Kidney/Pudenda - Unit 4 - Care of Patients with Urinary Disorders Flashcards Preview

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Flashcards in Kidney/Pudenda - Unit 4 - Care of Patients with Urinary Disorders Deck (90):
1

What is pyelonephritis?

Infection of the kidney (upper UTI)

2

What is urethritis?

Infection of the urethra (lower UTI)

3

What is cystitis?

Infection of the bladder

4

What is prostatitis?

Infection of the prostate (UTI's in men are typically associated with the prostate)

5

What is the typical causative organism for a UTI?

E. Coli

6

What are some risk factors for a UTI?

age, gender, history

7

What are some symptoms for a UTI?

burning w/urination (dysuria), cloudy urine, pain, odor, confusion in the elderly)

8

What is pyridium?

A bladder analgesic

9

What is macrodantin?

Urinary antiseptic

10

What are some antimicrobials used to treat UTI's?

Cipro, bactrim, amoxicillin, septra

11

What does anaspaz do?

It's an antispasmodic!

12

What are some symptoms for acute pyelonephritis?

Flank pain, fever/chills, H/A, malaise, anorexia, nausea, vomiting, cloudy urine with ammonia odor, urgency, frequency, nocturia

13

What is the difference between acute and chronic pyelonephritis?

Acute = active bacterial infection.

Chronic = repeated infections.

14

How do we treat pyelonephritis?

Meds (analgesics, antibiotics, antiemetics, antidiarrheal, increase fluids, check UA, treat underlying cause.

15

What are some key features of chronic pyelonephritis?

HTN, inability to conserve sodium, decreased concentrating ability, development of hyperkalemia and acidosis

16

If someone has a UTI, what might be elevated?

Elevated BUN, positive leukocyte esterase

17

What do cranberries and blueberry juice do to prevent UTI's?

Help prevent bacterial from attaching to urinary tract.

18

What is a condition that an older patient with acute glomerularnephritis is often misdiagnosed with?

Congestive heart failure

19

What is stress incontinence?

Loss of small amounts of urine with sneezing, laughing, or lifting (after pregnancy)

20

What is urge incontinence?

Inability to stop urine flow long enough to reach the toilet.

21

What is mixed incontinence?

Involuntary unpredictable loss of urine that does not generally respond to treatment

22

What is overflow incontinence?

Urinary incontinence related to bladder overdistention

23

What is functional incontinence?

Inability to get to the toilet to urinate

24

What are some risk factors for urinary incontinence?

Multiple pregnancies and vaginal births, aging, urinary bladder spasm, neurological disorders (parkinson's, etc), medication therapy, obesity, confusion, dementia, etc.

25

What are some signs and systems of incontinence?

Loss of urine, enuresis (bed wetting), bladder spasms, urinary retention, frequency, urgency, nocturia

26

Should we assess I/O with people who have urinary incontinence?

YES

27

What is a voiding cysto-urethrography?

X-ray taken while patient is voiding to assess size/shape/ of bladder.

28

What is urodynamic testing?

Measures pressure inside bladder.

29

We should have less than ___ CC after voiding.

100

30

What are some surgical interventions for incontinece?

Vaginal repair, retropubic suspenion, catheters, etc

31

What are some nursing interventions for incontinence?

Assess I/O, teach kegels, establish a toileting schedule, minimize a delay in toileting, incontinence garments, etc.

32

When should patients with incontinence take diuretics?

In the AM or mid-afternoon!

33

What are some meds for urinary incontinence?

Antibiotics, antidepressants, urinary antispasmodics or anticholinergics (ditroban, prodanthe), calcium channel blockers (men -- prostate), alpha-adrenergic antagonists, HRT (might send more blood to the pelvis)

34

Are skin breakdown and social isolation complications of urinary incontinence?

YES

35

What are urolithiasis?

Kidney stones!

36

What are stones made up of?

Calcium oxalate, phosphate (phosphorus in kidney), struvite (from infection), uric acid (high protein diet, gout)

37

What cause kidney stones?

Immobility, family, reduced vitamin D, urine stasis

38

What are symptoms of kidney stones?

Pain (sharp), sudden, severe (colic), pain gets worse upon movement, N/V, chills, fever, diaphoresis, urinary frequency, dysuria, oliquria/anuria, pallor, hematuria

39

What are some diagnostic tests for kidney stones?

Urinalysis (increased RBC, WBC + bacteria), radiology, Ct/MRI, ultrasound or cystoscopy

40

What are some non-surgical interventions for kidney stones?

Increase fluid to 3000 mL/day, medications that prevent the absorption of calcium (thiazide diuretics and phosphates), allopurinol for uric acid stones, opioids, cystoscopy, etc.

41

What is lithotripsy?

Shockwaves that break up the stones!

42

What do we do after lithotripsy?

Strain the urine!

43

Is it normal to have some hematuria and bruising after lithotripsy?

Yes

44

What are some surgical options for kidney stones?

Stents, nephrostomy, lithotomy (open up kidney, yuck!)

45

What's a ureterolithotomy?

They go into the ureter

46

What's a pyelolithotomy?

They go into kidney pelvis

47

What is a nephrolithotomy?

They go into the kidney.

48

What do we do pre-op for surgical management of a kidney stone?

Prepare client, teach about procedure, report abnormal findings, etc.

49

What do we do post-op for surgical management of kidney stones?

Assess pain, I/O, vitals, urinary pH, meds, strain all urine, ambulation, education, etc.

50

What are two complications of surgical management of kidney stones?

