diagnoses

- Acute pain related to infection - Deficient knowledge about: **Factors predisposing patient to infection and recurrence **Detection and prevention of recurrence **Pharmacologic therapy

Collaborative Problems and Potential Complications

- Sepsis (urosepsis) - Acute kidney injury - Chronic kidney disease

Nursing Process: The Care of the Patient With a UTI—Planning

- Major goals may include: **Relief of pain and discomfort **Increased knowledge of preventive measures and treatment modalities (types of treatment ex, medication, surgury etc ) **Absence of complications

Interventions for UTI

- Relieving pain - Medications as prescribed: antibiotics, analgesics, and antispasmodics - Application of heat to the perineum to relieve pain and spasm - Increased fluid intake - Avoidance of urinary tract irritants such as coffee, tea, citrus, spices, cola, and alcohol - Frequent voiding - Patient education

is the following statement true or false? Older adult patients often lack the typical symptoms of UTI and sepsis

True Older adult patients often lack the typical symptoms of UTI and sepsis

Urethrovesical and Uretherovesical Reflux?

Urethrovesical reflux and ureterovesical reflux are both conditions that involve the backflow of urine from the bladder up into the urethra and/or the ureters.

Urinary Incontinence

Affects more than 25 million adults in the United States Underdiagnosed and underreported Affects women and men Risk factors: refer to chart 55-6 Symptom of many possible disorders

Types of Urinary Incontinence

Stress Urge Functional Iatrogenic Mixed incontinence

Types of Urinary Incontinence

Stress Urge Functional Iatrogenic Mixed incontinence

Patient Education #1

- Urinary incontinence is not inevitable and is treatable - Management takes time (provide encouragement and support) - Education verbally and in writing (Chart 55-9) - Develop and use a voiding log or diary - Behavioral interventions - Medication education related to pharmacologic therapy - Strategies for promoting continence

Is the following statement true or false? Urinary incontinence is inevitable and is not treatable

False Urinary incontinence is not inevitable and is treatable

Patient Education- Developing an Action Plan for Incontinence

- Develop an education plan for a patient with mixed stress and urge incontinence. **Include the key points that are listed. **Explain the voiding diary. **Detail the behavioral interventions that may be used for a patient with stress and urge incontinence. **List medications that may be used to treat stress and urge incontinence. Explain medication actions and the education needed for the classifications of medications used to treat stress and urge incontinence. **Emphasize the importance of being culturally sensitive and the need to address the social needs of the patient.

Urinary Retention

- Inability of the bladder to empty completely - Residual urine: amount of urine left in the bladder after voiding -Causes include: **Adults 60 years and older may have 50 to 100 mL of residual urine remaining in the bladder after voiding **Postoperative spasms **Diabetes, prostatic enlargement, urethral pathology, trauma, pregnancy, neurologic disorder **Medications

Urinary Retention

Urolithiasis and Nephrolithiasis

-Calculi (stones) in the urinary tract or kidney -Pathophysiology -Causes: may be unknown -Depends on location and presence of obstruction or infection -Pain and hematuria -Diagnosis: radiography, blood chemistries, and stone analysis; strain all urine and save stones

Potential Sites of Urinary Calculi? slide 40

Methods of Treating Renal Stones slide 41

Methods of Treating Renal Stones slide 42 No need it's the same as 41-42-43

Methods of reating Renal Stones. Slide 43 the same as 41-42

Patient Education #2 for kidney stones

- Signs and symptoms to report - Follow-up care - Urine pH monitoring - Measures to prevent recurrent stones - Importance of fluid intake - Dietary education - Medication education as needed

Types of Genitourinary Trauma

-Ureteral: motor vehicle accidents, sport injuries, falls -Bladder: pelvic fracture, multiple trauma, blow to lower abdomen -Urethral: blunt trauma to lower abdomen and pelvis **s/s classic triad: blood visible at the meatus, inability to void, distended bladder

Genitourinary Trauma Management

-Medical management: control hemorrhage, pain and infection; monitor for oliguria, shock, s/s acute peritonitis (Peritonitis is a redness and swelling (inflammation) of the lining of your belly or abdomen.) -Surgical management: suprapubic catheter, surgical repair -Nursing management: **Assess frequently **Instruction about incision care and adequate fluid intake **Changes to report: fever, hematuria, flank pain

Urinary Tract Infections: Urinary tract infections (UTIs) are a common health issue that can affect both men and women, although they are more prevalent in women. They occur when bacteria, usually Escherichia coli (E.coli), enter the urethra and spread to the bladder, ureters, or kidneys. UTIs are the most common bacterial infection in women and a common site of acquired infection. UTIs can be caused by a variety of disorders, including tuberculosis, fungal, and parasitic infections, but bacterial infection is the most common cause. The symptoms of a UTI can include painful urination, a strong urge to urinate, frequent urination, cloudy or strong-smelling urine, and pelvic pain. A bacterial count of 10^5 CFU/mL or more in a urine sample is considered indicative of a UTI. However, in a person with symptoms, a count as low as 10^2 CFU/mL may be indicative of a UTI. It is important to seek medical attention if you suspect you have a UTI, as untreated infections can lead to more serious health complications.

