Urinary tract infections (UTI), Pyelonephritis, Kidney stones, CKD, Kidney cancer Flashcards
(42 cards)
Describe the locational difference between a lower and upper UTI?
Lower UTIs are commonly involved in the bladder and/or urethra.
While Upper UTIs involve the kidneys and/or ureters.
Describe the clinical presentation for a UTI?
- Altered mental state
- Nausea, vomiting
- SOB
What is a UTI’s relationship to falls?
- Pt has decreased strength
2. Increased frequency and/or urgency
What is the most common predisposing factor for UTIs?
Urinary catherization
Describe the pathogenesis of an UTI.
Usually gram-negative bacteria (E. coli) ascending into the urinary tract from the urethra.
HOWEVER, it can come from blood but this is less commonly seen.
Describe the clinical presentation of a UTI?
- Change in voiding habits
a. Increased freq, urgency, dysuria, nocturia, dyspareunia - Cloudy, bad-smelling urine, or hematuria (in serious cases)
- Pain: suprapubic, lower abdomen, groin, flank or back pain; possibility of shoulder pain
Describe the clinical presentation between a lower and upper UTI?
Lower UTI: Generally sudden onset of symptoms and will have the hallmark symptom of dysuria
Upper UTI: (silent UTI) Typically gradual onset and systemic symptoms such as fever, chills, and/or malaise.
When and how visceral dysfunction can present as shoulder pain?
Through referred pain - convergence.
Infectious agents and/or inflammatory mediators can diffuse locally and activate afferent (sensory) endings in the diaphragm. Usually from the 2nd order neuron in the dorsal horn.
Treatment options for UTI.
- Increased hydration
2. ABX
What is Pyelonephritis?
An infectious, inflammatory disease presumed to be caused by bacterial invasion of renal parenchyma
What is the most common cause of pyelonephritis?
One of the most common causes of pyelonephritis is backwards flow of infected urine from the bladder to the upper urinary tract. Usually called “ASCENDING UTIs”
Chronic pyelonephritis results from?
Results when kidneys become increasingly damaged due to repeated urinary infections
Describe both acute and chronic pyelonephritis.
Acute:
- abrupt onset of fever, chills, flank pain, and pain over the costovertebral angle
- Urinary frequency, dysuria, urgency, suprapubic discomfort
Chronic:
1. Weakness, loss of appetite, HTN, anemia, protein and blood in urine
Clinical diagnosis for stones that develop in the kidneys
Nephrolithiasis
Clinical diagnosis for stones occurring in urinary tract
Urolithiasis
Describe pathogenesis for renal calculi
Infection or generally due to increased blood concentration and urinary excretion of the primary component of the stone
Where along the urinary tract can kidney stones cause symptoms?
- Uretopelvic junction
- Crossing of iliac artery (midureter)
- Uretovesical junction
Why is it important to know what makes up your kidney stone?
For prevention purposes to help facilitate good prevention
What is the clinical presentation of kidney stones?
Hallmark complaint: abrupt pain associated with urinary tract obstruction = Renal colic
- Pain occurs once stone leaves kidney
- Generally is abrupt onset of excruciating pain in flank and upper abdominal quadrant, usually radiates to groin
- Urinary urgency and frequency
- Microscopic to gross hematuria
- Nausea/vomiting
- May be asymptomatic
Treatment options for liathasis
- Time (plus pain meds and hydration)
- Extracorporeal shock wave lithotripsy
- Ureteroscopy
Prevention for renal calculi
- Hydration
2. Dietary change, if appropriate for type of stone
Define glomerulonephritis
Group of diseases that damages glomerular portions of the kidney.
Accounts for ~50% of pts requiring dialysis
Glomerulonephritis can result from:
- Immunologic problems
- Drug/ toxin effects
- Vascular diseases
- Systemic disorders
What are the risk factors for glomerulonephritis?
- Diabetes mellitus
- System lupus erythrematosus
- HTN
