urologic disorder Flashcards

1
Q

Age-Related Changes in the Urinary System

A

Loss of nephrons, thickening of membranes in nephrons, and sclerosis of renal blood vessels
(results in less able to concentrate or dilute urine in response to osmolality of serum in the blood)
Creatinine clearance decreases with age
Nocturia: awaken from sleep to void
Bladder muscles weaken; connective tissue increases
Incontinence not normal consequence of age, but it is common
In men, urethral obstruction often a problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Health History

A

Chief complaint
Changes in urine quality or quantity, pain
History of present illness
Patient’s normal or usual pattern of urination
Pain or discomfort
Problem initiating or controlling urination
Document circumstances under which these problems occur
Past medical history
A history of streptococcal infections, recurrent urinary tract infections (UTIs), renal calculi (“stones”), gout, or hypercalcemia
Family history
Congenital kidney problems, such as polycystic kidneys or urinary tract malformations, diabetes mellitus, and hypertension
Review of systems
Changes in skin color, respiratory distress, edema, fatigue, nausea, vomiting, chills, and fever
Functional assessment
Daily fluid intake
Effects of the chief complaint on daily life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Physical Examination

A

Skin color (ashen, yellow); crystals on skin (uremic frost)
Tissue turgor: to detect dehydration or edema
Periorbital edema: suggests fluid retention. Inspect the mouth
for moisture and P/A of odor of urine
Observe respiratory rate, pattern, and effort (increased rate could
indicate metabolic acidosis, infection, and fluid overload)
Auscultate the lungs for crackles or rhonchi
Inspect the abdomen for scars and contours, and palpate for
tenderness and bladder distention
Auscultate the kidney area over costovertebral angle to detect
renal bruits
Edema
Inspect the genitalia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Inflammation of the urethra
By microorganisms, trauma, or hypersensitivity to chemicals in products such as vaginal deodorants, spermicidal jellies, or bubble baths

A

Urethritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs and symptoms Urethritis

A

Dysuria, frequency, urgency, and bladder spasms

Urethral discharge may be noted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Medical diagnosis Urethritis

A

Based on patient signs and symptoms, urinalysis, and urethral smear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Medical treatment Urethritis

A

Antimicrobials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Assessment Urethritis

A

Comfort, possible causative factors, and understanding of treatment and prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Interventions Urethritis

A

Sitz baths
Instruct female patients to wipe from front to back after toileting; void before and after sexual intercourse
Discourage bubble baths and vaginal deodorants
Instruct uncircumcised male patients to clean the penis under the foreskin regularly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Inflammation of the urinary bladder

A

Cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common cause Cystitis

A

is bacterial contamination

Other factors: prolonged immobility, renal calculi, urinary diversion, and indwelling catheters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Signs and symptoms Cystitis

A

Urgency, frequency, dysuria, hematuria, nocturia, bladder spasms, incontinence, and low-grade fever
Urine may be dark, tea-colored, or cloudy
Fever, fatigue, and pelvic or abdominal discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Medical diagnosis Cystitis

A

Urinalysis, culture and sensitivity

White blood cells (WBCs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Medical treatment Cystitis

A

Antibiotics

Mild analgesic; hyoscyamine (Cystospaz) and flavoxate (Urispas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Assessment Cystitis

A

Patient symptoms, causative factors, and understanding of treatment and prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

InterventionsCystitis

A

Patient teaching regarding medications, fluids, and prevention

17
Q

Pathophysiology and diagnosis
Inflammatory disease of the bladder, usually chronic
Cause is unknown
Bladder/pelvic pain; urinary frequency and urgency
Diagnosed by cystoscopy

A

Interstitial Cystitis

18
Q

Medical treatment Interstitial Cystitis

A

Symptom management; attempts to treat causes

19
Q

Nursing care Interstitial Cystitis

A

Primary role is teaching and support

20
Q

A result of inflammation of the renal pelvis

A

Pyelonephritis

21
Q

most often caused by ascending bacterial infection, but it may be bloodborne

A

Acute pyelonephritis

22
Q

often the result of reflux of urine during voiding; recurrent episodes of acute pyelonephritis with scarring and fibrosis of tissue (permanent)

A

Chronic pyelonephritis

23
Q

Signs and symptoms

Acute pyelonephritis

A

High fever, chills, nausea, vomiting, and dysuria; severe pain or constant dull ache occurs in the flank area ; malaise, dyuria with concurrent cystitis

24
Q

Signs and symptoms Chronic pyelonephritis

A

Bladder irritation, chronic fatigue, slight aching in one or both flank areas, low-grade fever, vague GI symptoms
May be asymptomatic

25
Medical treatment | Pyelonephritis
R/O obstruction as cause Pyuria: antibiotics 14 days with Acute; Chronic 4-6 weeks Dysuria: analgesics (pyridium), antispasmodics (eg. flavoxate) Drink at least eight 8-ounce glasses of fluids daily Intravenous fluids may be ordered if nausea and vomiting Dietary salt and protein restriction for patient with chronic disease
26
Assessment Pyelonephritis
Related signs and symptoms, history of urinary tract disorders, and effects of the infection on daily activities
27
Interventions for Pyelonephritis
Acute Pain Activity Intolerance Deficient Fluid Volume and Imbalanced Nutrition Ineffective Management of Therapeutic Regimen
28
Hereditary disorder Two types: childhood and adult In adults usually manifested by age 40 years Grapelike cysts in place of normal kidney tissue Cysts enlarge, compress functional renal tissue, and result in renal failure (sec. to RF = CHF and/or elv. B/P)
Polycystic Kidney Disease
29
Signs and symptoms Polycystic Kidney Disease
Dull, aching abdominal & lower back or flank pain or Colicky pain that begins abruptly
30
Medical treatment Polycystic Kidney Disease
Supportive treatment is recommended to preserve kidney function Control hypertension UTI : infections treated promptly with antibiotics Dialysis, nephrectomy, and transplantation once end-stage renal disease develops
31
Immunologic disease: inflammation of the capillary loops in the glomeruli (possible after strep infection)
Acute Glomerulonephritis
32
Signs and symptoms
``` Urine becomes tea colored as output decreases Peripheral and periorbital edema As glomerular filtration decreases: mild to severe hypertension occurs and hypervolemia results ```
33
Medical diagnosis
Patient assessment and laboratory tests Urinalysis, BUN, creatinine, and albumin Renal ultrasound, renal biopsy, or both
34
Medical treatment
Diuretics, antihypertensive medications, and antibiotics Bed rest; activity restriction Fluids, sodium, potassium, and protein may be restricted If renal failure develops, dialysis is necessary
35
Nursing Assessment
Signs and symptoms, Hx recent infections, and changes in urine
36
Nursing Interventions for
Excess Fluid Volume Activity Intolerance Self-Care Deficit Anxiety