Prostatitis is a medical condition characterized by inflammation of the prostate gland. The prostate gland is a walnut-sized gland located just below the bladder in men. It produces fluid that is part of semen. Prostatitis can be caused by bacterial or non-bacterial factors. Bacterial prostatitis is caused by infection of the prostate gland by bacteria, while non-bacterial prostatitis can be caused by other factors, such as nerve damage, autoimmune disorders, or irritation of the prostate gland.

Lower UTI

Renal parenchyma UTI material Urinary tract infections (UTIs) can affect any part of the urinary tract, including the renal parenchyma, which is the functional tissue of the kidneys. When the infection affects the renal parenchyma, it is known as pyelonephritis, which is a more serious type of UTI. Pyelonephritis is typically caused by a bacterial infection, which can spread from the lower urinary tract to the kidneys. The most common pathogen is Escherichia coli (E.coli), which is responsible for about 80% of all UTIs.

upper UTI

upper uti causes more systematic symptomps ? Yes, upper urinary tract infections (UTIs), such as pyelonephritis (an infection of the kidneys), can cause more systemic symptoms than lower UTIs. This is because upper UTIs involve not only the bladder and urethra but also the kidneys and renal pelvis. Symptoms of upper UTIs may include fever, chills, nausea, vomiting, back pain, and general malaise. These symptoms can indicate a more serious infection and may require more aggressive treatment, such as hospitalization and intravenous antibiotics.

yes

what is septic shock? Septic shock is a serious medical condition that occurs when an infection leads to a severe systemic inflammatory response in the body. It is a medical emergency that can quickly become life-threatening. When an infection spreads throughout the body, it can trigger an exaggerated immune response, causing inflammation, damage to tissues and organs, and potentially leading to organ failure

Urosepsis can cause septic shock

Uncomplicated urinary tract infections (UTIs) typically occur in an otherwise healthy urinary tract and usually only involve the bladder. This means that there are no underlying anatomical or functional abnormalities in the urinary tract that predispose to infections. Todo bien es solo azar mala suerte shit happens In uncomplicated UTIs, the symptoms are generally limited to the lower urinary tract and may include a frequent urge to urinate, painful urination, and a feeling of incomplete bladder emptying. These symptoms are caused by the presence of bacteria in the bladder, which irritate the bladder lining and trigger an inflammatory response. Uncomplicated UTIs are generally treated with a short course of antibiotics.

An abnormal genitourinary (GU) tract refers to any anatomical or functional defect or disorder affecting the organs of the urinary and genital systems. VAMOS QUIERE DECIR ANYTHING OUT OF THE NORM

uti Most common reason of infections health care Urinary tract infections (UTIs) are one of the most common reasons for healthcare-associated infections. This is because catheterization and other invasive procedures that are commonly performed in healthcare settings can introduce bacteria into the urinary tract and increase the risk of infection.

tuberculosis, fungal and parasitic infections

can cause uti's

Bacterial infection is most common cause of UTI ? Oui

***Escherichia coli (E.coli) most common pathogen of these bacteria

In the context of a urine culture, CFU stands for colony-forming units, which are used to measure the number of bacteria present in a urine sample. A count of 10 5th CFU/mL or more indicates that there is a significant amount of bacteria present in the urine, which is generally considered indicative of a urinary tract infection (UTI). This is because the urinary tract normally contains very few bacteria, so the presence of a large number of bacteria in the urine suggests that there is an infection present.

EVEN WITHOUT SYMPTOMPS

CFU stands for colony-forming units

Counts as low as 10 2nd in a person with symptoms is indicative of UTI

even it it has not reached the threshold of 10 5nd

parenchyma etymology The word "parenchyma" comes from the Greek words "para" (meaning "beside" or "alongside") and "enkhuma" (meaning "infusion" or "fluid"), which together roughly translate to "something that is infused beside (other tissue)". The term was originally used to describe the soft, functional tissue of an organ, as opposed to its harder, structural tissue (known as the stroma). Today, the term "parenchyma" is used more broadly to refer to the functional tissue of an organ, regardless of its consistency or location within the organ.

functional tissue of an organ, as opposed to its harder, structural tissue (known as the stroma like bone ).

perineum The perineum is the area of the body located between the pubic bone at the front of the pelvis and the tailbone at the back of the pelvis. It is a diamond-shaped region that includes the external genitalia (vulva or penis)

Urologic instrumentation allows bacteria to enter urethra and bladder Urologic instrumentation refers to medical procedures that involve inserting instruments into the urinary tract, such as catheters, scopes, or other devices. These procedures can increase the risk of introducing bacteria into the urinary tract, as they can disrupt the natural barriers that normally help prevent infections. When an instrument is inserted into the urethra, it can cause small abrasions or tears in the tissue, which can provide a pathway for bacteria to enter the bladder or other parts of the urinary tract.

