Week 2 Flashcards
Nasal fracture
- Common facial fx
Complications
-Airway obstruction, epistaxis, meningeal tears causing CSF fluid leakage, cosmetic deformity
- CSF leak – clear or __________ colored fluid leaking from nares; Test for glucose
-Raccoon eyes – orbital or basilar skull fx
Management
-Maintain _______, reduce edema, avoid ________ due to bleeding
Nasal fracture
- Common facial fx
Complications
-Airway obstruction, epistaxis, meningeal tears causing CSF fluid leakage, cosmetic deformity
- CSF leak – clear or pinkish colored fluid leaking from nares; Test for glucose
-Raccoon eyes – orbital or basilar skull fx
Management
-Maintain airway, reduce edema, avoid NSAIDs due to bleeding
Rhinoplasty
- Cosmetic or ____________
-Watch for ______________ (edema, infection, bleeding)
- Cosmetic or reconstructive
-Watch for complications (edema, infection, bleeding)
Epistaxis
- Most is anterior, more _____________ is posterior
-Goal is __________________
- Assess for s/s of hypovolemia (hemorrhage)
- Risk factors – coagulopathies, medications
- Occlusive pressure
_________ (posterior bleeding)
- Admit for observation
-Pain – provide meds
-Risk for infection – antibiotics
-Education post-epistaxis and packing removal
- Most is anterior, more concerning is posterior
-Goal is stop bleeding - Assess for s/s of hypovolemia (hemorrhage)
- Risk factors – coagulopathies, medications
- Occlusive pressure
Packing (posterior bleeding)
- Admit for observation
-Pain – provide meds
-Risk for infection – antibiotics
-Education post-epistaxis and packing removal
RHINITIS – ALLERGIC
- Seasonal or perennial
- Episodic, Intermittent, Persistent
Immune response from _____ to antigens
-Mast cells, basophils release ___________ , cytokines, prostaglandins, and leukotrienes –
cause ___________
- Sneezing, itchy watery eyes, thin watery nasal discharge
- Pale, boggy and swollen turbinate’s
- Avoid allergens
- Meds – antihistamines, leukotriene receptor antagonists, nasal spray corticosteroids (non-systematic absorption), decongestants
- Seasonal or perennial
- Episodic, Intermittent, Persistent
Immune response from IgE to antigens
-Mast cells, basophils release histamine, cytokines, prostaglandins, and leukotrienes –
cause symptoms
- Sneezing, itchy watery eyes, thin watery nasal discharge
- Pale, boggy and swollen turbinate’s
- Avoid allergens
- Meds – antihistamines, leukotriene receptor antagonists, nasal spray corticosteroids (non-systematic absorption), decongestants
RHINITIS – Viral
-Majority rhinoviruses
-More severe illness coxsackieviruses & adenoviruses
-Spread by _____________&______________
-Majority rhinoviruses
-More severe illness coxsackieviruses & adenoviruses
-Spread by airborne and droplet!
INFLUENZA
- Highly ______________
- ___________ precautions!!
- Causes significant morbidity and mortality
- 200,000 hospitalizations; ___________ deaths annually!!
-VACCINATIONS can prevent death - Some strains more virulent than other – _______ (swine flu)
Symptoms
- Abrupt; Chills, fever, anorexia, malaise, myalgia, cough, headache, sore throat
- Highly contagious
- Droplet precautions!!
- Causes significant morbidity and mortality
- 200,000 hospitalizations; 20,000 deaths annually!!
