Urinary Disorders
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| show | Urethra, Cystitis, Prostatitis, Pyelonephritis.
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| show | Vesicoureteral reflux, Obstruction, Calculi, Chronic diseases (DM), Urine characteristics, Gender, Age, Sexual activity, Use of antibiotics, Instrumentation, Genetics, Pregnancy, Hygiene.
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| show | Inflammation of bladder, Infectious vs. non-infectious, Bacteriuria, Colonization, Seen with elderly, Bacteria /s symptoms.
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| show | Pathogen and host, Escherichia coli, Staphylococcus saprophyticus, Klebisiella pneumonia, Proteus and Enterobacter species, Fungal (Candida), Viral and parasitic (trigamonis), Non-infectious (Radiation, Immunologic responses).
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| Cystitis Manifestations | show 🗑
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| Pyelonephritis Causes | show 🗑
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| show | 85% of cases is E.coli, Proteus, or Klebsiella
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| show | Tissue inflammation=scar tissue (fibrosis), Tubular cell necrosis, Abscess
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| show | Fever, Chills, Flank pain (Tender costal vertebral angle), N/V, diarrhea, Malaise, fatigue, symptoms of cystitis
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| Pyelonephritis Labs | show 🗑
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| Pyelonephritis Other Diagnostics | show 🗑
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| show | Drink 2-3 L water/day, avoid sugar-filled drinks, Cleanse perineal area daily, Wipe front to back, Avoid bubble baths, nylon underwear, sprays, douche, Wear loose fitting clothing, Empty bladder regularly
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| Pyelonephritis Antimicrobial Drug Therapy | show 🗑
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| Pyelonephritis Antiseptic Drug Therapy | show 🗑
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| show | Phenazopyridine (Pyridium), orange-red urine
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| Pyelonephritis Antispasmodic Drug Therapy | show 🗑
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| show | Cranberry juice, avoid caffeine, carbonated beverages, tomato products, increase fluid intake (if possible), Sitz bath, heating pads, I/O, Strict aseptic technique, Maintain closed urinary drainage system, Perineal care
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| Surgical Therapy for Pyelonephritis | show 🗑
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| show | stones in urinary tract, more common in WHITE MEN, young to middle adulthood
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| Urolithiasis Risk Factors | show 🗑
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| show | Excruciating pain-renal colic, Flank pain, Sudden and unbearable, Nausea, vomiting, Pallor & Diaphoresis, Frequency and dysuria, Oliguria or anuia
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| Urolithiasis Obstruction | show 🗑
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| show | Hydronephrosis (Distention of renal pelvis) or Hydroureter (Distention of ureter, Unrelieved=damage, function, Infection)
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| Urolithiasis Diagnostic Test | show 🗑
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| show | Promote stone passage & hydration, labs, avoid over/under hydration, look at diet, strain all urine
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| Urolithiasis Drug therapy | show 🗑
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| show | Extracorporeal shock wave lithotripsy, Moderate sedation, Monitor cardiac rhythm, Monitor for bruising, Hemorrhage, UO, may have Foley catheter, Strain urine
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| show | Ureteroscopy (Laser beams used, No soft tissue damage), Percutaneous nephrolithotomy (Small incision, stone fragmented by laser/transducer, Nephrostomy tube, Monitor bleeding , pneumothorax, and infection)
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| Urolithiasis Open Surgical Procedures | show 🗑
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| Nephrolitotomy | show 🗑
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| show | Malignant tumors of urinary tract, 90% occur in bladder, Most common after age of 60, Men more than women, White men more than Black men, Multifocal, Highly invasive, Untreated leads to liver, lung, bone
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| Urothelial Cancer Risk Factors | show 🗑
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| Urothelial Cancer Manifestations | show 🗑
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| show | UA-hematuria, Cystoscopy with bladder washings or biopsy, CT scan, MRI
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| Urothelial Cancer Interventions | show 🗑
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| show | Partial or Complete Cystectomy, Invasive tumors; Urinary Diversion will result, Ileal conduit, Cutaneous urostomy, Continent pouch/reservoir (Kock pouch)
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| Bladder Trauma | show 🗑
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| show | Incomplete emptying of the bladder, Mechanical obstruction or Functional problem, BPH (benign prostetic hyprofetophy)
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| Benign Prostetic Hyprohetophy | show 🗑
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| show | unable to completely empty bladder, Overflow voiding (25-30 ml urine eliminated at frequent intervals), Incontinence, Untreated, can progress to hydronephrosis and acute renal failure
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| show | Promote voiding and normal position, Provide privacy, Bathroom rounds, May catheterize to relieve, If male with BPH, use coude, Drain urine in 500ml increments and clamp catheter for 5 minutes to prevent vasovagal response (drop BP, syncopy, pass out)
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| Neurogenic Bladder | show 🗑
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| show | Bethanechol chloride (Urocholine): Stimulates detrusor muscle contraction promoting emptying in flaccid neurogenic bladder, Use in combination with bladder training, Post-op and Postpartum urinary retention, Atropine is antidote, Slow position changes
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| Neurogenic Bladder Medications Anticholingerics/Antispasmodics | show 🗑
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| show | Nutrition; Bladder Training, Measures to stimulate reflex voiding, trigger points, Crede’s method (applying pressure to the suprapubic region with the fingers of one or both hands), Clean intermittent self-catheterization every 3-4 hours
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| Urinary Incontinence | show 🗑
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| Forms of Urinary Incontinence | show 🗑
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| show | Increased abdominal pressure; <leakage by Diary, Kegal exercises, Nutritional (avoid things irritating bladder), Vaginal cone therapy(weights), Surgical
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| show | Duloxetine (Cymbalta), inhibits uptake of norephinephrine and serotonin, Drug of choice for treating Stress UI not relieved by kegals. Side effects: Nausea, Headache, Insomnia, Constipation
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| Urge Incontinence | show 🗑
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| Urge Incontinence Drugs | show 🗑
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| show | Interventions aimed at removal of obstruction: Prostate removal, Repair of genital prolapsed, Intermittent cath, Behavioral, Bethanechol chloride (Urocholine) used after surgery
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| show | Treat reversible cause. For non reversible: Urinary habit training, Catherization, Pessaries and penile clamps, Containment, Major concern: SKIN BREAKDOWN
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| show | Combo of 2 or more types of involuntary urine loss, Use interventions for each type identified
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| Surgical Treatment for Total Incontinence | show 🗑
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