Sexual intercourse promotes “milking” of bacteria from perineum and vagina

During sexual intercourse, the movements and friction of the penis or other object against the perineum and vagina can cause the "milking" or movement of bacteria from these areas into the urethra. This is particularly true in women, as the urethra is located very close to the vagina and anus, which are both sources of bacteria. In women, sexual activity can also cause microabrasions or tiny tears in the tissue of the vaginal wall or vulva, which can provide an entry point for bacteria into the urinary tract. Men can also experience microabrasions on the penis, particularly if there is vigorous or prolonged sexual activity.

It is not necessarily true that kidney function occurring from hematogenous transmission is always preceded by injury to the urinary tract. Hematogenous transmission refers to the spread of infection through the bloodstream, which can sometimes lead to the development of kidney infections (pyelonephritis) without any prior injury to the urinary tract. However, injury or obstruction to the urinary tract can certainly increase the risk of developing kidney infections, as it can create an environment where bacteria can easily grow and multiply.

HAI stands for healthcare-associated infection

what causes painful urination in UTI ? Painful urination, also known as dysuria, is a common symptom of urinary tract infections (UTIs). It is caused by irritation and inflammation of the lining of the urethra and bladder, which can occur when bacteria infect the urinary tract. When bacteria enter the urethra and bladder, they can attach to the lining of these structures and cause inflammation. This inflammation can make it difficult and painful to pass urine

Hesitancy refers to difficulty starting the flow of urine or delaying the start of urination. It is a common symptom of urinary tract problems, particularly in men with prostate enlargement or obstruction.

Bladder emptying **Weak stream A weak stream during urination can be a sign of an underlying urinary tract problem that affects bladder emptying. The bladder is a muscular organ that stores urine until it is ready to be emptied through the urethra. When the bladder contracts to expel urine, the urine flows out through the urethra in a steady stream. However, if there is an obstruction or narrowing in the urinary tract, the stream of urine may become weaker or slower.

Specimen by catheterization or supra needle aspiration more accurate Catheterization or suprapubic needle aspiration (SPA) are methods for obtaining a urine specimen for laboratory analysis in patients who are unable to provide a clean-catch urine sample. Both methods involve inserting a needle or catheter directly into the bladder to collect urine, bypassing the urethra and reducing the risk of contamination by bacteria from the skin or vagina. Compared to other urine collection methods, catheterization and SPA have been shown to be more accurate for diagnosing urinary tract infections (UTIs), as they provide a more representative sample of urine from the bladder itself. However, these methods are more invasive and carry a greater risk of complications such as bleeding, infection, or injury to surrounding organs.

Ultrasound uti Ultrasound can be a helpful diagnostic tool in assessing the urinary tract, including in cases of suspected urinary tract infection (UTI). Ultrasound uses high-frequency sound waves to create images of the kidneys, bladder, and other structures in the urinary system, allowing healthcare providers to evaluate the size, shape, and function of these organs.

what are Urinary diversions = kinda like a bypass Urinary diversions are surgical procedures that involve rerouting urine away from the bladder to an alternative site for collection and elimination. These procedures may be necessary for individuals who have had their bladder removed (cystectomy) or who have urinary tract obstructions, nerve damage, or other medical conditions that prevent normal bladder function.

what is a Bladder ultrasonography used for Bladder ultrasonography is used for several purposes, including: Diagnosing urinary tract problems: It can detect abnormalities in the bladder, such as bladder stones, tumors, or blockages. Evaluating bladder function: Bladder ultrasonography can be used to determine the volume of urine left in the bladder after urination (post-void residual volume). This measurement is important in diagnosing bladder dysfunction, such as urinary retention or overactive bladder. Monitoring urinary flow: Bladder ultrasonography can be used to evaluate the speed and pattern of urine flow, which can help diagnose urinary tract obstructions. Monitoring treatment: Bladder ultrasonography can be used to monitor the effectiveness of treatment for bladder conditions such as urinary incontinence or overactive bladder. Guiding bladder procedures: Ultrasound guidance can be used to help guide bladder procedures such as bladder catheterization or bladder biopsies. Overall, bladder ultrasonography is a safe and non-invasive diagnostic tool that can help diagnose and manage a variety of bladder-related conditions.

what is a cystogram A cystogram is a type of medical imaging test that uses X-rays to visualize the bladder. It is typically performed to evaluate the structure and function of the bladder, particularly after injury or surgery, or to diagnose urinary tract problems such as incontinence, recurrent urinary tract infections, or bladder cancer. During a cystogram, a special dye called contrast material is injected into the bladder through a catheter. The contrast material helps outline the shape of the bladder on X-ray images, allowing the healthcare provider to evaluate the bladder for abnormalities such as tumors, diverticula (small pouches), or obstructions.

