Urinary system Flashcards

(34 cards)

1
Q

at what volume will the sensation to void present?

A

In adults 150 ml

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2
Q

What are the ureters for?

A

To allows urine to pass down from kidney to bladder

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3
Q

What is considered urinary retention?

A

Great than 300ml < x2 episodes

Greater than 100ml< after voiding

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4
Q

What is normal urinary retention?

A

30-50ml usually remains in bladder and is considered normal

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5
Q

What type of muscle is in both ureters and internal urethral sphincter?

A

Smooth muscle

Involuntary

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6
Q

What muscle is in the external urethral sphincter and why?

A

Skeletal muscle
The external sphincter has to be relaxed in order for urine to pass through and be excreted, normally it is contracted
Skeletal muscle is voluntary control

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7
Q

What is a UTI? What are the different sub groups

A

An infection involving any part of the urinary system
Lower urinary tract infection
Upper urinary tract infection
Complicated vs uncomplicated UTI

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8
Q

Which infections are of the lower urinary tract?

A

Cystitis- inflammation of the urinary bladder
Bacterial prostatitis- Inflammation of the prostate gland
Bacterial urethritis- Inflammation of the Urethra

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9
Q

Which conditions are associated with upper urinary tract infections?

A

Acute pyelonephritis- inflammation of renal pelvis
Chronic Pyelonephritis- inflammation of renal pelvis
Renal abscess
Perineal abscess
Interstitial nephritis- Inflammation of the kidney

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10
Q

If a UTI is acquired in the hospital what is it dx as?

Most common cause?

A
Complicated UTI
Catheterization
Also- occur in Pts with urological abnormalities
pregnancy
Immunocompromised
Obstructions

Frequent recurrence!

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11
Q

Define uncomplicated UTI

A

Community acquired, common among young women, not usually recurrent

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12
Q

s/s of UTI

A
Increased frequency of urination with urgency
Delay, hesitancy
Dysuria- pain w/ urination
Nocturia
Hematuria
Cloudy foul smelling urine
Incontinence
Bladder spasms/bladder pressure
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13
Q

s/s of pyelonephritis

A
Fever, chills
N/V
Flank pain
CVA tenderness over affected kidney
Dysuria
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14
Q

What are some considerations regarding UTI and geriatric

A
Patients on many medications, tx of chronic medical conditions
Frequent use of antimicrobial agents
May be immunocompromised
Cognitive impairment
Immobility
Incomplete emptying of bladder
Use of bedpan rather than commode
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15
Q

Atypical presentation of UTI with older clients

A
Anorexia
fatigue
change in cognitive function
New incontinence 
Hyperventilation
Low grade fever
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16
Q

What test is preformed for UTI

A

Urinalysis

Urine Culture and sensitivity (urine C&S)

17
Q

Describe the steps of a urinalysis

A

Collect 10ml of urine in sterile cup using clean void or Cath
Deliver to laboratory immediately or must be refrigerated/ put on ice

18
Q

What will be present if UTI

A
Leukoesterase
Nitrates
WBC
Cloudy/foul smelling
Bacteria over 100,000
19
Q

What is the difference between urinalysis and Urine culture and sensitivity

A

Urinalysis shows that abnormal material is in urine

If urinalysis is c/w infection such as WBC, nitrates, leukoesterase, bacteria greater than 100,000

20
Q

How long do urine culture results take?

21
Q

Which medication is primarily given with community acquired UTI

A

Trimethoprim/sulfamethoxazole BACTRIM DS 3-7 days

Monitor for adverse rxn- rash common s/e

22
Q

Which medication can be used in low doses prophylactivley?

A

Bactrim DS

Used for clients that have chronic reoccurring UTI

23
Q

What other medications are given for UTI

A

Cephalexin- Keflex- NO with PCN allergy
Ciprofloxacin- cipro
Ceftriaxone

24
Q

Which medication is given if UTI is Fungal?

A

Fluconazole (diflucan)
for IV/oral use only
Many medication interactions
no PO w/ pregnancy/ breast feeding

25
If patient is still presenting with fever 24-48 hours after starting medication what is the concern?
If client still has fever after this time frame considering abx not working
26
A patient with UTI no longer has fever but complains of pain and dysuria, what medications can be given?
Phenazopyridine (Pyridium) - Analgesic effects - May turn urine red-orange ``` Hyoscyamine (anaspaz) -antispasmoic effects on detrusor -c/o constipation urinary retention (remember contraction of detrusor is needed to urinate) Drowsiness Dry mouth ```
27
What are some key points for patient teaching regarding care for UTI
Meds need to be finished! Try to void Q2-3 hours Drink 2-3 L of fluid daily
28
Teaching for prevention of UTI
Avoid bubble baths, nylon underwear, scented toilet tissues Wear loose fitting cotton underwear Void before and after sex Avoid douching Avoid vigorous cleaning or perineum with harsh soaps
29
How do you assess for kidney tenderness?
CVA test- make a fist and tap on CVA area, + if tender, swelling, bruising or redness occurs w/ kidney infection Located- b/l sides below portion of 12th rib and spinal column
30
Where would you auscultate and what would you hear?
Bruits b/l midclavicular side | Can palpate for thrill
31
What does a bruit indicate?
Usually renal artery stenosis
32
What can cause a UTI?
Bacterial- feces Fungal- candida Parasite (trichomonas) Viruses- rare
33
Risk factors for UTI
Female sex Renal calculi DM Sexual activity
34
What are the different types of incontinence
``` Stress incontinence Urge incontinence Overflow/ reflex incontinence Functional incontinence Iatrogenic incontinence ```