VUR & UTIs Flashcards
What is Vesicoureteral Reflux ?
abnormal retrograde flow of bladder urine into the ureters
- primary or secondary
What are some clinical manifestations or diagnosis of VUR ?
- many cases are asymptomatic
- UTIs (infant crying when peeing, urine dark, with pus or rotten smell, with children incontinence)
- Voiding cystourethrogram (VCUG)
- abdominal ultrasounds
What are some medical management of VUR ?
- long term low dose antibiotic prophylactually to prevent UTIs
- annual VCUG to assess the status of reflux
- inter catheterization to keep the bladder empty
- most will outgrow it as the ureters elongate with age and function of valve improves
- if severe enough the possible surgery to correct ureters and prevent reflux
What is some Post-Op RN interventions of VUR ?
- pain control (analgestics and muscle relaxants)
- foley
- possible stents and drains
- incision care/ dressing changes
- normal to have small amount of blood in urine and drainage (clots or dark red urine must report)
What is the most common pathogen that causes a UTI ?
E. Coli
- lives in our gut and could get into perineal area
What is urethritis ?
inflammation of urethra
What is cystitis ?
inflammation of the bladder wall, and urinary system
What is pyelonephritis ?
inflammation usually due to infection to the renal parenchyma and collecting system
- renal infections can cause back pain
What is Urosepsis ?
a UTI that has spread into the systemic circulation
- life threatening emergency
What are some possible causes of UTIs ?
- poor hygiene practices
- catheterization
- intrinsic obstructions (stone/tumor)
- urinary impairment (Neurogenic bladder)
- renal impairment
- menopause in women can be a factor due to the changes in vaginal pH
What are some S&S of cystitis ?
- frequency, urgency
- suprapubic pain
- dysuria
- hematuria
- fever
- confusion in older adults
What are some S&S of pyelonephritis ?
- flank pain
- dysuria
- pain at costovertebral angle
- same S&S as cystitis
What are some diagnostic tests for UTIs ?
- urinalysis: looking for WBCs, nitrates (indicates bacteriuria)
- urine culture: (clean catch) to determine specific bacteria and target antibiotic tx
What is acute pyelonephritis ?
inflammation of the renal parenchyma and collecting system
What is chronic pyelonephritis ?
kidneys have become small, atrophied, and lost function due to scarring or fibrotic
- pre-existing conditions cause: VUR issues with chronic UTIs
What is Phenazopyridine (Pyridium) ?
urinary analgesic
- muscle relaxer that helps with bladder spasms and pain
- used in combo with antibiotics
- provides soothing effect on urinary tract mucosa
- only works on urinary tract
- changes urine to reddish-orange (can be mistaken for blood and can stain underclothing)
What is a Foley Catheter ?
indwelling
- inserted through the urethra and drains urine from the bladder
What is a Suprapubic catheter ?
surgically placed puncture to the pubic area
- drains urine from the bladder
What are Nephrostomy tubes ?
drain urine directly from the kidneys
- placed surgically
- good for pt’s with kidneys infections because the infection can cause the kidneys and ureters to be so inflamed that urine won’t come out
What are some causes of urinary incontinence ?
confusion, depression, infection, atrophic vaginitis, urinary retention, restricted mobility, fecal impaction, or drugs
- incontinence has high prevalence in older women and men but it’s not a natural consequence to aging
