chapter 37- nursing care of patients with disorders of the urinary system Flashcards

• starts at the meatus
• ascending (they go up) can travel up to the kidneys
• most common by bacterium E. coli

hospital acquired infection

infection and ask for a urine specimen

2-3 L a day unless contraindicated

inflammation of the bladder wall

(bacteria enter the urethra after intercourse)

incomplete bladder emptying, previous UTI, aging changes and genital piercings

urgency, frequency, burning, cloudy, foul-smelling urine-hematuria, pelvic pain

kidney infection- higher risk for sepsis

inflammation due to an infection, irritant, trauma, or urethraa

by gonococcus and herpes.

s/s- burning, itching, frequency in voiding. meatus may be swollen and red

common in older adults severe, potentially fatal form of sepsis caused by uti

-signs tachycardia and blood pressure (hypotension)

causes orange urine. (medication used to treat cystitis)

yes, never use heating sources without an order

• take all antimicrobial medication
• fluids: increase
• uti s/s recognize & report
• prevention: interventions

backward pressur damages kidney tissue and can lead to chronic kidney disease; distends kidney (hydronephrosis) fluid on the kidney

causes: injury, STD'S, tissue trauma from catheters or surgical instruments, cancer, enlarged prostate.

occurs in men more than women

FREQUENT UTI'S

hard small stones in urinary tract.

strain the urine, send the stone in for a urinalysis

ureter stones

an obstruction of the stone causing nephrolithiosis

hereditary, chronic dehydration, diet: high sodium, sugar, protein, obesity, repeated infections

high levels of calcium, oxalate, or uric acid

causes include excess dietary intake of purine type foods (meats, gravies, red wine, sardines.

pain radiation to the genitalia

a ureteral stone causes urine backup, leading to hydroureter, hydronephrosis and potential renal damage if untreated

if low-oxalated diet is prescribed money foods may be restricted, including beets, chocolate, spinach, rhubarb, nuts, peanuts, and sweet potatoes

hydration, diet, exercise

calcium, uric acid, blood urea nitrogen (BUN), creatine

hematuria, crystals, urine PH

IV pyelogram

hydration, analgesics, alpha-blocker (tamsulosin)

*analgesis- relieves serve renal colic pain

decrease urinary calcium excretion

sends shock waves to the stone itself to help crush it

blood tinged urine (pink) for about 1 to 3 days and back pain

***remember*** BRIGHT RED BLOOD AND BLOOD CLOTS NEED TO BE REPORTED

increase fluid intake to get rid of the stones and filter your urine to get the stones tested in lab to define which type of kidney stone it is.

inserted in an imaging lab, the tube will be inserted into the kidney.

watch for signs of infection

abnormal dilation (stretching) of the ureter caused by urine backing up due to obstruction, most commonly kidney stones

obstruction causes urine backup

• kidney enlarges as urine collects
• kidney pressure increase

block Foley catheter, BPH , tumors, kidney stones, scar tissue, birth defect pregnancies

frequency, urgency, pysuria, flank and back pain

Invasive cancer

• early signs- painless and hematuria
• late signs- pelvic pain, dysuria, inability ton urinate

cystoscopy and transurethral biopsy, urine tumor markers, bladder tumor associated antigen(BTA) and carcinoembryanic antigen (CEA)

intravesical therapy (chemotherapy) medication instilled directly into the bladder. & immunotherapy(BCG)

live weekend bacteria used to stimulate the immune response. hold medication in bladder - 2 hours

• must sit down to void to prevent splashing.
• avoid pregnancy- use condoms during sex for 1 week

teach patient to avoid sunlight

• most common today
• creates new bladder from intestine and implants ureters and urethra into the neobladder
• allows voiding via urethra

smoking, obesity, hypertension, long-term kidney dialysis, exposure to radiation, absestos, or industrial pollution.

S/S- hematuria, dull pain in the flank area, and mass In the area

a procedure where a small tissue sample of the kidney with a needle guided by ultra sound or ct scan to evaluate kidney disease

post procedure- monitor for bleeding (vitals and check urine), strict bed rest for 6-24 hours, patient positioning, hydration and activity restriction for discharge

NEVER the first choice for kidney cancers because they are chemotherapy resistant.

watching for pneumothorax signs- Shortness of breath- diminished breath sounds on affected side

renal calculi can be a complication of gout, which is a disorder of purine metabolism. limit high- purine foods such as organ meats, anchovies, herring, sardines, alcohol beverages, and gravy. increasing fruits and vegetables may reduce uric acid stone formation.