Assuming an average urine output of 30 mL/hour, the normal urine output in 8 hours would be: 30 mL/hour x 8 hours = 240 mL Therefore, a normal urine output for 8 hours is approximately 240 mL. However, as I mentioned earlier, individual factors can cause variation in urine output, and it is best to consult with a healthcare provider for a more personalized assessment.

cystoscopy Cystoscopy is a medical procedure in which a thin, flexible tube with a camera and light at the end (called a cystoscope) is inserted into the urethra and guided into the bladder to examine the lining of the bladder and urethra. During the procedure, the physician can visualize the structures of the urinary tract and look for any abnormalities such as tumors, stones, inflammation, or structural problems.

A bladder ultrasonography is a noninvasive method of measuring urine volume in the bladder;

need full bladder

Is contrast dye made of iodine? Yes, in medical imaging procedures, iodine is commonly used as a contrast agent, which is a type of dye that helps highlight certain structures or areas of the body during imaging. The iodine is usually administered intravenously or orally and is used in procedures such as CT scans, X-rays, and angiograms to help visualize blood vessels, organs, and other structures. The contrast agent made with iodine is usually referred to as iodinated contrast media.

some people are allergic to it

When fluid intake decreases, specific gravity normally increases. With high fluid intake, specific gravity decreases

75 cc = 75 ml

trick you

Urine that is bright yellow is an anticipated abnormal finding in the client taking a multivitamin preparation. Urine that is orange may be caused by intake of phenytoin or other medications. Orange- to amber-colored urine may also indicate concentrated urine due to dehydration or fever. Urine that is pink to red may indicate lower urinary tract bleeding. Yellow to milky white urine may indicate infection, pyuria, or, in the female client, the use of vaginal creams.

Adverse effects of medications are a common cause of decreased renal function in older adults.

and therefore decreased creatinine clearance

Angiography provides the details of the arterial supply to the kidneys, specifically the number and location of renal arteries. Radiography shows the size and position of the kidneys, ureters, and bladder. A CT scan is useful in identifying calculi, congenital abnormalities, obstruction, infections, and polycystic diseases. Cystoscopy is used for providing a visual examination of the internal bladder.

what is urinary urgency? Urinary urgency is a symptom characterized by a sudden and strong urge to urinate, often accompanied by the feeling that it is difficult to hold urine. It can be a common symptom of various urinary tract disorders, including an enlarged prostate (BPH), urinary tract infection, interstitial cystitis, and overactive bladder.

After renal angiography involving a femoral puncture site, the nurse should check the client's pedal pulses frequently to detect reduced circulation to the feet caused by vascular injury. after we carried out this invasive procedure

A voiding cystogram involves the insertion of a urinary catheter, which can result in the introduction of microorganism into the urinary tract. Fluid intake is encouraged to flush the urinary tract and promote removal of microorganisms

A dull sound when percussing over the bladder indicates a full bladder.

pruritus and urticaria, which may indicate a mild anaphylactic reaction to the arteriogram dye

Pruritus is a medical term that refers to itching or a sensation of itchiness on the skin or in the mucous membranes. It can be caused by a variety of factors, including: allergic reactions

Hesitancy refers to difficulty in initiating urination or a delay in starting the urinary stream,

A decrease in creatinine clearance may indicate decreased kidney function, and certain medications or supplements may contribute to this decline in renal function. Therefore, it is important to confirm all medications and supplements taken by the client to identify any potential nephrotoxic agents or medications that may need to be adjusted.

Encourage high fluid intake. after any nuclear scan procedure

because people are given radioactive shit

Dullness to percussion of the bladder following voiding indicates incomplete bladder emptying.

Ultrasonography requires a full bladder; therefore, fluid intake should be encouraged before theprocedures ultra llena

los de la sonata necesitan agua despues del concierto

a fluid volume/////////////////// deficit you can just say a fluid deficit (simple)

means that you don't have enough fluid = dehydration

Many age-related changes in the renal and urinary systems should be taken into consideration when taking the health history of the older adult. One change includes a decreased glomerular surface area resulting in a decreased glomerular filtration rate.