-VACCINATIONS can prevent death - Some strains more virulent than other – H1N1(swine flu)
Symptoms
- Abrupt; Chills, fever, anorexia, malaise, myalgia, cough, headache, sore throat
INFLUENZA
Prevention best way to contain
- ________
- Particularly important for children, elderly, and those with chronic medical conditions
Treatment
- ___________ – fluids, rest
- Three antiviral meds: Zanamivir (Relenza), oseltamivir (Tamiflu), peramivir (Rapivab)
- Need to be started within _________ of onset of symptoms
- Shorten duration, may help prevent complications
Prevention best way to contain
- Vaccine
- Particularly important for children, elderly, and those with chronic medical conditions
Treatment
- Supportive – fluids, rest
- Three antiviral meds: Zanamivir (Relenza), oseltamivir (Tamiflu), peramivir (Rapivab)
- Need to be started within 48 hours of onset of symptoms
- Shorten duration, may help prevent complications
WHO SHOULD BE PRIORITIZED FOR FLU VACCINATION DURING A VACCINE SHORTAGE (CDC)
- Children aged 6 months - 4 years (59 months);
- People aged 50+
- People w/ chronic pulmonary (including asthma), cardiovascular (except hypertension),
renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus); - People who are immunosuppressed (including immunosuppression caused by medications or by HIV);
- Women who are or will be pregnant during the influenza season;
- People aged 6 months - 18 years and receiving long-term aspirin therapy and who therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
- Residents of nursing homes and other chronic-care facilities;
- American Indians/Alaska Natives;
- Morbidly obese (body-mass index is 40 or greater);
- Health-care personnel;
- Household contacts and caregivers of children younger than 5 years and adults aged 50+, with particular emphasis on vaccinating contacts of children aged younger than 6 months; and
- Household contacts and caregivers of people with medical conditions that put them at higher risk for severe complications from influenza
- Children aged 6 months - 4 years (59 months);
- People aged 50+
- People w/ chronic pulmonary (including asthma), cardiovascular (except hypertension),
renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus); - People who are immunosuppressed (including immunosuppression caused by medications or by HIV);
- Women who are or will be pregnant during the influenza season;
- People aged 6 months - 18 years and receiving long-term aspirin therapy and who therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
- Residents of nursing homes and other chronic-care facilities;
- American Indians/Alaska Natives;
- Morbidly obese (body-mass index is 40 or greater);
- Health-care personnel;
- Household contacts and caregivers of children younger than 5 years and adults aged 50+, with particular emphasis on vaccinating contacts of children aged younger than 6 months; and
- Household contacts and caregivers of people with medical conditions that put them at higher risk for severe complications from influenza
Sinusitis
Viral typically follows URI; No treatment
Bacterial infection treat with antibiotics
-Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis = common bacteria
______ pressure/pain, purulent drainage, __________
Viral typically follows URI; No treatment
Bacterial infection treat with antibiotics
-Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis = common bacteria
Sinus pressure/pain, purulent drainage, headaches
Pharyngitis
- Inflammation of __________________
- Sore throat, pain with ______________
- Red, edematous posterior pharynx, with or without exudate
- Concern is Beta hemolytic streptococci
____________ until 24 to 48hrs on abx
- Inflammation of the pharyngeal walls
- Sore throat, pain with swallowing
- Red, edematous posterior pharynx, with or without exudate
- Concern is Beta hemolytic streptococci
Contagious until 24 to 48hrs on abx
Peritonisllar Abscess
- Difficulty swallowing, pain, muffled voice
- Often caused by betahemolytic strep – requires ________________ & __________
- Difficulty swallowing, pain, muffled voice
- Often caused by betahemolytic strep – requires needle aspiration and antibiotics
BRONCHITIS
- Usually a self-limiting inflammation of the ______ respiratory tract
- Usually caused by _______
Presenting Signs & Symptoms
- _______ – can last up to 3 weeks
- Clear mucoid secretions, can be green in color or purulent
- Color of sputum not an indication of bacterial infection
- Diagnosis based on physical assessment and history
Treatment
- Relieve symptoms – cough suppressants, fluid intake
- Β2 agonist if underlying lung disease
- STOP ___________!
- Usually a self-limiting inflammation of the lower respiratory tract
- Usually caused by a virus
Presenting Signs & Symptoms
- Cough – can last up to 3 weeks
- Clear mucoid secretions, can be green in color or purulent
- Color of sputum not an indication of bacterial infection
- Diagnosis based on physical assessment and history
Treatment
- Relieve symptoms – cough suppressants, fluid intake
- Β2 agonist if underlying lung disease
- STOP SMOKING!
