kidneys (extra slides) quiz 1 Flashcards

Question

diagnostics for UTIs

Answer 1

* History and physical examination * Imaging studies of urinary tract (e.g., IVP, cystoscopy) (if indicated) * Urinalysis * Urine for culture and sensitivity (if indicated)

Answer 2

uncomplicated UTI * Adequate fluid intake * Antibiotic: 1- to 3-day treatment regimen * Nitrofurantoin (MacroBid) * Trimethoprim–sulphamethoxazole (Septra) * Counselling about risk for recurrence and reduction of risk factors Recurrent, Uncomplicated UTI * Repeated urinalysis and consideration of need for urine culture and sensitivity testing * Antibiotic: 3- to 5-day treatment regimen * Nitrofurantoin (MacroBid) * Sensitivity-guided antibiotic (ampicillin, amoxicillin, first-generation cephalosporin, fluoroquinolone) * Trimethoprim–sulphamethoxazole (Septra) * Consideration of 3- to 6-mo trial of suppressive antibiotics * Adequate fluid intake * Counselling about risk for recurrence and reduction of risk factors * Imaging study of urinary tract in select cases

Answer 3

Subjective Data Important Health Information Past health history: Previous UTIs; urinary calculi, stasis, reflux, strictures, or retention; neurogenic bladder; pregnancy; prostatic hyperplasia; sexually transmied infection; bladder cancer Medications: Use of antibiotics, anticholinergics, antispasmodics Surgery or other treatments: Recent urological instrumentation (catheterization, cystoscopy, surgery) Symptoms * Lassitude, malaise * Nausea, vomiting, and anorexia; chills * Suprapubic or low back pain, pressure in bladder area, costovertebral tenderness; bladder spasms, dysuria, burning on urination, sense of incomplete emptying * Urinary frequency, urgency, hesitancy; nocturia Objective Data General Fever Urinary Hematuria; cloudy, foul-smelling urine; tender, enlarged kidney Possible Findings Leukocytosis; urinalysis positive for bacteria, pyuria, RBCs, and WBCs; positive urine culture; IVP, CT scan, ultrasound, voiding cysto-urethrogram and cystoscopy demonstrating abnormalities of urinary tract

Answer 4

* Impaired urinary elimination related to multiple causality (effects of UTI) * Readiness for enhanced health management as evidenced by expressed desire to enhance management of risk factors

Answer 5

1. The patient must take all antibiotics as prescribed. Symptoms may improve after 1 to 2 days of therapy, but organisms may still be present. 2. The patient must be instructed about appropriate hygiene, including the following: a. Careful cleansing of perineal region b. Wiping from front to back after urinating c. Cleansing with soap and water after each bowel movement 3. The patient should be taught about the importance of emptying the bladder before and after intercourse, which may help flush out bacteria introduced during intercourse. The patient should wash the genital area with warm water before having sex. 4. The patient should be advised to urinate regularly, approximately q2–4 hr during the day. 5. The patient should be advised about how to maintain adequate fluid intake (33 mL [1 oz] per kilogram of body weight per day). 6. The patient should understand why harsh soaps, bubble baths, powders, and sprays should not be applied in the perineal area. 7. The patient should be advised to report symptoms or signs of recurrent UTI (e.g., cloudy urine, pain on urination, urgency, frequency).

Answer 6

calculi formation in the urinary tract

Answer 7

Metabolic * Abnormalities that result in increased urine levels of calcium, oxaluric acid, uric acid, or citric acid Climate * Warm climates that cause increased fluid loss, low urine volume, and increased solute concentration in urine Diet * Excessive amounts of tea or fruit juices that elevate urinary oxalate level * Large intake of calcium* and oxalate * Large intake of dietary proteins that increase uric acid excretion * Low fluid intake that increases urinary concentration Genetic * Family history of stone formation, cystinuria, gout, or renal acidosis Lifestyle * Sedentary occupation, immobility

Answer 8

urinalysis, urine culture, IVP, retrograde pyelogram, ultrasound, and cystoscopy. A plain film of the abdomen and renal ultrasound will identify larger, radiopaque stones. An IVP or retrograde pyelogram is used to localize the degree and the site of obstruction or to confirm the presence of a radiolucent stone, such as a uric acid or cystine calculus Ultrasonography can be used to identify a radiopaque or radiolucent calculus in the renal pelvis, the calyx, or the proximal ureter.

Answer 9

treating the symptoms of pain, infection, or obstruction as indicated for the individual patient. Opioids are typically required at frequent intervals for relief of renal colic pain. Many stones pass spontaneousl

Answer 10

is an uncontrolled loss of urine that is of sufficient magnitude to be a problem