Term
| UTI refers to any portion of the LOWER urinary tract. This includes: |
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Definition
1. Cystitis
2. Urethritis
3. Prostatitis |
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Term
| Upper UTI refers to conditions including: |
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Definition
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Term
| UTIs are caused by Klebsiella, Proteus |
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Definition
Klebsiella, Proteus
pseudomonas
Serratia
E Coli ** most common |
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Term
| Untreated UTI lead to ---- |
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Definition
| urosepsis --. septic shock --. death |
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Term
| Risk Factors for UTI: Female Gender |
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Definition
1. Shorter urethra
2. Close proximity of the urethra to the rectum
3. Decreased estrogen in aging women promotes atrophy of the urethral opening towards rectum (*** increases risk of urosepsis in women)
4. Sexual intercourse
5. frequent feminine hygiene spray, tampons, spermicidal jellys...
6. pregnancy
7. poorly fitted diaphragms
8. hormonal influences vaginal flora
9. synthetic underwear and pantyhose
10. wet bathing suits
11. frequent submersion into baths/hot tubs |
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Term
| Risk factors for pts hospitalized |
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Definition
| 1. indwelling urinary catheter |
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Term
| Other Risk factors of UTI: |
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Definition
1. stool incontinence
22. bladder distension
3. urinary conditions
4. possible gentic link
5. disease - DM |
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Term
| Older adults have an increase risk of UTI: |
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Definition
Increased risk of bacteremia, sepsis, and shock
Renal complications increase for older adult clients d/t decreased number of functioning nephrons and fluid intake |
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Term
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Definition
1. lower back or lower abdominal discomfort and tenderness over bladder area
2. nausea
3. urinary frequency and urgency
4. dysuria, bladder cramping, spasms
5. perineal itching
6. hematuria
7. pyuria |
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Term
|
Definition
1. fever
2. vomiting
3. voiding in small amounts
4. nocturia
5. urethral dicharge
6. cloudy or foul smelling urine |
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Term
|
Definition
1. urinalysis and urine culture 7 sensitivity
2. WBC count and differential if urosepsis suspected |
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Term
| Teach client for urinarlysis |
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Definition
1. instruct pt proper technique for collecion of a CLEAN CATCH urine speciman
2. Collect Catheterized Urine Specimen using STERILE technique |
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Term
| Expected urinarlysis findings |
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Definition
1. Bacteria, sediment, WBC, RBC
2. POSITIVE leukocyte esterase (85%-90% specific)
3 POSITIVE nitrate 95% specific |
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Term
| PT with UTI will have a WBC of |
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Definition
wbc at or above 10,000/mm3 with a shift to the left
9including an INCREASED number of immature cells in response to infection) |
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Term
| Cystoscopy is used for ----- UTI |
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Definition
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Term
| ** Promote fluid intake up to __ L daily |
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Definition
3
*consult with provider regarding Rx fluid restrictions if needed.
nursing care |
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Term
| T/F clients should be encouraged to urinate 3-4 hrs instead of waiting for bladder to be completely full |
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Definition
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Term
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Definition
1. fluroquinolones (ciprofloxacin)
2. nitrofurantoin (Macrobid)
3. sulfonamides (Bactrim or septra) |
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Term
| Important Q to ask clients who are prescribed sulfonamide: |
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Definition
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Term
| T/F clients should take these antibiotics with food. cipro, macrobid, bactrim |
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Definition
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Term
| _____ is a bladder analgesic used to treat UTI |
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Definition
phenzaopyridine
** will NOT treat infection, will relieve bladder discomfort;
8** will turn urine orange
** take with food. |
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Term
| T/F cranberry juice should be encouraged as an alternative to water to |
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Definition
true
to decrease risk of infection |
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Term
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Definition
urethral obstruction
pyelonephritis
chronic renal failure
urosepsis
septic shock
death |
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Term
| ------ infection and inflammation of the renal pelvis, calyces, and medulla |
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Definition
pyelonephritis
88 usually begins in the lower urinary tract with organisms ascedning into the renal pelvis |
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Term
| the cause of most acute cases of pyelonephritis |
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Definition
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Term
| what happens with repeated infections occur in the urinary tract? |
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Definition
| scarring that changes blood flow to the kidney, glomerulus, and tubular structure |
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Term
| impaired filtration, reasborption, and secretion will ---- |
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Definition
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Term
_____ an active bacterial infection causes:
1. interstitial inflammation
2. tubular cell necrosis
3. abscess formation in capsule, cortex, or medulla
4. temp altered renal function |
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Definition
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Term
| _____ is the result of repeated infections that cause progressive inflammation & scarring |
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Definition
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Term
| _____ results in the thickening of the calyces and postinflammatory fibrosis with permanent renal tissue scarring |