PNEUMONIA - Acute infection of the lung parenchyma
Caused in three ways
- __________
- ____________
- Hematogenous spread from primary infection elsewhere
— See Table 27-1 Risk Factors —
Presenting Signs & Symptoms
- Cough, fever, chills, dyspnea, confusion, tachypnea, pleuritic chest pain
- OLDER patients > 65 yo may not have typical signs
Caused in three ways
- Aspiration
- Inhalation
- Hematogenous spread from primary infection elsewhere
— See Table 27-1 Risk Factors —
Presenting Signs & Symptoms
- Cough, fever, chills, dyspnea, confusion, tachypnea, pleuritic chest pain
- OLDER patients > 65 yo may not have typical signs
Community Acquired Pneumonia
- No hospitalization or resident of long-term care for past 14 days
- Hospitalization is based on CURB-65 criteria
Hospital Acquired Pneumonia (______________)
- Non-intubated patient 48 hours or longer after admission and was not present on admission
- VAP – Ventilator Associated Pneumonia (nosocomial) intubated patients (MCA-3)
- Associated with longer hospital stays, higher cost, sicker patients and increased morbidity and mortality !
Community Acquired Pneumonia
- No hospitalization or resident of long-term care for past 14 days
- Hospitalization is based on CURB-65 criteria
Hospital Acquired Pneumonia (nosocomial)
- Non-intubated patient 48 hours or longer after admission and was not present on admission
- VAP – Ventilator Associated Pneumonia (nosocomial) intubated patients (MCA-3)
- Associated with longer hospital stays, higher cost, sicker patients and increased morbidity and mortality !
PNEUMONIA Complications
- Pleural effusion
- Acute __________ __________ – leading cause of death
- Intubation
- Sepsis
- Serious life-threatening condition (MCA-2 & 3)
- Pleural effusion
- Acute respiratory failure – leading cause of death
- Intubation
- Sepsis
- Serious life-threatening condition (MCA-2 & 3)
PNEUMONIA Labs and Diagnostics
-Increased _____
-Possible ____________ imbalance due to dehydration
-ABGs depending on patient status
-Blood cultures possible – depends on clinical presentation
-Chest x-ray, possible CT
- Sputum sample for culture
-Increased WBC
-Possible electrolyte imbalance due to dehydration
-ABGs depending on patient status
-Blood cultures possible – depends on clinical presentation
-Chest x-ray, possible CT
- Sputum sample for culture
PNEUMONIA Treatment
- ______ – within 4 hours in ED!
- Broad spectrum initially then can tailor after sputum culture
- IV for more serious, PO if outpatient
- PO Steroids – possible
- β-2 agonist (albuterol) – possible
- ABX – within 4 hours in ED!
- Broad spectrum initially then can tailor after sputum culture
- IV for more serious, PO if outpatient
- PO Steroids – possible
- β-2 agonist (albuterol) – possible
PNEUMONIA Nursing
- Increase ________
- Rest
- Adequate nutrition
- TAKE all meds!!
-Pneumococcal _____________!!! – Best way to prevent illness!
- Influenza ________________!!! - Best way to prevent illness!
- Increase fluids
- Rest
- Adequate nutrition
- TAKE all meds!!
-Pneumococcal Vaccination!!! – Best way to prevent illness!
- Influenza Vaccination!!! - Best way to prevent illness!
