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Impaired Renal 1215

Impaired Renal from Nursing 1215

The common pathogen that causes UTIs E. Coli
This type of UTI usually has systemic symptoms such as fever, chills, and flank pain Upper UTI
This is inflammation of the bladder Cystitis
This is inflammation of the urethra Urethritis
This classification of UTI is one that is defined as an uncomplicated UTI in a person who has never been infected Initial UTI
This classification of UTI is one that is defined as reinfection caused by a second pathogen in a person that has experienced a previous infection that was unsuccessfully eradicated. Recurrent UTI
Define unresolved bacteriuria Recurrent UTIs that are: A. Initially resistant to antibiotics B. The antibiotic agent does not reach adequate concentrations to kill the bacteria. C. The drug is discontinued before the bacteriuria is eradicated
What is bacterial persistence? Bacteria: A. Develop a resistance to the antibiotic being used for treatment B. A foreign body in the urinary system allows for bacteria to survive even with antibiotic therapy.
What are symptoms of UTIs Frequency, urgency, burning, nocturia, lower back and suprapubic pain, hematuria, urinary retention
Fever is an indicator of what type of UTI? Pyelonephritis
Older adults don't have typical symptoms for UTIs. What symptoms do we see? Mostly neurological symptoms Abdominal discomfort, cognitive impairment, clinical deterioration
What type of testing can we use to test for UTIs? Urine analysis and sensitivity testing
People with this medical condition see frequently recurring UTIs? Diabetics
This is an intervention designed to flush out bacteria. Drinking 2- 3mL/day
What is an important teaching point to make when teaching about the drug therapy for UTIs? Continue the dose even after symptoms disappear
This is an Upper UTI that is characterized by bacteria infection of the renal pelvis, tubules, and interstitial tissue of one or both of the kidneys Pyelonephritis
What are some of the causes of Pyelonephritis? Urine reflux back into the ureters Urinary obstruction such as BPH and kidney stones
What type of Pyelonephritis has enlarged kidneys with interstitial infiltrations of the inflammatory cells? Acute Pyelonephritis
This type of Pyelonephritis results in atrophy and destruction of tubules/glomeruli. This can cause eventually renal failure. Chronic Pyelonephritis
What are some s/s of Pyelonephritis? Flank pain (from kidney involvement) Pyuria (pus in the urine) fatigue, chills, fever, vomitting, malaise CVA (costovertebral angle) tenderness
Why is it important to monitor BP of someone with Pyelonephritis? It helps prevent renal deterioration
List some of the causes of renal calculi Increased or decreased pH Slow urine flow; maybe from obstruction Immobility Damage to the UT Repeat UTI
What are some symptoms of renal calculi? Oliguria from obstruction Pain at the CVA (costovertebral angle) traveling to the groin UIT symptoms Hematuria intermittent pain (spasms as the stone is being pushed down the UT) Fever Pain Chills
An important part of diagnostic study for renal calculi is to do what with the stone? Retrieve it and analyze it
What are ways to diagnose renal calculi? cystoscope IV pyelogram: highlights UT KUB: Kidney, ureter, bladder (hydronecrosis) Serum labs: increased calcium, oxalate, uric acid Renal stone analysis
What is some nutritional teaching we can do for those with renal calculi? 1. Intake adequate amounts of fluid and calories 2. Decrease protein and sodium to prevent further trauma to the renal system 3. Limit calcium only if there is a significant amount of calcium in the stone
Name some procedures to rid the body of renal calculi? a. Ureteroscopy: laser = sand like particles b. ESWL = non-invasive c. Electrohydraulic lithotripsy: small pieces that have to be removed by forceps or suction. d. Percutaneous Nephrolithotomy e. Surgical removal
High protein diets are associated with what for renal calculi? Increased urinary excretion of calcium which can lead to calcium kidney stones
Dark ruffage (spinach and cabbage), tomato, beets, and tea are associated with what type of renal calculi? Oxalate stones
A patient is placed on low purine diet. We would expect to see this intervention with the formation of what type of renal calculi Uric stone
What is one important intervention that can help the passage of renal calculi? Ambulation and give fluids
Monitoring the patient's I/O can help identify what? Obstruction
What are some types of urinary diversions? Incontinent and continent orthotopic bladder
This is a urinary diversion to the skin? Incontinent Diversion
What are some important things to know about incontinent urinary diversions? They have a stoma that is not continent and will need to use a external collecting device
How often do you catheterize continent urinary diversions? every 4 -6 hours
This type of procedure creates a new bladder and urine can drain through the urethra Orthotopic neobladder
What is an important teaching point for orthotopic neobladder? There is no connection between the brain and this bladder to tell you when to go. You must have a voiding schedule
This condition occurs in 50% of men by age 50. BPH
What are some symptoms of BPH? difficulty urinating and intermittency Dribbling Frequency, urgency, dysuria, bladder pain, nocturia, incontinence
What is a complication with BPH? How is it treated? Acute urinary retention treated with catheter to drain the bladder
What is serious complication with BPH that is potentially fatal? Renal failure from hydronephrosis
What are some medications to avoid with BPH? decongestants, anticholinergics, and antihistamines
This drug can take up to 6 months to be effective for the treatment of BPH symptoms Finasteride (Proscar)
Name some procedures used to treat BPH Transurthral Needle Ablation: heats the prostate Transuretral incision of the prostate (TUIP) Transurthetral Resection (TURP): removal of prostatic tissue Laser prostactomy: cut, coagulate, vaporize prostatic tissue
What are two substance individuals with BPH should avoid? Alcohol and caffeine which cause smooth muscle contraction
What are some postoperative complications of BPH procedures? Hemorrhage, bladder spasm, urinary incontinence, and infection
Explain CBI associated with BPH Continuous bladder irrigation Rate of infusion is based on color of the drainage
Created by: mrsamjones