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29 Cards in this Set
- Front
- Back
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Where do UTI's usually develop?
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The lower urinary tract (urethra and bladder)
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Why do urinary tract infections occur and who are they most common in?
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They occur when normal flora bacteria enter the urethra and grow.
These infections are more common in women due to the relatively short urethra and the close proximity of it to the vagina and rectum |
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How do infections in the Upper Urinary tract occur?
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Normally when infections in the lower tract go untreated.
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What can happen in severe cases of UTI?
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Severe cases can result in sepsis.
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What are common symptoms of UTI?
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-Painful urination
-Frequent urges to urinate -Difficulty in urination -Pain usually beginning as visceral discomfort converts to extereme burning pain -Sometimes pain can be referred to shoulder or neck -Urine will have foul odour and may appear cloudy. |
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What is the classic triad of symptoms for UTI's
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Painful urination, frequency of urination and difficulty of urination.
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How are UTI's assessed and for?
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In addition to the triad pt's will appear to be restless and uncomfortable.
Skin will be pale, cool and moist for lower UTI and warm and Dry for upper UTI. Palpation of the abdomen will usually reveal tenderness over the pubis or pain in the flank. |
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How are UTI's managed?
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-Supportive pre-hospital care of the ABC's
- Allow patient to ride in position of comfort -Be prepared for nausea or vomiting - Establish an IV and administer a fluid bolus.to promote blood flow through the kidney and dilute the urine |
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Where do kidney stones originate?
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The renal pelvis
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Why do they form?
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They result when an excess of insoluble salts or uric acid crystallizes in the urine.
Usually due to water insufficient to disolve the salts. |
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Pain?
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Patients with kidney stones will almost always be in extreme pain.
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Where can the stone be trapped and what can result?
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If a stone has lodged in the lower ureter symptoms of a urinary infection may be present without the fever.
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What does prehospital care for kidney stones involve?
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Centres on pain relief. Ensure the ABC's and allow the patient to assume a position of comfort.
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What about an IV?
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Establish an IV line and administer fluids to promote movement of the stone through the system.
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What is Acute Renal Failure?
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A sudden (possibly period of days) decrease in filtration through the glomeruli.
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What is this accompanied by?
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It is accompanied by an increase in the level of toxins in the blood.
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What is the most common contributing factor to ARF?
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Sepsis is the most common contributing factor to ARF. Patients admitted to an ICU with ARF have mortality rate of 50-60%.
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What happens with ARF?
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If the urine output drops to less that 500ml/day it is oliguria. Stops is Anuria.
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What happens to the patient?
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Generalized edema
Acid Buildup High levels of nitrogenous and metabolic wastes in the blood |
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What can happen if left untreated?
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ARF can lead to hypertension and metabolic acidosis
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What are you looking for with ARF?
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Impared Mentation
Hypotension Fluid Retention Tachycardia Increased PR and QT intervals associated with hyperkalemia Pale, cool and moist skin Edema in extremities and face Look for scars, ecchymosis or distension |
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What is the treatment plan for ARF?
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Support the ABC's
High flow O2 BVM support if necessary Shock position |
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What about IV's
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Consider a bolus but be aware of pulmonary edema
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What is chronic renal failure?
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Progressive and irreversible inadequate kidney function due to permanent loss of nephrons.
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How can this occur?
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More than half of cases are caused by systemic diseases such as diabetes or hypertension.
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What happens?
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As kidney function diminishes waste products build up in the blood.
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What does this cause?
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Systemic complications such as hypertension, congestive heart failure, anemia and electrolyte imbalances.
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What symptoms do patients exhibit?
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-Altered LOC due to eletrolyte imbalance and effects on nerve transmission in the brain.
-Late stage, seizure and coma and possible. -Also lethargy, nausea, headaches, cramps and signs of anemia -May appear jaundiced due to buildup of wastes. -Powder accumulation called uremic frost may be present around the face -Edema in the extremities |
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What is management of the CRF patient?
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-Support the ABC's
-High Flow O2 -Be ready for third space shock |