TUBERCULOSIS
-Infections disease caused by _______________ tuberculosis
-Usually infects _______ – but can be found in brain, kidney, bones
-More than 2 billion world wide are infected with TB
-Leading cause of mortality in people with _____ infection
-Occurs disproportionately in poor, underserved, and minority populations
-There are drug resistant strains of TB which have emerged hurting efforts to decrease spread of the disease
-Infections disease caused by Mycobacterium tuberculosis
-Usually infects lungs – but can be found in brain, kidney, bones
-More than 2 billion world wide are infected with TB
-Leading cause of mortality in people with HIV infection
-Occurs disproportionately in poor, underserved, and minority populations
-There are drug resistant strains of TB which have emerged hurting efforts to decrease spread of the disease
TUBERCULOSIS Pathophysiology
-M. tuberculosis is a gram-__________, acid-fast bacillus
-Usually spread via _________ particles
-Contagious – needs close, frequent, or prolonged exposures
-Once inhaled a Ghon lesion or focus forms, which represents a calcified TB granuloma – the
hallmark of primary TB
-Body’s attempt to stop infection. Granuloma walls off infection preventing spread of disease
-M. tuberculosis is a gram-positive, acid-fast bacillus
-Usually spread via airborne particles
-Contagious – needs close, frequent, or prolonged exposures
-Once inhaled a Ghon lesion or focus forms, which represents a calcified TB granuloma – the
hallmark of primary TB
-Body’s attempt to stop infection. Granuloma walls off infection preventing spread of disease
TUBERCULOSIS Classifications
- Primary – most people wall off bacteria and are ____________
- Latent – Have disease walled off , but at risk for_________________ later. If active disease
within 2-years of infection its considered Primary TB - Reactivated – Latent TB that becomes active _________ after initial infection
- Pulmonary, or Extrapulmonary
- Only _______% will develop active TB
- Primary – most people wall off bacteria and are asymptomatic
- Latent – Have disease walled off , but at risk for developing disease later. If active disease
within 2-years of infection its considered Primary TB - Reactivated – Latent TB that becomes active 2-years after initial infection
- Pulmonary, or Extrapulmonary
- Only 5-10% will develop active TB
TUBERCULOSIS Signs & Symptoms
- _____ weeks after infection or reactivation
- Initial dry cough that becomes productive
- Constitutional sx (fatigue, malaise, anorexia, weight loss, low-grade fever, _______ sweats)
- Dyspnea and ___________ late symptoms
Can also present more acutely
- High fever
- Chills, generalized flulike symptoms
- Pleuritic pain
- Productive cough
- Adventitious breath sounds
- 2-3 weeks after infection or reactivation
- Initial dry cough that becomes productive
- Constitutional sx (fatigue, malaise, anorexia, weight loss, low-grade fever, night sweats)
- Dyspnea and hemoptysis late symptoms
Can also present more acutely
- High fever
- Chills, generalized flulike symptoms
- Pleuritic pain
- Productive cough
- Adventitious breath sounds
TUBERCULOSIS Diagnostic Studies
-Tuberculin skin test (TST)
- AKA: Mantoux test
-Uses _____________________ (PPD) injected intradermally
- Assess for induration in 48 – 72 hours
- Presence of ___________ (not redness) at injection site indicates development of antibodies secondary to exposure to TB.
Tuberculin skin test (TST)
-Positive if ≥____ mm induration in low-risk individuals
- Response ↓ in immune-compromised patients; Reactions ≥5 mm considered positive
-A waning immune response can cause false negative results.
- Repeating TST may boost reaction.
- Two-step testing recommended for health care workers getting repeated testing and those with decreased response to allergens
- Two-step testing ensures future positive results accurately interpreted.
-Tuberculin skin test (TST)
- AKA: Mantoux test
-Uses purified protein derivative (PPD) injected intradermally
- Assess for induration in 48 – 72 hours
- Presence of induration (not redness) at injection site indicates development of antibodies secondary to exposure to TB.
Tuberculin skin test (TST)
-Positive if ≥15 mm induration in low-risk individuals
- Response ↓ in immune-compromised patients; Reactions ≥5 mm considered positive
-A waning immune response can cause false negative results.
- Repeating TST may boost reaction.
- Two-step testing recommended for health care workers getting repeated testing and those with decreased response to allergens
- Two-step testing ensures future positive results accurately interpreted.
TUBERCULOSIS Other diagnostic tests
Interferon-γ release assays ________
- Detects T-cell lymphocytes in response to mycobacteria
- Includes QuantiFERON-TB and the T-SPOT.TB tests
- Rapid results
- Several advantages over TST but more expensive
- Can’t distinguish between active or latent TB (LTBI)
_________ Cultures
- Requires 3 consecutive sputum cultures on different days – and demonstration of tuburcle bacilli which may take up to 8 weeks
- Treat regardless of sputum if warranted
_____________
- Cannot make diagnosis solely on x-ray
- Upper lobe infiltrates, cavitary infiltrates, and lymph node involvement suggest TB
Interferon-γ release assays (IGRAs)
- Detects T-cell lymphocytes in response to mycobacteria
- Includes QuantiFERON-TB and the T-SPOT.TB tests
- Rapid results
- Several advantages over TST but more expensive
- Can’t distinguish between active or latent TB (LTBI)
Sputum Cultures
- Requires 3 consecutive sputum cultures on different days – and demonstration of tuburcle bacilli which may take up to 8 weeks
- Treat regardless of sputum if warranted
Chest X-ray
- Cannot make diagnosis solely on x-ray
- Upper lobe infiltrates, cavitary infiltrates, and lymph node involvement suggest TB
TUBERCULOSIS
Pharmacology
- Active TB
- Treatment is ____________.
