Urinary Disorders

Question 1

Name the problem:

— generally caused by complications of an STD, trauma during catheterization, childbirth, 1/3rd of cases have unknown cause
— occurs more often in men
— most common symptom: obstruction of urine flow
— tx is usually surgical dilation

Answer 1

Urethral stricture

— can also be caused by an enlarged prostate; common in men, due to narrowing of urethra

Question 2

Name the problem:

— common type of nosocomial infection
— causes include: strictures, reflux, catheter use, being female, antibiotic use, sexual intercourse, urolithiasis, diabetes
— symptoms: frequency, urgency, dysuria
— most common tx is antibiotics

Answer 2

Urinary tract infection

*prevention is key

Question 3

What are some ways to prevent CAUTI?

Answer 3

— hand hygiene
— sterile technique
— do not insert foley unless absolutely needed
— do not leave foley inserted for long period of time
— prevent dependent loops
— secure catheter to pt leg
— keep collection bag below bladder

Question 4

Name the problem:

— symptoms include: urinary frequency, urgency, and dysuria; low back pain, nocturia, incontinence, hematuria, pyuria, suprapubic tenderness
— could potentially lead to sepsis
— inflammatory condition of bladder
— prevention: increase fluid, good peri care, dont delay urination, nutritional supplements (cranberry)

Answer 4

Cystitis

Question 5

Name some interventions for cystitis

Answer 5

— antibiotics: for bacterial
— increase fluid intake
— cranberry juice
— analgesics: certain drugs can turn urine orange!
— antispasmodics

Avoid foods/drinks such as coffee, carbonation, tomato products; irritation

Question 6

Name the problem:

postmenopausal patients report dysuria, urgency, lower abdominal pain, and vag discharge. mentions her and partner are being treated for chlamydia, he reports similar symptoms. UA results may show high WBC without presence of bacteria

Answer 6

Urethritis

Question 7

Name the problem:

50 year old man presents to ED with “the worst pain I’ve ever had.” You can barely get an assessment as he is doubled over and guarding his lower abdomen. He is admitted to the floor on IV opioids after confirmatory KUB. Common symptoms include sever pain, hematuria, n/v, pallor, diaphoresis

Answer 7

Urolithiasis - kidney stones

Question 8

Name some nursing outcomes for a client with urolithiasis

Answer 8

Pain management: opioids
— antispasmodics
Infection prevention
— increase fluid intake
— antibiotics if needed
— UA
Obstruction prevention
— increase fluids
— I&O
— strain urine
Lithotripsy
— bruising is expected
— use of shock waves
— monitor for increase pain, fever, chills, dysuria

Question 9

Name the problem

— causes can vary and can be temporary or permanent
— 25-45% of all women report this issue in their lifetime
— involuntary loss of urine severe enough to cause social or hygienic problems
— types include: functional, stress, urge, overflow, and mixed form

Answer 9

Urinary incontinence

Question 10

Name the problem:

— this problem can occur in the bladder, kidney, or renal pelvis
— hematuria is often the first major sign
— dysuria, frequency, and urgency occur when infection or obstruction are present
— dx with UA, cystoscope, biopsy, cysteureterography
— tx ranges from removal of bladder to surrounding tissues

Answer 10

Urothelial cancer