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MN - Week 5,7 & 8
Urinary Tract Disorders
| Question | Answer |
|---|---|
| What Structures Make Up The Upper Urinary Tract? | -Kidneys -Ureters |
| What Structures Make Up The Lower Urinary Tract? | -Bladder -Urethra |
| Define Urinalysis | The analysis of urine. |
| What Diagnostic Tests Are Available For Urinalysis? | -Dipsticks -Specific gravity (urine concentration) -Sediment exam -Protein:creatinine ratio -Culture and sensitivity testing |
| How Can Urine Be Collected For Urinalysis? | -Free catch -Catheterisation -Cystocentesis (fluid drawn directly from bladder) |
| What Does It Mean For A Urinary Tract Disorder To Be Pre-Renal, Renal Or Post-Renal? | -Pre-renal = disrupted blood supply to the kidneys -Renal = issue with kidney itself -Post-renal = Obstruction past kidneys |
| What Parts Of A Blood Test Indicate Urinary Disease? | -Elevated urea/creatinine (azotaemia) -Elevated phosphates -Loss of protein (albumin) |
| What Forms Of Diagnostic Imaging Can Be Used To Diagnose Urinary Tract Disorders? | -Radiography -Ultrasound -Cystoscopy -Computed tomography |
| Define Renal Disease | The inability of the kidney to maintain normal function. Damage may be to nephron/glomerulus. |
| What Percentage Of Renal Damage Must Take Place Before Clinical Signs Are Seen? | 66% |
| What Can Cause Acute Renal Failure? | -Circulatory problems (hypovolaemia, hypotension, cardiac disease) -Infectious disease (lepto, FIP, pyelonephritis) -Toxins (ethylene glycol, lilies, grapes, raisins) -Drugs -Urinary obstruction -Severe systemic disease |
| What Are The Clinical Signs Of Acute Renal Failure? | -Lethargy -Inappetence -Vomiting and diarrhoea -PUPD or oliguria/anuria -Dehydration -Uremic breath and ulceration -Large painful bladder or empty bladder |
| How Can Acute Renal Failure Be Diagnosed? | -Diagnose underlying cause -Key clinical signs = reduced urine output + painful kidneys -Blood sampling for elevated urea/creatinine/phosphorus, acidotic, hyperkalaemia |
| How Can Acute Renal Failure Be Managed? | -Correct dehydration -Convert anuria – polyuria -Address electrolyte imbalance -Treat underlying cause -Correct nutrition |
| How Can Patients With Acute Renal Failure Due To Toxicity Be Treated? | -Induce emesis -Activated charcoal -Antidote if available -IVFT |
| What Are The Nursing Considerations For Patients With Acute Renal Failure? | -Monitor vital parameters -Repeat blood and urine samples -Pain scoring -IVFT -Water and nutrition intake -Monitor urine output -Catheter care -Administration of medication -TLC -Barrier nursing (if infectious) |
| When Is Renal Failure Classed As Chronic? | After 3 months. |
| What Are The Causes Of Chronic Renal Failure? | -Progression from acute renal failure -Infections -Toxins -Neoplasia |
| What Are The Clinical Signs Of Chronic Renal Failure? | -Polyuria/polydipsia (PUPD) -Lethargy -Weight loss -Dehydration -Reduced appetite -Vomiting and diarrhoea -Uremic breath + mouth ulcers -Small, firm kidneys -High blood pressure |
| How Can Chronic Renal Failure Be Diagnosed? | -Blood sampling, increased urea/creatinine/phosphorus, anaemia, SDMA (systemic dimethylarginine) -Urine testing, low specific gravity, proteinuria, haematuria |
| How Can Chronic Renal Failure Be Managed? | -Minimise dehydration -Maintain nutrition -Manage symptoms and side effects -Prepare owner for poor prognosis *Incurable* |
| What Medications Can Be Given To Manage Chronic Renal Failure? | -Sub cut fluids -Phosphate binders -Anti-emetics -Gastro-protectants -Potassium supplementation -Anti-hypertensive meds |
| What Specific Nutrition Should Be Given To Patients With Chronic Renal Failure? | -Anything to get them eating initially -Do not start renal diet in hospital – may associate -Prescription renal diets in long run: Low protein but high biological value Highly palatable Restricted phosphorus Antioxidants High fat |
| What Are The Nursing Considerations For Patients With Chronic Renal Failure? | -Monitor clinical signs and vital parameters -Ensure access to water, IVFT -Regular toilet breaks -Monitor urine output/catheter care -Nutrition/feeding tube -Administration of medication |
| What Three Conditions Can Cause Chronic Renal Failure? | -Polycystic kidney disease = fluid filled cysts form on the kidneys -Protein losing nephropathies/glomerulopathies = loss of protein into the urine -Pyelonephritis = bacterial infection |
| Define Cystitis | Inflammation of the bladder lining. |
| What Can Cause Cystitis? | -Ascending infection -Trauma from uroliths Other systemic illness |
| What Are The Clinical Signs Of A UTI? | -Dysuria (difficulty passing urine) -Pollakiuria (frequent passing of small volumes of urine) -Stranguria (straining, slow passage of urine) -Periuria (toileting in house – when trained) -Changes in appearance of urine -Small, painful bladder |