Cystoscopy is a diagnostic procedure that allows a healthcare provider to examine the inside of the bladder and urethra using a cystoscope, which is a thin tube with a camera and light at the end.

Renal failure secondary to diabetic nephropathy refers to the progressive kidney damage that can occur as a result of uncontrolled diabetes mellitus. Over time, high blood glucose levels can damage the small blood vessels in the kidneys, leading to a decrease in kidney function and eventually, kidney failure.

A CT scan (Computed Tomography) is a diagnostic medical imaging test that uses X-rays and computer technology to produce detailed images of internal structures of the body. The CT scan can provide detailed images of the body's internal organs, bones, blood vessels, and soft tissues.

An IVP (Intravenous Pyelogram) is a diagnostic test used to examine the urinary system. During the procedure, a contrast dye is injected into a vein in the arm, which travels through the bloodstream and is filtered by the kidneys.

Cranberry juice is often recommended as a natural remedy for urinary tract infections (UTIs) because it contains compounds called proanthocyanidins (PACs). PACs are believed to help prevent bacteria, such as Escherichia coli (E. coli), from adhering to the walls of the urinary tract, which can help to prevent and treat UTIs.

The renal pelvis is a funnel-shaped structure located in the central area of the kidney. It is the area where urine is collected and funneled into the ureter, which is a tube that carries urine from the kidney to the bladder.

stricture de estrecho narrow en ingles and it can cause pyelonephritis A stricture is an abnormal narrowing of a hollow tube or passageway within the body. It can occur in various parts of the body, including the urinary tract, digestive system, and blood vessels.

CAUTI stands for Catheter-Associated Urinary Tract Infection.

LUTS stands for lower urinary tract symptoms,

A CBC with differential provides additional information about the types of white blood cells present in the blood. The differential count measures the percentage of each type of white blood cell present in the blood, including: Neutrophils: which are the most common type of white blood cell and help fight bacterial infections. Lymphocytes: which help fight viral infections and other diseases. Monocytes: which help fight infections caused by bacteria, viruses, and fungi. Eosinophils: which are involved in allergic reactions and help fight parasites. Basophils: which are involved in allergic reactions and inflammation.

how does a UTI cause nocturia A UTI, or urinary tract infection, can cause nocturia, which is the need to urinate frequently during the night. This happens because the infection causes inflammation and irritation in the lining of the bladder, which can result in bladder muscle spasms and a feeling of urgency to urinate, even when the bladder is not full.

contraseptive practices can cause a uti a condom for example

Contraceptive practices: Certain types of contraceptives, such as diaphragms, spermicides, and condoms, can increase the risk of UTIs by disrupting the normal balance of bacteria in the vagina or urethra. Women who use these types of contraceptives may be more likely to develop UTIs than those who do not.

there are several types of urinary incontinence, including: Stress incontinence: This type of incontinence occurs when there is increased pressure on the bladder, causing leakage of urine. It often occurs during physical activities such as coughing, sneezing, or exercise. Urge incontinence: This type of incontinence occurs when there is a sudden, intense urge to urinate, followed by involuntary loss of urine. It is often caused by an overactive bladder muscle. Functional incontinence: This type of incontinence occurs when a person has difficulty reaching the toilet in time due to physical or mental impairment, such as arthritis or dementia. Iatrogenic incontinence: This type of incontinence is caused by medical treatments or procedures, such as surgery or medication. Mixed incontinence: This type of incontinence is a combination of stress and urge incontinence, and is the most common type of incontinence in women. Other types of urinary incontinence include overflow incontinence, which occurs when the bladder is constantly full and leaks urine, and transient incontinence, which is a temporary form of incontinence that is often caused by a medical condition or medication.

Explain the voiding diary. A voiding diary is a record of an individual's urinary habits, which can be used to help diagnose and manage urinary problems such as incontinence or overactive bladder. The diary typically records the time and amount of each urination, as well as any episodes of leakage or urge to urinate. It may also include notes on fluid intake, medication use, and any activities or events that may have affected urinary habits. The purpose of a voiding diary is to provide a detailed picture of an individual's urinary habits over a period of time, typically 24-48 hours, although longer periods may be necessary in some cases. The information collected in the diary can help healthcare providers identify patterns and potential triggers of urinary problems, and develop personalized treatment plans.

Pelvic floor muscle exercises (Kegel exercises): These exercises involve contracting and relaxing the muscles of the pelvic floor to help strengthen and improve control of the muscles that support the bladder and urethra. They are particularly helpful for stress incontinence.

Behavioral interventions are used for patients with stress and urge incontinence. These include pelvic floor muscle exercises(Kegel exercises), bladder training, fluid and diet management, scheduled toileting, biofeedback, electrical stimulation, and weight loss and exercise. These interventions can be effective in reducing symptoms when used alone or in combination with other treatments. A personalized treatment plan should be developed with a healthcare provider.

