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Nsg Ch. 45
Urinary Disorders
| Question | Answer |
|---|---|
| define cystitis? prostatitis? urethritis? pyelonephritis? | cys: inflammation of bladder pros: infl of prostate gland ure: infl or urethra pye: infl of renal pelvis |
| What is involved in a lower UTI? upper UTI? | lower: cystitis, prostatitis, urethritis upper: acute pyelonephritis, chronic pyelonephritis, renal abscess, interstitial nephritis, perirenal abscess |
| What is diff bn complicated and uncomplicated UTI | un: community-acquired com: nosocomial related to catheterization |
| an acid/alkaline diet is often for UTIs, what foods are involved? | acid: meat, no veg, no fruit, cereal grain alk: fruit, veg, milk, no meat/fish/cereals |
| What does urethrovesical reflux/ureterovesical/vesicoureteral refer to? | backward flow of urine from bladder in to one or both ureters |
| s/s of cystitis | burning on urination, frequency(void >3h), urgency, nocturia, incontinence, pain |
| In elderly, what is chief presenting s/s or UTI? | fatigue, change in cognitive fx |
| What is important to do with UTI for dx? | C&S and have them come back for repeat urine culture |
| What is med mgmt for lower UTI? | bactrim, macrodent, cipro, levoquin, pyridium(helps with spasms, not cure) |
| How can you instruct pt to not get recurrent UTI? | shower, not tub, wipe front to back, drink lots, void often |
| Pyelonephritis can be acute and chronic, what is main diff? | chronic usually has no s/s except HTN, so control HTN and antibiotics |
| What are the 4 diff types of incontinence | stress: sneeze, cough and lose urine urge: strong urge, can't reach toilet reflex: spinal cord inj, no sensor awareness Overflow: inability to empty normally |
| Med mgmt for incontinence | anticholinergics inhibit contraction and 1st line for urge incontinence. Antidepressants(Endep, Asendin) decr bladder contractions, incr bladder neck resistance Sudafed |
| What are two types of neurogenic bladder? tx? | spastic(reflex): bladder contracts, but not empties flaccid: r/t trauma and DM tx: bethanechol incr contraction of detrusor muscle |
| what is the Crede method? What is a nsg mgmt for spastic bladder? | pushing/massaging bladder to help it empty. Bladder retraining: timed voiding, schedule q2h |
| What is single best action a nurse can do b4 catheterization? | Wash hands |
| how to get urine sample | clamp catheter tube, wait for urine to gather, get our with syringe, put in sample cup, remove clamp |
| What are two types of catheters? | indwelling and suprapubic and straight |
| if catheter bag gets contaminated what should nurse do? | put in new catheter |
| What is med mgmt for renal stones? | incr water intake and decr protein/Na diet foods |
| Types of stones are Ca phosphate, oxalate, uric acid, cystine, struvite, which one would need a low purine diet? | uric acid |
| Spinach, chocolate, tea, rhubarb, peanuts, wheat bran are foods to avoid in which stone formation? | Ca oxalate |
| Should a low calcium diet be prescribed to avoid stones? | No, esp in women cause can lead to osteoporosis. Can restrict true absorptive hypercalciuria |
| How does urine flow in a cutaneous urinary diversion? continent urinary diversion? | cutaneous: opening created in abd wall and skin continent: portion of intestine is used to creat new reservoir for urine like Kock and Indiana pouch(most common) |
| What is most common cutaneous urinary diversion? | ileal conduit |
| If pt suddenly develops HTN, what might be the reason related to the kidney? | renal art stenosis |
| what is hydronephrosis and tx? | dilation r/t stone, water on kidney tx: correct cause |
| what is tx for urethritis, inflam of urethra from ascending inf from STDs and UTIs? | tetrcycline and doxycycline |
| what is main s/s in urethral diverticula tx? | painful voiding r/t obstruction and rupture of periurethral glands tx: transurethral incision/excision of sac |
| what should nurse educate a pt with chronic cystitis? tx? | educate to get antidepression meds cause lots of pain r/t chronic bladder inflammation tx: elavil will chill out nerve endings Elmiron enhances bladder inner layer to protect from urine |
| renal tuberculosis renal disease and AIDS |
Created by:
palmerag
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