| How Can A UTI Be Diagnosed? | -Urine dipstick (protein, blood, WBCs) -Culture and sensitivity |
| How Can A UTI Be Treated? | -Antibiotics -Anti-inflammatories -Pain relief -Encourage fluid intake |
| What Are The Nursing Considerations For Patients With UTIs? | -Pain scoring -Monitoring vital signs -Ensure toileting opportunities -Monitor urine output -Hygiene -Prevent urine scald -Ensure water intake |
| What Is Urolithiasis? | -Formation of calculi/uroliths within the urinary tract -Caused by supersaturation of a solute/crystalloid leading to the formation of crystals |
| What Factors Effect The Formation Of Uroliths? | -Urine PH -UTIs -Breed -Diet |
| What Are The Four Main Types Of Urolith? | -Struvite -Calcium oxalate dihydrate -Cystine -Urate |
| What Are The Clinical Signs Of Urolithiasis? | -Recurrent UTIs -Obstruction |
| How Can Urolithiasis Be Diagnosed? | -Most radiolucent – radiography -Urinalysis (sediment, PH, culture and sensitivity) -Stone analysis |
| How Can Urolithiasis Be Treated? | -Catheterise to relieve obstruction (short term fix) -Surgery (cystotomy, urethrotomy) -Medical dissolution (with diet and medication) |
| What Are The Nursing Considerations For Patients With Urolithiasis? | -Pain scoring -IVFT and encourage water intake -Nutrition -Monitor urine output -Catheter care -Administration of medication -Post surgical care |
| How Can Urolithiasis Be Managed/Prevented Long Term? | -Nutrition - alter PH of urine -Wet food - encourages hydration -Regular urinalysis |
| What Are The Nursing Considerations For Patients With Chronic Urolithiasis? | -Monitor clinical signs -Nutrition -Encourage water intake -Encourage urination -Weight management -Environmental advice |
| How Can Feline Non-Obstructive Lower Urinary Tract Disease Be Treated? | -Try to address underlying cause -Increase water intake -Diet and weight control -Reduce stress in the household (separate litter trays etc) -Bladder supplements -Pain relief during episodes |
| What Are The Clinical Signs Of Feline Obstructive Lower Urinary Tract Disease? | -Non-productive straining -Vocalisation -Large, painful bladder -Vomiting -Lethargy -Slow heart rate |
| How Can Feline Obstructive Lower Urinary Tract Disease Be Treated? | -Baseline blood tests -Stabilise electrolyte imbalances, IVFT, cystocentesis -Catheterisation (under ga) – obstruction may need to be pushed back into bladder to relieve obstruction -Pain relief -Antibiotics -Spasmolytics -Monitor urine output |
| What Are The Nursing Considerations For Blocked Cats? | -Monitor vital signs -Pain scoring -IVFT -Care of urinary catheter -Monitor urine output -Diagnostic tests |
| What Types Of Neoplasia Are Commonly Seen In The Bladder? | -Transitional cell carcinomas (in the trigone area) -Squamous cell carcinoma -Adenocarcinoma -Papilloma -Adenomas -Lymphoma |
| What Are The Clinical Signs Of A Neoplasia In The Bladder? | -Signs of a UTI (dysuria, haematuria, stranguria, pollakiuria) -PUPD -Tenesmus/constipation -Palpable caudal abdominal mass |
| How Many A Neoplasia In The Bladder Be Diagnosed? | -Palpation of abdominal mass -Urinalysis -Imaging -Ultrasound -Contrast radiograph -Biopsy |
| Why Must Cystocentesis Not Be Performed If Neoplasia Is Suspected? | Risk of needle spreading cancerous cells. |
| How Many A Neoplasia In The Bladder Be Treated? | -Depends on staging -Complete cure is difficult - aim to slow growth and relieve clinical signs -Surgery - usually to relieve urinary obstruction -Chemotherapy -Radiotherapy |
| Define Incontinence | Inability to control urination. |
| What Are The Two Different Classifications Of Incontinence? | -Neurogenic = due to spinal cord injury/disease -Non-neurogenic = due to ectopic ureters and urethral sphincter mechanism incontinence |
| What Are The Clinical Signs Of Incontinence? | -Wetting the bed – especially whilst sleeping -Dribbling urine whilst walking -Urine scalding -Malodour |
| How Can Neutering Cause Incontinence? | Oestrogen is responsible for controlling the urinary sphincter, in neutering this hormone is significantly reduced/taken away. |
| How Can Incontinence Be Treated? | -Treat underlying cause if possible -Surgery for ectopic ureters -Medication for USMI (phenylpropanolamine or estriol) -Prevent urine scalding -Plenty of toilet breaks |
| What Are The Nursing Considerations For Incontinent Patients? | -Monitor clinical signs -Maintain good hygiene -Bedding -Grooming -Prevention of urine scald by barrier creams -Allow plenty of opportunity to toilet -Owner support |
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aimee_knows_nothing
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