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Definition
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Term
----- is more common with :
obstructions
urinary anomaly
vesicourecteral urine refluc |
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Definition
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Term
| junction where ureter connects to the bladder |
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Definition
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Term
| Risk factors of pyelonephritis: older |
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Definition
1. women over 65+
2. older men with prostate problems
2. incomplete bladder emptying
4. may exhibit GI or pulmonary symptoms INSTEAD of febrile responses
5. urine pH increases in older adults and promotes bacterial growth |
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Term
| Risk factors: pyelonephritis |
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Definition
1. chronic urinary stone disorders
2 spinal cord injury
3. pregnancy
4. congenital malformations
5. bladder tumors
6. chronic illness (DM, HTN, chronic cystitis)
7. decrease in vascular blood flow --. decrease in blood flow to kidneys |
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Term
chills
colicky type abdominal pain
nausea
malase/fatigue
burning, urgency, frequency with urination
costovertebral tenderness |
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Definition
| subjective data pyelonphritis |
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Term
-fever, tachycardia, tachypnea, HTN
- flank and back pain
-vomitting
-nocturia
-inability to concentrate urine or conserve sodium **
asymptomatic bacteremia |
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Definition
objective data- pyenophritis
*** chronic pyelonephritis |
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Term
| Lab Tests for pyelonephritis: |
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Definition
1. Urinalysis and urine culture & sensitivity
2. WBC count and differential
3. Blood cultures
4. serum creatine and BUN
5. c-reactive protein |
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Term
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Definition
1. dark color, cloudy appearance and foul odor
2. bacteria, sediment, WBC, RBC
3. Positive leukocyte essterase 85-95%
4. positive nitrate (95%) |
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Term
| a count at or above 10,000mm3 with a shift to the left |
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Definition
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Term
| increase in number of immature cells in response to infection |
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Definition
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Term
| ----- presence of bacteria if a sysTEMIC infection is present |
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Definition
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Term
--- elevated during acute episodes
consistentlly elevated with chronic infection |
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Definition
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Term
| elevaed during exacerbating inflammatory process |
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Definition
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Term
| T/f EsR elevated during acute or chronic inflammation |
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Definition
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Term
| ----- of kidneys, ureters, bladder may demonstrate calcuil or structural abnormalities |
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Definition
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Term
| ---- used to ID active pyelonephrtis or an abcess r/t specific enzymes present |
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Definition
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Term
| --- demonstrate calculi, structural, or vascular abnormalities |
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Definition
| intravenous pyelongram (IVP) |
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Term
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Definition
| 1. Assess renal function and allergy to contrast dye PRIOR to procedure |
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Term
| teach client (IVP)1. bowel prep may be rx prior to procedure for image clairty |
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Definition
1. bowel prep may be rx prior to procedure for image clairty
2. inform hydration prior and diuretic administration following the procedure may be prescribed to reduce risk of nephrotoxicity |
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Term
| ---- removal of stone from the kidney |
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Definition
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Term
| ---- removal of kidneynephrectomy |
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Definition
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Term
| what is usually administered for pyelolithtomy, nephrectomy, ureteroplasty |
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Definition
| IV antibiotics and analgesics |
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Term
| ---- done to repair or revise the ureter |
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Definition
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Term
| COMPLICATIONS of pyelonephrits |
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Definition
1. septic shock
2. renal failure
3. HTN |
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Term
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Definition
1. hypOtension
2. tachycardia
4. fever |
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Term
| nursing actions for RENAL FAILURe |
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Definition
1. monitor 1 + O
2. bun and creatine
3. encourage fluid intake |
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Term
| nursing actions for HTN1. |
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Definition
1, monitor bp trends
22. changes from baseline |
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Term
| Which of the following findings should a nurse expect to see when revewiing a lab report of pyelonephritis. |
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Definition
1. elevated BUN
2.positive leukocyte esterase
3. baceriuria |
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Term
Who is at risk for developing pyelonephtis:
a. pregnant pt
2. catherized urine spcimen obtained
c. client not voided for 8hr post op
d. neurogenic bladder
e. dm |
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Definition
| a. pregnant, neurogenic bladder, DM |
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Term
A nurse is caring for a client who is dx with a UTI. The client reports pain and burning sensation upon urination, cloudy urine with odor? which of the following actions should the nurse take?
1. offer warm sitz bath
2. encouraged increase fluids
3. obtain vs
4. administer antibiotic |
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Definition
4. administer antibiotic
-client greatest risk is injury from uTI |
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