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Urinary
| Question | Answer |
|---|---|
| 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
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