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Nsg Ch. 45

Urinary Disorders

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