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47 Cards in this Set
- Front
- Back
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Infection of the bladder is called
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cystitis
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infection of the urethra is called
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urethritis
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infection of the prostate is called
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prostatitis
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infection of the kidney is called
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pyelonephritis
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what are the S/S of UTI
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dysuria
burining upon urination frequency and urgency nocturia incontinence hematuria back and/or pelvic pain |
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Risk factors in UTI
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inability to empty bladder completely
decreased natural host defenses indwelling catheters - 80 % nonsocomial infections obstruction - stones altered metabolic states - DM pregnancy, gout neurologic D/O |
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Risk factors for Geriatric UTI
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Neurogenic bladder (CVA)
neuropath (Diabetes) less antibacterial activity of prostatic secretions prostatic hyperplalsia or carcinoma catheters immobility |
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to reduce odds of bladder infection you should...
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have adequate fluid intake
encourage voiding upright position bladder training avoid indwelling catheters intermittent cath better q 4-8 hrs than foley showers better than tub baths |
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What is the Tx for infections of the Bladder (cystitis)
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get urine culture
antibacterial agent (nitrofurantoin-not for renal failure pts; Trimethoprim/sulfamethoxazole or Bactrim - most common. |
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What is the Tx for infection of the kidney (pyelonephritis)?
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relieve obstruction
urine culture antibacterial gents - TMP-SMZ (Bactrim) or fluoroquinolone (cipro) |
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Name 4 types of urinary incontinence
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stress
urge overflow functional |
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what causes stress incontinence
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increase in intraabdominal pressure - sneezing...
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what causes urge incontinence
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UTI or bladder tumor, neurologic dysfunction (above the arch reflex) can be spastic bladder
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what causes overflow incontinence
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neurologic abnormalities or obstruction (lower motor neuron) can be flaccid bladder.
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what causes functional incontinence
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cognitive or physical impairment - easiest to cure. Easy to remove clothing, commode close by....
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what are the 2 type of neurogenic bladders
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Spastic and flaccid
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what is a spastic bladder
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urge incontinence, hypertrophy of bladder wall
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what is a flaccid bladder
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overflow incontinence, lower motor neuron lesion below arch reflex
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what are the causes of a neurogenic bladder?
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spinal cord injury or tumor
neurologic disease (MS) congenital anomalies (spina bifida, myelomeniogocele) infection systemic disorders (DM) |
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what are Tx for incontinence & neurogenic bladder
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History and Assessment
Diagnostic studies - urethrogram, systourethroscopy, retograde cystography, cystometry |
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Nsg Considerations for incontinence/neurogenic bladder
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promote toileting in timely way
kegel exercises bladder training for spastic bladder habit training for flaccid bladder intermittent or continuous catherization surgery for stress incontinence urecholie for flaccid bladder ditropan for overactive bladder |
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A spastic bladder is what type of incontinence, uses what type of med for Tx, and what type of training
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urge incontinence
ditropan (oxybutynin) bladder training |
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A flaccid bladder is what type of incontinence, uses what type of med for Tx, and what type of training
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overflow incontinence
urecholine (bethanechol) Habit training |
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risk factors for renal stones
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infection
urinary stasis immobility hyperparathyroidism - increase Ca+ excessive Vit d intake myeloproliferative diseases (leukemia, multiple myeloma) granulomatous disease - sarcoidosis, TB Malignancy - because of destruction of bone & increase Ca+ in blood |
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intense loin pain
pyuria hematuria N&V diarrhea |
S/S of renal pelvis stones
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hematura
low urine output increased desire to void radiating pain |
ureter stones
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infection
hematuria |
bladder stones
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what are the diagnostic tools for urolithiasis
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KUB
US IV urography retrograde pyelography 24 hr urine catch stone analysis |
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what does the 24 hr urine catch look at?
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calcium, uric acid, creatinine, sodium, pH, total voume
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Tx for urolithiasis
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pain relief
increased fluids, I/O lithotripsy, watch for obstruction endourologic stone removal ureteroscopy, stone dissolution, strain urine, surgery |
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mL of fluids in a day
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3000mL
3 Liters |
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care for after lithotripsy
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pain control
strain urine daily urinalysis IV 3000mL Saline daily observe for obstruction |
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what is the nutritional therapy considerations for calcium stones
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restrict sodium and protein - not Ca+
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what is the nutritional therapy considerations for uric acid stones
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low-purine diet
limit shellfish, anchovies, asparagus, organ meats, mushrooms |
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what is the nutritional therapy considerations for oxalate stones
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restrict - spinach, strawberries, rhubarb, chocolate, tea, peanuts, wheat bran.
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what are the S/S of trauma to the GU system
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Ureter - leaking
bladder - ecchymosis, shock urethra - blood at meatus, unable to void, distended baldder |
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Tx for Renal Trauma
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Tx hemorrhage, pain
surgery - stents for ureter damage or delay repair due to swelling catheter placement for urine output verify renal function |
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Tx for bladder cancer
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surgery - transurethral resection, cystectomy
radiation medication - chemotherapy methotextrate, cystoplain topical chemotherapy - bacille Calmette-Guerin (BCG) goes on in bladder wall - must turn pt side to side Photdynamic techniques. |
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Bladder cancer S/S
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visible, painless hematuria
UTI pelvic or back pain - metastasis |
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what are 4 different ways to get bladder cancer diagnosis
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cystoscopy
excretory urography CT Ultrasonography |
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what are Immediate S/S of complications from urinary diversion?
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wound infection, dehiscence, urinary leakage, ureteral obstruction, ileus, stomal gangreene
what color is normal for stoma |
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what color is normal for stoma
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beefy red, not grey or blue
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is cloudy mucous normal in a urinary diversion
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yes
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what are the S/S of delayed complications from urinary diversion?
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ureteral obstruction, narrowing of stoma, renal deterioration RT chronic reflux, pyelonephritis, renal claculi
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what are some Nsg considerations for urinary diversions
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monitor for oliguria,hematuria
stoma and skin care control pain Ostomy appliance address body image issues prevent complications such as peritonitis and stoma conditions |
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client has undergone urinary diversion. what would be characteristic of a healthy stoma?
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beefy red
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what would be characteristic of urine from a newly created urinary diversion
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slight hematuria
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