- Two phases of treatment
- Initial (8 weeks)
- Continuation (18 weeks)
- Four-drug regimen
__________-
___________-
__________-
___________
Know these 4 drugs! (Table 27-11)
- Orange urine
- Interaction with ______________
Primary concern with all drugs is liver / non-viral ___________
Check ______ prior to initiation and monitor throughout treatment
Pharmacology
- Active TB
- Treatment is aggressive.
- Two phases of treatment
- Initial (8 weeks)
- Continuation (18 weeks)
- Four-drug regimen
- Isoniazid (INH)
- Rifampin (Rifadin)
- Pyrazinamide (PZA)
- Ethambutol
Know these 4 drugs! (Table 27-11)
- Orange urine
- Interaction with alcohol (ETOH)
Primary concern with all drugs is liver / non-viral hepatitis
Check LFTs prior to initiation and monitor throughout treatment
TUBERCULOSIS
Pharmacology
- Latent TB
- Usually treated with _____ for 6 to 9 months
- HIV patients should take INH for 9 months.
- Alternative 3-month regimen of INH and rifapentine OR 4 months of rifampin
- Read about BCG vaccine in text book
- Latent TB
- Usually treated with INH for 6 to 9 months
- HIV patients should take INH for 9 months.
- Alternative 3-month regimen of INH and rifapentine OR 4 months of rifampin
- Read about BCG vaccine in text book
TB; Directly observed therapy (DOT)
-_____________ is major factor in multidrug resistance and treatment failures.
- Requires watching patient __________ drugs
- Preferred strategy to ensure adherence
- May be administered by public health nurses at clinic site
-Noncompliance is major factor in multidrug resistance and treatment failures.
- Requires watching patient swallow drugs
- Preferred strategy to ensure adherence
- May be administered by public health nurses at clinic site
TUBERCULOSIS Actions to take
Active TB (Acute care setting)
- ___________ isolation precautions
- Providers must wear _____ mask or use PAPR
- IF patient needs to leave room they need to wear a __________ mask
At home
- Close contacts evaluated for dx
- Avoid close contacts and congestion, public transport
- Open windows
-Patient be outside as much as possible
-Cover mouth/nose when sneezing/coughing
- Infectious until ___ sputum samples are negative – weeks to months
Active TB (Acute care setting)
- Airborne isolation precautions
- Providers must wear N95 mask or use PAPR
- IF patient needs to leave room they need to wear a surgical mask
At home
- Close contacts evaluated for dx
- Avoid close contacts and congestion, public transport
- Open windows
-Patient be outside as much as possible
-Cover mouth/nose when sneezing/coughing
- Infectious until 2 sputum samples are negative – weeks to months
PLEURAL EFFUSION
Pathology
- Pleural space normally contains 5-15ml of fluid that acts as a lubricant between chest wall and lungs
- Effusion is an abnormal ____________________ in this space
- Can be transudative or exudative
- Transudative – clear, pale yellow, caused by heart failure, decreased oncotic pressure (liver disease)
- Exudative – ___________
- Empyema – collection of purulent fluid in the pleural space
Pathology
- Pleural space normally contains 5-15ml of fluid that acts as a lubricant between chest wall and lungs
- Effusion is an abnormal collection of fluid in this space
- Can be transudative or exudative
- Transudative – clear, pale yellow, caused by heart failure, decreased oncotic pressure (liver disease)
- Exudative – infection
- Empyema – collection of purulent fluid in the pleural space
PLEURAL EFFUSION Signs & Symptoms
- Dyspnea, cough, sharp, non-radiating chest pain (worse on ___________)
- Decreased chest wall movement
- _____________ to percussion
- Diminished breath sounds over effusion
- Dyspnea, cough, sharp, non-radiating chest pain (worse on inhalation)
- Decreased chest wall movement
- Dullness to percussion
- Diminished breath sounds over effusion
PLEURAL EFFUSION
Diagnostics
- Chest x-ray
-CT scan
Procedures - Thoracentesis
- Aspiration of _______ in the pleural space
- Nursing – positioning, education, monitor VS – hypotension!