Postoperative urinary spasms can occur after surgery in the bladder or urinary tract, and are typically caused by irritation or inflammation of the bladder or urethra. These spasms can be uncomfortable and may cause urgency, frequency, and pain with urination.

some medications can cause urinary incontinence and urinary retention

Diabetes can cause urinary retention by damaging the nerves that control bladder function. This condition, known as diabetic neuropathy, can affect the autonomic nerves that control involuntary functions such as digestion and bladder control. When these nerves are damaged, they may not be able to properly signal the bladder to contract and empty urine, leading to incomplete bladder emptying and urinary retention.

Urolithiasis refers to stones that form in the lower urinary tract,

uro vs nephro daaaa The term "urolithiasis" comes from the combination of two Greek words: "ouron," meaning urine, and "lithos," meaning stone.

nephrolithiasis refers to stones that form in the kidney.

uro vs nephro daaaa

Urolithiasis and nephrolithiasis are medical terms used to describe the formation of stones in the urinary system. Urolithiasis refers to stones that form in the lower urinary tract, while nephrolithiasis refers to stones that form in the kidney. Kidney stones are formed when substances such as calcium, oxalate, and uric acid build up in the urine and form crystals. These crystals can then clump together to form stones, which can range in size from a grain of sand to a golf ball.

Blood chemistries refer to a group of laboratory tests that measure the levels of various substances in the blood

Straining all urine and saving stones is a common medical recommendation for patients who are at risk of developing urolithiasis or nephrolithiasis. By straining their urine, patients can catch any stones that pass through their urinary tract and save them for analysis.

Straining means filtering the urine to catch any solid particles or debris, such as stones or sediment.

Potential Sites of Urinary Calculi Urinary calculi, also known as urinary stones, can form in different parts of the urinary tract. The potential sites of urinary calculi include: Kidneys: Stones can form in one or both kidneys. These are called nephrolithiasis. Ureters: These are the tubes that carry urine from the kidneys to the bladder. Stones that form in the ureters are called ureteral calculi. Bladder: Stones that form in the bladder are called bladder stones. Urethra: This is the tube that carries urine from the bladder to the outside of the body. Stones that form in the urethra are called urethral calculi. The most common site for urinary calculi is the kidneys, with about 80% of stones forming there. Ureteral stones account for about 10% to 20% of urinary calculi, while bladder and urethral stones are relatively rare. The location of the stone can affect the symptoms experienced by the patient and the treatment options available.

everywhere in the urinary system

Methods of Treating Renal Stones There are several methods used for treating renal stones, depending on the size and location of the stone, the severity of the symptoms, and the overall health of the patient. These methods include: Observation: Small stones (less than 5mm in size) may pass through the urinary tract on their own, without the need for any intervention. In such cases, the patient may be advised to drink plenty of fluids and monitor their symptoms. Medications: Certain medications can be used to help pass small stones or to prevent the formation of new stones. These include alpha-blockers, which relax the muscles in the ureter and help the stone pass more easily, and medications that lower the levels of substances that contribute to stone formation. Extracorporeal Shock Wave Lithotripsy (ESWL): This is a non-invasive procedure that uses shock waves to break up the stone into smaller pieces that can be passed more easily. It is typically used for stones that are less than 2cm in size. Ureteroscopy: This is a minimally invasive procedure that involves passing a thin, flexible scope through the urethra, bladder, and ureter to reach the stone. The stone can then be removed or broken up using a laser. Percutaneous Nephrolithotomy (PCNL): This is a surgical procedure that involves making a small incision in the back and inserting a scope to directly access the kidney and remove the stone. Open surgery: In rare cases, open surgery may be required to remove a large or complicated stone

Urine pH monitoring for kidney stones Urine pH monitoring is an important diagnostic tool used in the management of kidney stones. Urine pH is a measure of the acidity or alkalinity of the urine, and it can provide valuable information about the risk of kidney stone formation and the type of kidney stones present. In general, a urine pH between 5.0 and 7.0 is considered normal. A urine pH below 5.0 indicates acidic urine, which can increase the risk of uric acid and cystine stone formation. On the other hand, a urine pH above 7.0 indicates alkaline urine, which can increase the risk of calcium phosphate and struvite stone formation. Monitoring urine pH can help healthcare providers determine the appropriate treatment for kidney stones.

