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medsurg exam 4

urinary tract disorder pt 2

QuestionAnswer
infections of the urinary tract are categorized by upper and lower
lower urinary tract infections Cystitis Urethritis
upper urinary tract infections Pyelonephritis
sources of infection Usually introduced via ascending tract Urologic instrumentation Nosocomial Infection (which is why we don't keep foleys in as long)
Cystitis inflammation of bladder
Cystitis involves bladder mucose
in Cystitis, mucosa become hyperemic and may hemorrhage
causes of Cystitis infections, tissue thats vulnerable
clinical manifestations of Cystitis in adults burning, frequency, urgency, not able to void, can't empty, fever/chills, n/v, cloudy/sediment/odorous/blood/mucus urine, abd/back pain
clinical manifestations of Cystitis in elderly change in LOC - lethargic, nocturia, incontinence, anorexia
lab findings in cystitis increased serum WBCs Urinalysis - WBC, RBC, pus Urine C & S - >100,000
pharm management of cystitis Analgesics and antibiotics
Analgesics for cystitis Pyridium
Pyridium pt education gets rid of pain, not the infection causes bright orange pee
antibiotics for cystitis Macrobid (5-7 days) Bactrim (3-5 days) Cipro (7-14 days, if also in kidney)
Nutritional Interventions for cystitis Increase Fluid Intake 8 glasses of fluid per day Avoid caffeine, alcohol, citrus - they irritate the bladder
health promotion for cystitis Proper wiping Shower Cotton underwear Avoid pantyhose Increase fluids - drink plenty of water Ill fitting diaphragm Spermicides increase pH - colonize e. coli Void immediately after sex
urethritis Inflammation of the urethra
symptoms of urethritis in female burning, mimic cystitis symptoms
symptoms of urethritis in male burning, discharge
most common symptom of urethritis burning dysuria
urethritis is caused by E coli, gonorrhea, chlamydia
urethritis treatment Antibiotics Fluids Avoid sexual intercourse until symptoms subside
acute pyelonephritis infection in kidney
how does acute pyelonephritis happen Bacteria enter the renal pelvis, usually from lower GU tract 85% of cases are E. coli
acute pyelonephritis activates inflammatory response so WBCs increase more than in cystitis
acute pyelonephritis Edema Involved Tissue Scarring and Fibrosis in kidneys Renal Damage as a result of scarring and fibrosis
clinical manifestations of acute pyelonephritis (KNOW) High Fever, Chills, Nausea Flank Pain!, Marked Tenderness in flank Muscular Pain !May be signs of Cystitis recently because infection typically moves up the GU tract
diagnostic tests for acute pyelonephritis Urine C&S KUB IVP Cystourethrogram Azotemia (high BUN) Anemia
treatment of acute pyelonephritis Consider factors which may be contributing to the infection PO antibiotic therapy (7-14 days) IV antibiotics in severe cases Increase fluid intake Follow-up urine culture For relapse - 6 week course of antibiotics
factors which may be contributing to the infection UTI, enlarged prostate, renal calculi
nursing interventions for acute pyelonephritis Education about the disease process and health promotion activities Stress importance of completing the entire antibiotic course 8 glasses fluid/day (even after antibiotics completed) Rest to increase comfort
chronic pyelonephritis occurs usually from long term UTIs
recurrent acute infections lead to destruction of nephron and renal insufficiency
Suprapubic Catheter is placed directly into bladder just above pubic symphysis
Suprapubic Catheters can be temporary or permanent
when manipulating Suprapubic Catheter maintain strict aseptic technique and ensure patency
insertion of suprapubic catheter trocar used to puncture bladder, catheter inserted, balloon inflated
Created by: leh195
 

 



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