- Usually 1000 – 1200 mL removed
- ______________ – serious complication
- Puncture of the lung with deflation
- Watch for __________ at puncture site, pain, VS
Diagnostics
- Chest x-ray
-CT scan
Procedures - Thoracentesis
- Aspiration of fluid in the pleural space
- Nursing – positioning, education, monitor VS – hypotension!
- Usually 1000 – 1200 mL removed
- Pneumothorax – serious complication
- Puncture of the lung with deflation
- Watch for bleeding at puncture site, pain, VS
PULMONARY EMBOLISM Pathophysiology
- Blockage of _____________________ by thrombus, fat or air embolus, or tumor tissue
- Usually from ______
- Obstructs alveolar perfusion
- Most commonly affects _________ lobes
- Blockage of pulmonary arteries by thrombus, fat or air embolus, or tumor tissue
- Usually from DVT
- Obstructs alveolar perfusion
- Most commonly affects lower lobes
PULMONARY EMBOLISM
Signs & Symptoms
- Variable
____________ most common
- Tachypnea, cough, chest pain, hemoptysis, crackles, wheezing, fever, tachycardia, syncope, change in LOC
- Dependent on size and extent of emboli
Emergency
- Needs immediate intervention
-Can lead to cardiovascular collapse and ________
Signs & Symptoms
- Variable
- Dyspnea most common
- Tachypnea, cough, chest pain, hemoptysis, crackles, wheezing, fever, tachycardia, syncope, change in LOC
- Dependent on size and extent of emboli
Emergency
- Needs immediate intervention
-Can lead to cardiovascular collapse and death
PULMONARY EMBOLISM Nursing Actions
- Call for help
-Apply oxygen!
-Intubate if needed - IV access
- Attach to a monitor
- VS!
- Call for help
-Apply oxygen!
-Intubate if needed - IV access
- Attach to a monitor
- VS!
PULMONARY EMBOLISM Diagnostics
- CT with contrast - angiography
- V/Q scan – not as good a test as CT
- ABGs
- CT with contrast - angiography
- V/Q scan – not as good a test as CT
- ABGs
PULMONARY EMBOLISM
Treatment
- Support cardiopulmonary system
- Fluids
- Vasopressors
Anticoagulation
- MAY use tPA but rare
- LMWH (enoxaparin or fondaparinux)
- Once daily
- Warfarin (Coumadin) at diagnosis – for three months
- Monitor INR if on warfarin
-Placement of an inferior vena cava (IVC) fi lter to catch clots
Education
-Disease process
- DVTs
- Explore anxiety and concerns
Treatment
- Support cardiopulmonary system
- Fluids
- Vasopressors
Anticoagulation
- MAY use tPA but rare
- LMWH (enoxaparin or fondaparinux)
- Once daily
- Warfarin (Coumadin) at diagnosis – for three months
- Monitor INR if on warfarin
-Placement of an inferior vena cava (IVC) fi lter to catch clots
Education
-Disease process
- DVTs
- Explore anxiety and concerns
UTI (Urinary Tract Infections)
- Most common ___________infection in women
- _________ is most common pathogen (see Table 45-1)
»>Upper and lower UTI
- Most common bacterial infection in women
- E. coli is most common pathogen (see Table 45-1)
»>Upper and lower UTI
Lower UTI (see Table 45-3: Symptoms of a LUTI)
- Painful, frequent urination, with hesitancy
- NOT systemic (localized to _______ urinary tract)
- Treated with PO ___________ (See Table 45-4)
-Relief of symptoms in ______
- Phenazopyridine (Pyridium) - turns urine ________ color! Inform patients!
- Painful, frequent urination, with hesitancy
- NOT systemic (localized to lower urinary tract)
- Treated with PO antibiotics (See Table 45-4)
-Relief of symptoms in 24hrs. - Phenazopyridine (Pyridium) - turns urine orange color! Inform patients!
Upper UTI
- More _________ !
- May be ___________
-Can lead to __________ a life-threatening infection
- Pyelonephritis – infection of the renal parenchyma
-Symptoms – fever, chills, LUTI, flank pain, bloody urine
- Depending on how ill the patient is, IV antibiotics are used to treat with possible inpatient admission for brief stay
- More serious!
