urinary week 3 Flashcards
Gero: prostate
enlargement
obstruct flow
frequent oliguria
anuria
Gero: bladder tone
increased urgency
incontinence
UTI
less power (men)
Specific gravity
Evaluates the ability of kidneys to concentrate solutes in urine and is altered by the presence of blood, protein, and casts in the urine
Osmolality
Concentrating ability is lost early in kidney disease; these tests findings may disclose early defects in kidney function
Hematuria
can develop from an abnormality anywhere along the genitourinary tract and is more common in women than in med
White blood cells in urine
should be very few; increased numbers indicate infection or inflammation
Protein in urine
occasional loss of up to 150mg/day of protein in urine primarily is considered normal and usually does not require further evaluation
Glucose in urine
Should be absent; its presence is suspicious for diabetes
Cystitis
An infection in any part of the urinary system, the kidneys, bladder, or urethra.
Cystitis: manifestations
Frequency Urgency Suprapubic pain Burining Hematuria Fever N/v
Pyelonephritis
Inflammation of the kidney due to a bacterial infection.
Pyelonephritis: manifestations
Flank pain
Dysuria
Pain at costovertebral angle
same s/s as cystitis
Cystitis and Pyelonephritis: diagnosis
Dipstick for leukocyte estrace and nitrates UA/C&S
Cystitis and Pyelonephritis: treatment
anti-microbials
increase fluid intake
prevention education
Cystitis and Pyelonephritis: nursing goals
Symptom relief Teaching and prevention Showers > baths Perineal cleansing (front to back) Voiding after intercourse Anti-microbial therapy White toilet paper No perfumes to peri area
Kidney stone: s/s
Fever Stomach pain Vomiting Backache Blood in urine Dizziness
Kidney stone (renal calculi) diagnosis
UA Cystoscopy IVD Renal stone analysis KUB (x-ray) Serum: calcium, oxalate, uric acid
Kidney stone (renal calculi): risk factors
infection urinary stasis immobility hypercalcemia increase uric acid increase urinary oxalate level
Urolithiasis and Nephrolitiasis
What is the problem Risk factors Clinical manifestations Medical management fluids filter urine pain meds diet changes Pass on own Lithotripsy Surgery Nephrostomy tube
Pyelonephritis: patho
Inflammation of the kidney due to a bacterial infection.
Pyelonephritis: s/s
fever chills vomiting malaise flank pain hematuria
Pyelonephritis treatment
abx
analgesic
Overflow incontinence
occurs when you are unable to completely empty your bladder; this leads to overflow, which leaks out unexpectedly. You may or may not sense that your bladder is full
urge incontinence
Loss of bladder control, varying from a slight loss of urine after sneezing, coughing, or laughing to complete inability to control urination.
Stress incontinence
happens when physical movement or activity — such as coughing, laughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder, causing you to leak urine
not related to psychological stress
Functional incontinence
occurs when an individual with normal bladder and urethral function has difficulty getting to the toilet before urination occurs. Those with impaired mobility or mental confusion may have this type of incontinence.
Urinary retention: patho
Difficulty urinating and completely emptying the bladder.
Urinary retention: manifestations
the inability to completely empty your bladder when urinating.
frequent urination in small amounts.
difficulty starting the flow of urine, called hesitancy.
a slow urine stream.
the urgent need to urinate, but with little success.
feeling the need to urinate after finishing urination.
Urinary retention: complications
chronic infections pyelonephritis sepsis hydronephritis Calculi
Urinary retention: nursing management
Promoting urinary elimination
promoting home care
Bladder scan, straight cath., foley
benign prostatic hypertrophy
Age-associated prostate gland enlargement that can cause urination difficulty.
This type of prostate enlargement isn’t thought to be a precursor to prostate cancer.
With this condition, the urinary stream may be weak, or stop and start. In some cases, it can lead to infection, bladder stones, and reduced kidney function.
BPH: s/s
weak urine stream frequent urination dribbling after urination urge to urinate leakage of urine (overflow incontinence) frequent urination during night
BPH: TURP
Transurethral resection of the prostate (TURP) is a surgery used to treat urinary problems that are caused by an enlarged prostate. An instrument called a resectoscope is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra).
BPH: bladder irrigation
Warm bladder irrigation fluid can decrease the drop of body temperature and the incidence of hypothermia and shiver during and after the operation for BPH. Warm irrigation fluid should be considered as a standard practice in BPH surgeries.
BPH: TUR syndrome
from too much irrigation and resultant hyponatremia
– N/V HTN bradycardia disorientation
BPH: color of drainage
want light pink without clots
BPH: management
calculate UOP
BPH: medications
Finasteride
Dutasteride/tamulosin
Dutaseride
autonomic dysreflexia
Spinal cord injury at t-6 that is triggered by stimuli at t-6 or below
What triggers autonomic dysreflexia
Restrictive clothing
Full bladder or UTI
Fecal impaction
Pressure areas
Autonomic dysreflexia: Complications
Complications come from sustained severe peripheral hypertenion
- sz
- retinal hemorrhage
- pulmonary edema
- renal insuffiency
- MI
- cerebral hemorrhage
Autonomic dysreflexia: s/s from vasodilation above t-6
Flushed face
– high BP
HA
– distended neck veins
decreased heart rate
– sweating
Autonomic dysreflexia: s/s from vasodilation below level of injury
pale
cool
no sweating
Genitourinary trauma: cause
pelvic fractures, blunt trauma, MVA, penetrating injuries or recent urethral or bladder surgery
What should a nurse do if there is suspected genitourinary trauma
do NOT insert catheter until provider has cleared
Genitourinary trauma: specific injuries and clinical manifestations
urethral trauma
bladder trauma
Genitourinary trauma: medical management
surgical management
Cancer of bladder: medical and nursing management
surgery
meds
radiation
Urinary diversion
Ileal conduit
- stoma in which urine comes out of (cutaneous ureterostomy)
- stoma should be pink
- client will alway smell of urine (psychosocial factors)
