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Non pharmological ways to treat uti cranberry juice avoid caffeine, carbonated beverages, tomato products increase fluid intake (if possible) sitz bath heating pads
what should we do as nurses for a uti monitor uo strict aseptic technique maintain closed urinary drainage system perineal care help to restroom
surgery for uti cytoscopy (urethral stent placement) "dont pull the string!" ureteroplasty- repair of ureter
what is urolithiasis stones in the urinary tract, more common in white men.
manifestations of urolithiasis excruciating pain (renal colic) flank pain sudden and unbearable n/v pallor and diaphoresis frequency and dysuia (oliguria and anuia)medical emergency
complications of urolithiasis obstruction requires prompt recognition and treatment (permanent damage can occur in <48 hours-weeks) added pressure= decrease gfr= renal failure unrelieved=damage, decrease function infection
what is hydronephrosis? distention of renal pelvis
what is hydroureter? distention of ureter
interventions for urolithiasis promote stone passage & hydration drug therapy (morpine, tordal, NSAIDS, flomax) strain all urine
what procedures would you do to remove stones? Lithotripsy (shock waves) Ureteroscopy- laser beams, no soft tissue damage percutaneous nephrolithotomy- small incision, stone fragmented by laser/transducer
what should you monitor with Lithotripsy? monitor cardiac rhythm, brusing, hemorrhage, uo, strain urine
what should you monitor with ureteroscopy? (laser beam used) no soft tissue damage
what should you monitor with percutaneous nephrolithotomy? monitor bleeding, pnemothorax, and infection
open surgical procedures for kidney stones ureterlithotomy pyelolithotomy nephrolitotomy
what is urothelial cancer? malignant tumors of the urinary tract, 90% occur in bladder
risk factors for urothelial cancer tobacco use occupational: if your around chemicals
manifestations of urothelial cancer painless hematuria symptoms of uti obstruction
Inerventions for urothelial cancer bacille Calmette-Guerin (BCG) instilled in bladder, inflammatory reaction to reduce/eliminate tumor
surgical management for urothelial cancer partial or complete cystectomy (removal of the bladder) which creates a urinary diversion (kock pouch)
what is urinary retention? incomplete emptying of the bladder
what is bladder trauma? penetrating or blunt injury to bladder
manifestations or urinary retention? unable to completely empty bladder overflow voiding (25-30ml at frequent intervals) incontinence dull tone upon percussion distended bladder
what kind of catheter should you use for a male with a bph? coude
how should you catheterize client to relieve urinary retention? drain urine in 500ml increments and clamp catheter for 5-10 mins to prevent vasovagal response
what is a neurogenic bladder? disruption of the nervous system of the bladder that controls bladder filling, perception of fullness and need to void
what is a spastic bladder dysfunction? spasm more than 400mls
what is flaccid bladder dysfunction full or over stretched loss of muscle tone
Cholinergic drugs for a neurogenic bladder urocholine- stimulates muscle to promote emptying of the flaccid bladder use in combination with bladder training has effects on bp (change positions slowly)
anticholintergics/antispasmodics ditropan, detrol relaxes muscle to suppress the urge to void caution use with glaucoma
treatment of neurogenic bladder cranberry juice bladder training pull pubic hair Crede's method (apply pressure to suapublic region) clean self-cath every 3-4 hours
what to take for stress incontinence cymbalta
what to take for urge incontinence estrogen- increased risk for endometrial cancer and thrombophlebitis
what to do for overflow incontinence remove the obstruction (prostate, repair genital prolasps, intermittent cath)
what to do for functional incontinence treat reversible cause if not reversible (habit training, catherization, penile clamps, skin breakdown)
what is nephrotic syndrome? allows large molecules are able to pass thru membrane into urine.
What are the causes of nephrotic syndrome? immune or inflammatory genetic hyperlipidemia renal vein thrombus
Manifestations of Nephrotic syndrome proteinuria >3.5g in 24 hours low albumin high lipids fatty urine edema htn increased coagulation renal insufficiency
complications of nephrotic syndrom renal vein thrombosis DVT PE
What is glomerulonephrytis? unknown cause develops over 20-30yrs leads to renal failure
What is diabetic nephropathy? renal failure r/t diabetes
what should you educate someone with diabetic nephropathy? avoid nephrotoxi agents avoid dehydration
Medications for glomerular disorders antibiotics prednisone cytoxan ACE inhibitors
Treatment of diabetic nephropathy restrict activity low sodium diet 1-2 gr low protein if azotemia is present plasmaphoresis dialysis
what do you monitor with diabetic nephropathy? sign of fluid overload (abnormal lung sounds, pitting edema, JVD) uremic systems
what is renal artery stenosis? narrowing of the renal artery caused by atherosclerosis HTN epigastric bruit decreased na+, fat, cholesterol diet
Created by: chelseanicholas