Anemia in the elderly can be caused by a variety of factors, including: Anemia in the elderly is a common condition that can have multiple causes. Iron deficiency anemia is the most common type of anemia in older adults and can be caused by poor diet, gastrointestinal bleeding, or chronic diseases. Vitamin deficiency anemia can result from inadequate intake of folate or vitamin B12, which is often due to poor diet or malabsorption disorders. Anemia of chronic disease is a type of anemia that occurs in individuals with chronic inflammatory or infectious diseases, such as cancer or rheumatoid arthritis. Hemolytic anemia is a type of anemia that occurs when red blood cells are destroyed faster than they are produced. It can be caused by autoimmune disorders or certain medications. Myelodysplastic syndrome is a bone marrow disorder that can cause anemia in older adults. Kidney disease can also contribute to anemia in the elderly by reducing the production of erythropoietin, a hormone necessary for the production of red blood cells.

why does an elevated BUN or slightly elevated indicate dehydration ? An elevated blood urea nitrogen (BUN) level may indicate dehydration because BUN is a waste product that is normally excreted by the kidneys. When there is less fluid in the body due to dehydration, the kidneys conserve water by reducing urine output, which can lead to an increase in BUN levels. Additionally, dehydration can lead to decreased blood flow to the kidneys, which can also cause an increase in BUN levels.

In medicine, a triad refers to a group of three signs or symptoms that frequently occur together and may suggest a particular diagnosis or condition. The classic triad often refers to a well-known group of three symptoms that are strongly associated with a specific medical condition triad = tres

triad = tres

Peritonitis is an inflammation of the peritoneum, which is the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs.

A result of 10^5 CFU/mL or higher in a urine sample is usually considered indicative of a urinary tract infection (UTI).

in a person with symptoms, a count as low as 10^2 CFU/mL may be indicative of a UTI.

Older adults **Symptoms often absent

UTI

**Fever less likely UTI

Older people

is parenchyma made of nephrons Yes partialy , the renal parenchyma is composed of nephrons, which are the functional units of the kidney. Each nephron consists of a renal corpuscle and a renal tubule.

Escherichia coli (E.coli) pyelonephritis

Pyelonephritis is typically caused by a bacterial infection, which can spread from the lower urinary tract to the kidneys. The most common pathogen is Escherichia coli (E.coli), which is responsible for about 80% of all UTIs.

Where is the renal pelvis located

The area at the center of the kidney.

why do we get N/V with pyelonephritis? Nausea and vomiting can occur in pyelonephritis due to inflammation and infection of the renal pelvis and the kidney. This can lead to irritation of the lining of the stomach and the intestinal tract, which can result in nausea and vomiting because of the body's immune response to the infection, as well as the release of inflammatory cytokines.. Additionally, the body's immune response to the infection can cause systemic symptoms, including nausea and vomiting. Pyelonephritis can also cause fever and dehydration, which can contribute to the development of nausea and vomiting.

wow

why does Obesity increase the risk of a UTI? Obesity can increase the risk of a UTI for several reasons. First, excess body weight can lead to poor hygiene and make it difficult to properly clean the genital area, which can increase the risk of bacterial growth and infection. Second, obesity is often associated with conditions such as diabetes, which can impair the immune system and make it more difficult for the body to fight off infections. Third, obesity can cause changes in the urinary tract that can make it more difficult to empty the bladder completely, which can lead to a buildup of bacteria and an increased risk of infection. Finally, studies have also suggested that obesity may alter the microbiome of the gut and urinary tract, which can make it more susceptible to infection.

Gortha Kerchit why does Constipation increase the risk of a UTI? Constipation can increase the risk of a UTI because it can lead to the retention of stool in the rectum, which can put pressure on the bladder and prevent it from fully emptying. This can create an environment in the bladder that is conducive to bacterial growth and infection.

Clean-catch sample of urine A clean-catch sample of urine is a method of collecting a urine sample to avoid contamination from bacteria normally present on the skin or in the urethra. To obtain a clean-catch sample, the person will typically clean the genital area with an antiseptic solution and then collect a midstream urine sample into a sterile container. This type of sample is often used for urine culture and sensitivity testing to diagnose a urinary tract infection or other urinary tract conditions.

CT scan vs (CT urogram) Ct more general and urogram more specific to the urinary tract A CT scan is a diagnostic imaging test that uses X-rays and computer technology to produce detailed images of the body. It can be used to diagnose a variety of conditions, including urinary tract disorders, but it does not specifically focus on the urinary system. On the other hand, a CT urogram is a type of CT scan that specifically focuses on the urinary system. It involves the injection of a contrast dye into a vein in the arm, which then travels through the bloodstream and is excreted by the kidneys into the urinary system.