Obstruction and Hydronephrosis (back up of the kidney)

51

Who is at high risk for bladder and urothelial cancer?

Males over 50, smokers, exposure to chemicals

52

What are symptoms of bladder/urothelial cancer?

Painless early, hematuria, frequency, change in urine color, burning with voiding, difficulty voiding

53

What is a cystectomy?

removal of bladder

54

What is an ileal conduit?

Ureters into ileum, stoma w/pouch

55

What is a uretero-sigmoidostomy?

Ureters into sigmoid, urine exits rectume

56

What is an ileal reservoir/kock's pouch?

Internal pouch from ileum, nipple valve - place catheter in to drain urine (self-cath)

57

What is a nephrostomy?

External tubes drain renal pelvis

58

What is a complication of an ileal conduit?

Urine is CAUSTIC! So make sure everything fits well.

59

What do we do pre-op bladder cancer surgery?

Type of diversion?, discuss urine control

60

What do we do post-op bladder cancer surgery?

Assess drains/output, I/O, stoma care, support system-family

61

What does a uroflowmetry test do?

Rate + fill degree

62

What does an electromyography (EMG) test do?

Strength of pelvic muscle contraction.

63

How much urine should be left in the bladder after voiding?

Less than 100 CC

64

What are some surgical interventions for bladder problems?

Vaginal repair, retropubic suspension, artificial sphincter, catheters, collagen injections in the periurethral area

65

What are some nursing interventions for the bladder?

Assess I/O, teach kegels, establish toileting schedule, initiate bladder training program, minimize delays in toileting, incontinence garments, limit beverages after evening meals, if diuretics are prescribed, take them in the morning or mid afternoon

66

What are some meds used with urinary incontinence?

Antibiotics, antidepressants, urinary antisposmodics or anticholinergics (ditroban, prodanthe), Calcium channel blockers (men -- decreases prostate), alpha-adrenergic antagonists, HRT (could increase blood supply to pelvis)

67

Are skin breakdown and social isolation complications of urinary incontinence?

YES

68

What are kidney stones made up of?

Calcium oxalate, phosphate, struvite (come from infection & grow fast), uric acid

69

What are causes of kidney stones?

Immobility, family history, reduced vitamin D, urine stasis

70

What are some symptoms of kidney stones?

Sharp pain that's sudden, severe - pain gets worse when the stone is moving.
Flank pain = stone in kidney or ureter, N/V, chills, fever, diaphoresis, urinary frequency, dysuria, oliquria/anuria, pallor, hematuria

71

what are some diagnostic tests for kidney stones?

Urinalysis, KUB/IVP, CT or MRI, ultrasound or cystoscopy

72

What's some non-surgical treatment for kidney stones?

Increase fluid intake to 3000 mL/day, take meds, treat uric acid stones with allopurinol, pain relievers, cystoscopy, percutaneous neprhostomy, lithotripsy

73

What are some surgical treatments for kidney stones?

Stents, nephrostomy, lithotomy (if all else fails!)

74

Ureterolithotomy (?), pyleolithotomy (?), nephrolithotomy (?)

Ureterolithotomy (ureter), pyleolithotomy (kidney pelvis), nephrolithotomy (into the kidney)

75

Renal Cell Cancer (Adenocarcinoma) - Stages 1 & 2 are ___ kidney, and 3 &4 are ___ kidney.

Inside ---> outside.

76

What causes the symptoms for renal cell cancer?

Stretching, compressing or invasion of structure in and near kidney.

77

What are some symptoms of renal cancer?

Hematuria, flank pain, palpable flank mass, fever, weakness, anemia, fluid/electrolyte imbalance, HTN

78

How do we treat renal cancer?

Palliative radiation therapy, biologic therapy, cryoblation, radical nephrectomy

79

Should a patient who had surgery for renal cancer limit activity, do dressing changes, avoid lifting and sports, etc?

yes.

80

What is glomerulonephritis?

Inflammation of the glomerular capillaries

81

What happens with acute glomerulonephritis?

Immune complexes develop and become trapped in glomerular tissue - prognosis varies.

82

What happens in chronic glomerulonephritis?

Can occur without previous history, progressive destruction of glomeruli and eventual hardening, 3rd leading cause of ESRD (end stage renal disease)

83

Nephrotic Syndrome - a disease. T/F?

False - it is not a disease.

84

What is nephrotic syndrome?

Comes from glomerular damage - permeable to proteins.

85

What are risk factors for nephrotic syndrome?

Immunologic disorders, toxic injury, multi-system diseases, infection & neoplasms

86

What is the sequence of events for patients with glomerular nephritis (put edema, salt and water retention, glom. membrane damage, hematuria & proteinuria and immune response in order)

1. Immune response
2. Glomerular capillary membrane damage
3. Hematuria and proteinuria
4. Salt and water retention
5. Edema

87

What are some clinical findings for patients with glomerularnephritis?

Fever, peripheral edema, proteinuria, headache, dyspnea

88

What are the events of nephrotic syndrome? (Put proteinuria, generalized edema, renal insult, increased glomerular permeability and decreased serum protein - in order!)

1. renal insult.
2. Increased glomerular permeability.
3. Proteinuria.
4. Decreased serum protein.
5. Generalized edema.

89

What are some signs and symptoms that the nurse should monitor for with nephrotic syndrome?

Malnutrition, hematuria, infection, peritonitis, hyperkalemia, fever

90

Will serum lipid levels be low or high in nephrotic syndrome?

YES