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Urge Incontinenec
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Functional Incontinenece
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Kidneys

QuestionAnswer
Urge Incontinenec cant suppress sudden urge to void.
Functional Incontinenece Normal bladder function but has physical or cognitive impairement. Cant access toilet in time
Stress Incontinenence Pelic floor muscle/ligament weakness. . Sneezing, coughing, position changes, bending. Increased intrabdominal pressure
Urge Incontinece Drugs anticholinergics
Stress incontinenece drugs beta 3 adrenergic agonists (Mirabegron)
Incontinence Pt Ed No caffeine, carbonation, alcohol, artifical sweetener. Keep voiding diary
Incontinenece NC Promote adequate fluid intake, education verbally and in writing
Incontinence RF older adults, institionalized, UIT, impaction, sepsis, UTI, postmenopause, diabetes
External Spinchter Maintains continence
Detrusor muscle in lower pelvic floor that allows bladder to contract
Micturition Center Receives signal that bladder is full, releases signal to void; in Pons in brainstem
Voiding From increased parasympathetic and decreased sympathetic function; requires intact sacral nerves
Urgency Incontinence Patho overactive detrusor muscle
Stress Incontinence RF Obesity, childbirth, pelvic surgery, radiation, diabetes, postmenopause
Urgency RF aging, UTI, BPH, radiation, stones, tumors, alcohol, diuretics
Overflow RF MEN, enlarged prostate
Functional RF Broken legs, dementia,
Transient Incontinence Sudden, from reversible conditions. RF: UTI, constipation, fecal impaction
Neurogenic Bladder CNS disturbance to bladder. RF: stroke, Parkinsons,
Natural Urinary Protection low pH, high osmolality, high urea. Urination flushes bacteria
Men UTI RF STIs- gonorrhea, clamydia
Older Adult UTI S/S NEW ONSET confusion and incontinence
UTI Diagosis Clean catch specimen, Nitrate Dipstick
Urethritis inflammation of urethra. Men and STIs
Urethritis S/S Pain, dysuria, discharge, abcess, epididymitis, prostatitis
Cystitis/UTI S/S frequency, urgency, suprapubiv pain, pink or cloudy urine
UTI medications tatracycline, doxycycline. 3 days for uncomplicated. Antispasmodics for pain
Urinary Analgesic phenazopyridine. Will turn secretions orange. For UTI. Reduce pain
Urinary antiseptics Nitrofurantoin. Prevent UTIs
UTI Pt Ed no coffee, tea, pain, spices, cola, alcohol. Void q 2-3 hours. Daily cranberry juice or capsules
Functional Unit of Kidney nephron
Glomerulus Within bowmans capsule. Blood vessels, capillaries. Affernet brings blood in. Efferent carreis it away. Pressure gradient
Acute Pyelo Expected S/S CVA tenderness- flank pain, pyuria, chills, fever, increased WBC
Acute Pyelo Treatment 2 wks of antibiotics
Acute Pyelo Dx IV pyelogram, UA shows WBC casts, bacteria, cloudiness
Chronic Pyelo RF urine stasis or obstruction- neruogenic bladder, kidney stones, intrarenal disease
Chronic Pyelo Patho atrophied kidneys, calices scarring, chronic inflammation
Chornic Pyelo S/S flank pain, polyuria, weight loss, thirst, fatigue
Chronic Pyelo Treat Long term antimicrobials. 3-4 L fluids a day.
Nephrolithiasis RF dehydration, meds, excess solutes
Kidney Stone S/S spasmodic intermittent pain that radiates, N/V, diaphoresis, hematuria
High oxalate foods apinach, swiss chard, chocolate, peanuts, pecans
Prevent Kidney Stones limit protein intake, 3-4 L fluids/day, avoid excess sweating
Low Purine Diet To prevent uric acid stones. Shellfish, anchovies, asparagus, mushrooms, organ meats, proteins
Acute Glomerulonephritis Impaired filtration in glomerulus- increased proteinuria, casts, and hematuria
Chronic glomerulonephritis small, fibrotic kidneys; leads to need for dialysis
Chronic glomerulonephritis Labs hypoalbuminemia, GFR under 50, hypocalcemia, hyperphosphatemia, hyperkalemia, metabolic acidosis, tall T waves
Nephrotic Syndrome S/S Massive proteinuria, ascites, hyperlipidemia, diffuse edema, hypoalbuminemia
AGN S/S hematuria, casts, proteinuria, cola colored uris, azotemia, periorbital edema
How to diagnosis AGN ASO titer, possible kidney biopsy
Treat AGN Corticosteroids, HTN meds, restrict sodium, increase carbohydrates
Chronic glomerulonephritis S/S HTN, weight loss, dizziness, yellow gray skin, periorbital edema, Pericarditis
Nephrotic Syndrome Treat Lisinopril (ACE inhibitor), diuretics, statin, low sodium diet
AKI RF obstruction, hypotension, renal vein or artery obstruction
Polycystic Kidney Disease S/S stones, proteinuria, flank pain, increased abdominal fullness
Polycystic Kidney Disease RF genetic- dominant or recessive
Polycystic Kidney Disease Dx Kidney US or abdominal palpitation- shows enlarged kidneys
Intrarenal AKI RF renal ischemia, rhabdomyolisis, ATN, ACEs, NSAIDs, AGN, pyelo
Postrenal AKI RF Stones, strictures, BPH, pregnancy
Prerenal AKI RF Hypoperfusion- burns, renal artery stenosis, HF, hemorrhage
Oliguria Less than 400 mg/day or 0.5mg/kg/hr for 6 hours
Diuresis Phase of AKI Monitor for dehydration; increased uric acid in blood; gradual increase in urine output: 1-3 L/day
Oliguric Phase of AKI Hyperkalemia, hyponatremia, metabolic acidosis, elevated BUN/creatinine
Recovery Phase of AKI begins when GFR increased and BUN/creatinine decrease
Cola colored urine, proteinuria, azotemia, HTN, increased BUN AGN
AGN Patho Immune response to infection increases glomerular permiability
Chronic Glomerulonephritis Patho Chronic inflammation leads to nephron loss and atrophied kidneys; eventual kidney failure
Persistent proteinuria, HTN, progressive decline Chronic Glomerulonephritis
Nephrotic Syndrome Patho Increased glomerular membrane permianility
Risk for AKI creatinine increased to 1.5x over baseline or less that .5mg/kg/hr for 6 hours. GFR deceaseds by less that 25%
Impaired healing, pruriitis, dermatitis, frost Uremic syndrome. CKD complication
Gross hematuria and RBC casts Nephritic syndrome
AV Fistula No IV or BP on arm.
Created by: Student1999
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