**Nocturnal enuresis- loss of urine during sleep

Bladder storage SIGN OF A UTI

**Hesitancy – difficulty starting the urine stream

GENRE TU HESITE

Interprofessional Care meaning Interprofessional care refers to a healthcare approach where healthcare professionals from different disciplines collaborate and work together to provide comprehensive, patient-centered care.

does a cystogram use dye?

anything with scopy involves a camera ex: cystoscopy

Urticaria, also known as hive from dye

can a fistula cause a uti Yes, a fistula can cause a UTI (urinary tract infection). A fistula is an abnormal connection or passageway between two organs or structures in the body. In the urinary system, a fistula can develop between the bladder and another organ, such as the colon, vagina, or urethra. This connection can allow bacteria from the other organ to enter the urinary tract, leading to a UTI.

stones can cause Pain and hematuria

It often occurs during physical activities such as coughing, sneezing, or exercise.

Stress incontinence:

It is often caused by an overactive bladder muscle.

Urge incontinence: This type of incontinence occurs when there is a sudden, intense urge to urinate, followed by involuntary loss of urine.

incontinence due to physical (can't walk or walks very slowly) or mental impairment, such as arthritis or dementia.

Functional incontinence: This type of incontinence occurs when a person has difficulty reaching the toilet in time

This type of incontinence is caused by medical treatments or procedures, such as surgery or medication.

Iatrogenic incontinence: ITARO= phyciacian

This type of incontinence is caused by medical treatments or procedures, such as surgery or medication.

Iatrogenic incontinence:

This type of incontinence is a combination of stress and urge incontinence, and is the most common type of incontinence in women.

Mixed incontinence

what do we call the type of incontinence, which occurs when the bladder is constantly full and leaks urine,

overflow incontinence,

a temporary form of incontinence that is often caused by a medical condition or medication.

transient incontinence,

Behavioral interventions biofeedback for incontinence Behavioral interventions, including biofeedback, are non-medical treatments that focus on changing behaviors, thoughts, or emotions to improve physical and mental health. Biofeedback is a technique that uses electronic instruments to monitor and provide feedback about physiological processes such as heart rate, muscle tension, and brain waves. The goal of biofeedback is to help individuals learn how to control these physiological processes and improve their health and well-being.

Bladder training is a behavioral intervention used to treat urinary incontinence, which is the unintentional loss of urine. Bladder training involves teaching individuals to control their bladder by gradually increasing the time between urinations.

electrical stimulation incontinence Electrical stimulation is a non-invasive treatment that uses a small electrical current to stimulate the muscles of the pelvic floor to improve bladder control and treat urinary incontinence. This treatment can be used for both men and women.

One of the most effective ways to prevent kidney stones is to increase fluid intake, which helps to dilute urine and prevent the buildup of minerals that can lead to stone formation.

The most common site for urinary calculi is the kidneys, with about 80% of stones forming there

Kidney disease can also contribute to anemia in the elderly by reducing the production of erythropoietin, a hormone necessary for the production of red blood cells.

**Non localized abdominal discomfort rather than dysuria

signs of uti in old people what does dysuria mean again ?

Fever less likely?

in older people with a UTi

Kidney stones can cause pain and hematuria (blood in the urine) when they become lodged in the urinary tract and obstruct the flow of urine. The pain associated with kidney stones typically occurs as a result of the stone's movement through the urinary tract. As the stone travels through the ureter, it can cause irritation, inflammation, and spasms in the surrounding tissues, They cause a wound

lo hieren. herida

Iatrogenic etymology ped iatra= pediatra pediatrician The term "iatrogenic" comes from the Greek words "iatros," meaning "physician," and "genos," meaning "origin" or "birth." Therefore, iatrogenic literally means "originating from a physician" or "caused by medical treatment."

In some cases, increasing bladder neck resistance can be beneficial, such as in the treatment of stress urinary incontinence, where a stronger bladder neck can help prevent leakage of urine during physical activity or coughing.

Anticholinergic agent

Anticholinergic agents are considered first-line medications for urge incontinence. xk they decrease the contraction of smooth muscles.

Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure used to remove large kidney stones that cannot be passed naturally or treated with other non-invasive methods.

ex: BPH

percutaneous lithotripsy

Percutaneous lithotripsy is a minimally invasive surgical procedure used to remove kidney stones that are too large or too hard to pass naturally through the urinary tract. The procedure involves the use of a small incision made in the back to access the kidney, and a special instrument called a nephroscope is inserted through the incision to break up the stone into smaller pieces using ultrasound, laser, or mechanical energy.

. Biofeedback-assisted pelvic muscle exercise (PME) uses either electromyography or manometry to help the individualidentify the pelvic muscles as he or she attempts to learn which muscle group is involved whenperforming PME

why can't kids stop urine midstream Children may have difficulty stopping urine midstream because their pelvic floor muscles and urethral sphincter muscles are still developing and may not be strong enough to fully control the flow of urine. This is especially true for younger children who are still learning how to use the toilet and may not have developed the necessary muscle control or coordination.

everytime you see gram such is in urogram a dye is used