Term
|
Definition
•Bacterial origin
•E-coli
•Females > Males
•UTI in Men – STD exposure?
•Older men – urine retention? (prostrate)
•
|
|
|
Term
|
Definition
•Lower
•Cystitis, prostatitis, urethritis
•Upper
•Pyelonephritis, renal abscess, nephritis
|
|
|
Term
| uti complicated v uncomplicated |
|
Definition
•Uncomplicated
•Simple bacteria, community acquired, not recurrent
•Complicated
•Nosocomial, DM, obstructions, recurrent
|
|
|
Term
|
Definition
•Inability or failure to empty the bladder-creates stasis
•Obstructed urinary flow
•Strictures
•Tumors
•Calculi
•Immunosuppressed
•Instrumentation (catheters)
•Inflammation
•Contributing conditions
•Pregnancy, DM, Gout, Neuro disorders
|
|
|
Term
|
Definition
•Wiping front to back
•Hygiene (avoid harsh soaps)
•Cotton underwear
•Void after coitus
•Bladder training-going to bathroom at regular intervals 2-4 hours
•Foley care
•Indwelling foley
•Level of bag à bladder
|
|
|
Term
|
Definition
•Wiping front to back
•Hygiene (avoid harsh soaps)
•Cotton underwear
•Void after coitus
•Bladder training-going to bathroom at regular intervals 2-4 hours
•Foley care
•Indwelling foley
•Level of bag à bladder
|
|
|
Term
|
Definition
•Dysuria
•Hematuria
•Microscopic and gross
•Frequency
•Nocturia
•Urgency
•Fever
•Change in urine color, clarity, and odor
•Back/flank pain
•Bladder spasms
•Confusion (elderly)
•High SG
•Nitrate-byproduct of WBC destruction
•Looking for blood, hemoglob, leuk, ketones, nitrates
|
|
|
Term
|
Definition
•Most helpful for recurrent infections
•Rarely done with uncomplicated UTI’s
•Positive when colony count is 105 of colony forming units (CFU)
•UTI can still be present despite negative culture!
•Usually culturing:
•Men and all children-kids should not be having uti’s
•DM, pregnancy, sexually active
•Those with other risk factors!
Know when to culture!!!
|
|
|
Term
| UTI Med and nursing management |
|
Definition
•Extensive teaching to prevent recurrent infections
•Antibiotics
•May need follow up U/A and culture
•Fluids
•Pyridium (phenazopyridine)-prevent bladder spasm, stain clothes because urine can be orange
•Juices to make urine acidic (cranberry, orange etc)
•Antibiotic prophylaxis (try not to)
|
|
|
Term
|
Definition
•Bacterial infection of the upper renal tract (Kidneys)
•Usually from upward spread of untreated UTI
•Also caused by: polynephritis, nephritic syndrome
•
•More ‘severe’ presentation than UTI
•Marked change on physical exam: flank pain
•
•Antibiotic treatment starting with 2 weeks, up to 6 weeks.
|
|
|
Term
|
Definition
•Result usually of an untreated UTI
•Often fromindwelling catheters, old people, urostasis
•Significant accumulation of WBC/Bands in blood
•Deadly complication…notably in elderly population
•Multi-system failure
•Hypovolemia
•Confusion
•Failure to thrive-not reaching developmental goals
|
|
|
Term
| urosepsis can lead to renal failure by |
|
Definition
Infections (recurrent) à
Inflammation/Scarring à
Nephron Destruction à
Unable to filter (Capillary Destruction) à
GFR increases, BUN increases à
= Renal Failure
|
|
|
Term
|
Definition
•May or may not create an obstruction
•Usually if stone is >5mm, obstruction occurs (adult)
•Cause damage to ureters
•Hematuria (gross)
•Pain (severe)
•Scarring (stricture)
|
|
|
Term
|
Definition
•Calcium oxalate – most common, taking too much calcium etc,
•Struvite (Staghorn) – ‘infection stone’ consist of magnesium, ammonium, and calcium phosphate
•Recurrent UTI’s
•Uric Acid
•Cystine – genetic disorder from decreased cystinereabsorption in the kidney.
|
|
|
Term
|
Definition
•Renal colic
•Severe, intermittent flank pain
•N/V
•Hematuria
•Fever, chills
•Not necessarily dysuria
|
|
|
Term
| who's at risk for renal calculi |
|
Definition
•Caucasian Males
•Warmer climates (south)-more prone to dehydration
•Genetics
•Previous occurrence
•Dehydration, alcohol, infections, gout
•Can be completely idiopathic
|
|
|
Term
| diagnostic and lab testing of renal calculi |
|
Definition
•X-ray
•Renal ultrasound
•CT scan with IV contrast
•U/A with culture
•Intravenous pyelogram if obstruction suspected-will show obstruction from contrast dye, can put stent in and allow to painfully pass
|
|
|
Term
| treatment and nursing care of renal calculi |
|
Definition
•Fluids
•Strain urine-catch stone for sample****
•Pain relief-opiates
•Antibiotics
•Dietary changes
•Ambulate more
•Lithotripsy and/or surgery
|
|
|
Term
| Acute urine retention (benign prostatic hypertrophy) |
|
Definition
•BPH most common cause of acute urine retention
•Medical emergency
•Bladder can hold about 2000-3000ml max before…
•BPH itself is a very stable disease state unless urine retention occurs
•Treatment centers on controlling prostrate size before it becomes problematic.
|
|
|
Term
| prevention and treatment BPH/acute urine retention |
|
Definition
•Prevention
•Alpha-adrenergic blockers (Hytrin, Flomax)
•Take about 5-30 days to see improvement.
•5-alpha reductase inhibitors (Avodart) drug of choice
•Work in about 3-5 days, but full effects take over one year.
•If these meds are discontinued, condition resorts back to original prostrate size and med will need time to work again. Almost a complete loss…
|
|
|
Term
| when prevention of BPH/acute urine retention fails.... |
|
Definition
•Foley
•TURP-metal thing in dick
•Stents
|
|
|