- May be systemic
-Can lead to urosepsis a life-threatening infection - Pyelonephritis – infection of the renal parenchyma
-Symptoms – fever, chills, LUTI, flank pain, bloody urine - Depending on how ill the patient is, IV antibiotics are used to treat with possible inpatient admission for brief stay
UTI Diagnostics
- Urinalysis or dipstick
- WBCs, leukocyte esterase, RBCs – indicative of an infection
- Blood cultures if patient has signs of systemic infection (fever, chills, low BP)
- Urinalysis or dipstick
- WBCs, leukocyte esterase, RBCs – indicative of an infection
- Blood cultures if patient has signs of systemic infection (fever, chills, low BP)
UTI relief/help
Garlic
Beet
UNSWEET cranberry juice
2 liters water to flush system
Garlic
Beet
UNSWEET cranberry juice
2 liters water to flush system
URETHRITIS
- Think _____ (trichomonas, chlamydial, and gonorrhea infections
- Treat with ___________ (PO or IV)
- Many resistant strains of bacteria!!! Must use most recent treatment recommendations by ______ !
- Think STI (trichomonas, chlamydial, and gonorrhea infections
- Treat with antibiotics (PO or IV)
- Many resistant strains of bacteria!!! Must use most recent treatment recommendations by CDC!
GLOMERULONEPHRITIS
- Inflammation of the ________
- Usually in both _________
- 3rd leading cause of End-Stage Renal Disease (ESRD) in the U.S.
Acute post-streptococcal glomerulonephritis
- Children and young adults
- 1-2 weeks after a ______________ (tonsillitis, skin – impetigo )
- Symptoms – oliguria, hematuria, swelling, fatigue
- Inflammation of the glomeruli
- Usually in both kidneys
- 3rd leading cause of End-Stage Renal Disease (ESRD) in the U.S.
Acute post-streptococcal glomerulonephritis
- Children and young adults
- 1-2 weeks after a strep infection (tonsillitis, skin – impetigo )
- Symptoms – oliguria, hematuria, swelling, fatigue
URINARY CALCULI
_______________ (kidney stone)
- 1-2 million a year
- More frequent in _______ than in African Americans
- Review Table 45-10: Risk Factors
-There are different types of kidney stones- Review Table 45-11
-Treatment and prevention may vary depending on type of stone
Nephrolithiasis (kidney stone)
- 1-2 million a year
- More frequent in White than in African Americans
- Review Table 45-10: Risk Factors
-There are different types of kidney stones- Review Table 45-11
-Treatment and prevention may vary depending on type of stone
URINARY CALCULI
Causes:
- Genetics
- Diet: ________ in Ca, Vitamin D, protein, oxalate, purines, alkali
- Urinary _________ & UTI (immobilization)
- Dehydration
- Diuretic use
- Hypercalcemia & hyperparathyroidism
- Uric acid elevation (Gout)
- Genetics
- Diet: high in Ca, Vitamin D, protein, oxalate, purines, alkali
- Urinary Stasis & UTI (immobilization)
- Dehydration
- Diuretic use
- Hypercalcemia & hyperparathyroidism
- Uric acid elevation (Gout)
URINARY CALCULI Interventions:
- Monitor for Infection
- Nutritional therapy
- Fluids 3L/day
- Pain management [analgesics, warm baths..]
- Mobilization or repositioning
- Prep for Severe Pain
- Monitor for Infection
- Nutritional therapy
- Fluids 3L/day
- Pain management
- Mobilization or repositioning
- Prep for Severe Pain
Urine incontinence
Overflow
Stress
Urge
BENIGN PROSTATIC HYPERPLASIA (BPH)
Surgical management
- TURP
Post-surgical care
- Urinary catheter with/without 3-way continuous irrigation placed into bladder
- Bleeding
- Pain
-Infection
- Urination
- I/O
- Sexual dysfunction
Surgical management
- TURP
Post-surgical care
- Urinary catheter with/without 3-way continuous irrigation placed into bladder
- Bleeding
- Pain
-Infection
- Urination
- I/O
- Sexual dysfunction
Mnemonic for TB meds
R
I
P
E
