urological problems Flashcards
(20 cards)
INFECTIOUS DISORDER: UTI
UTI (______)
_____ urinary tract & _____ are most common sites.
more common in _______ d/t _____ urethra, _______ emptying, & irritation.
_____ in urine is great for microorganism growth
____ is most common bacteria
UTI (uncomplicated)
LOWER urinary tract & BLADDER are most common sites.
more common in WOMEN d/t SHORTER urethra, INCOMPLETE emptying & irritation.
PROTEIN in urine is great for microorganism growth
ECOLI is most common bacteria
LOWER UTI: ETIOLOGY
bacteriuria:
urethritis:
cystitis:
bacteriuria: bacteria in urine NOT causing infection
urethritis: infection in urethra
cystitis: infection in bladder
INFECTIOUS DISORDERS: UTI UNCOMPLICATED
s/s:
dx:
treatment:
s/s: asymptomatic, urgency, frequency, dysuria, hematuria, cloudy/foul urine, fever/chills/fatigue
dx: H&P, urinalysis, urine culture, CBC
treatment: ANTIBIOTICS, increase fluids, avoid irritants (ETOH, caffeine), loose cotton clothes, frequent urination, probiotics
UTI: PROTECTIVE FACTORS
pH = _____
_____ of urea
sex specific factors:
- males:
- females:
urine flow is ______.
- ____ valve at urethral attachment to bladder
____ system
pH = ACIDIC
PRESENCE of urea
sex specific factors:
- males: PROSTATE SECRETIONS
- females: URETHRAL GLAND SECRETIONS
urine flow is UNIDIRECTIONAL
- ONE WAY valve at urethral attachment to bladder
IMMUNE system
UTI: RISK FACTORS
catheterization: _____
sex: ______
- perineal irritation
age: _____
P______
______ activity
urinary _____ or ______
catheterization: CAUTIs
sex: FEMALES higher risk
age: INCREASES
PREGNANCY
SEXUAL activity
urinary OBSTRUCTION or REFLUX
UTI: MORE RISK FACTORS
I______
I_______
____ cognition
_____ issues
males ______
immobility
incontinence (urine or stool)
DECREASED cognition
HYGIENE issues
males more likely to have recurrent UTIs bc bacteria can hide deep in prostate, BPH causing urinary retention
LOWER UTI: CLINICAL MANIFESTATIONS:
urethritis: x2
cystitis: x4
____ possible in both
urethritis:
- dysuria
- asymptomatic - most common
cystitis:
- frequency
- urgency
- suprapubic discomfort
- dysuria
HEMATURIA possible in both
ATYPICAL UTI MANIFESTATIONS: CHILDREN
F_____ & I______
P_____ & V_______
D______
I_______
O_______
FEVER and IRRITABILITY
POOR FEEDING & VOMITING
DIARRHEA
ILL APPEARANCE
OLD ENOUGH to verbalize?
ATYPICAL UTI MANIFESTATIONS: ELDERY
A_____
C_____
L____
A_____
Hx______
ANXIETY
CONFUSION
LETHARGY
ANOREXIA
Hx of FALLS
PHARM FOR LOWER UTIs:
use:
trimethoprim-sulfamethoxazole:
ciprofloxacin
nitrofurantoin
can CURE uti
use: to treat e.coli
trimethoprim-sulfamethoxazole:
- first line
- do not give with sulfa allergies
ciprofloxacin:
- can give with sulfa allergies
nitrofurantoin:
- for recurring lower UTIs
URINARY TRACT ANALGESIC:
med:
therapeutic use:
MOA:
AE:
does NOT cure uti
med: phenazopyridine
therapeutic use: relief of PAIN d/t UTI
MOA: not specifically known; excreted in urine and exerts topical analgesic effect on mucosa of urinary tract
AE: well-tolerated; REDDISH-ORANGE URINE
OVERACTIVE BLADDER
definition:
causes: x6
definition: when muscles contract involuntarily even when urine volume is low, contractions cause urgency to uriante
1. neurological disorders (stroke)
2. DM
3. UTIs
4. hormonal changes (menopause)
5. tumors/stones
6. obstructions
OVERACTIVE BLADDER
____ urge to ____.
- may experience ______.
_____ frequency.
- _____ or more times in 24 hrs
N______
- wake up more than ___ times/night
SUDDEN urge to URAINTE
- may experience URGENCY INCONTINENCE
INCREASED frequency
- 8 or more times in 24 hours
NOCTURIA
- wake up more than 2 times/night
MIRABEGRON
class:
MOA:
Adverse rxns:
class: antispasmotic
MOA: selectively stimulates beta 3 adrenergic receptors, relaxing bladder smooth muscle
Adverse rxns: HTN, urinary retention, UTI, h/a
INCONTINENCE
defintion:
3 types:
definition: involuntary loss of urine, not normal part of aging, but is r/t age-related change in fx & structure of lower urinary tract
3 types: urgency, stress, others
URGENCY INCONTINENCE
involves _____ leakage of urine _____ after ____ sensation to urinate.
causes:
- overactive ____ muscle that suddenly _____. ( ____ with age)
- bladder ____ that irritates bladder lining.
- bladder outlet ______ (enlarged prostate)
- ____ conditions
- D_____
involves INVOLUNTARY leakage of urine IMMEDIATELY after SUDDEN sensation to urinate.
causes:
- overactive DETRUSOR muscle that suddenly CONTRACTS. (INCREASES with age).
- bladder INFECTION that irritates bladder lining.
- bladder outlet OBSTRUCTION (enlarged prostate)
- CNS conditions
- DRUGS (diuretics & ETOH)
STRESS INCONTINENCE
occurs when urine is involuntary ___ & increases in _______.
- precipitated by ____ or _____.
causes:
- loss of ______
- loss of ________ of bladder & urethra
risk factors:
- A____
- O____
- C____
- P_____
occurs when urine in involuntary LOST & increases in INTRAABDOMINAL PRESSURE
- precipitated by EFFORT or EXERTION
causes:
- loss of PELVIC MUSCLE
- loss of FASCIAL SUPPORT of bladder & urethra
risk factors:
- Age
- Obesity
- Childbirth-related trauma
- Pelvin surgery
OTHER TYPES OF INCONTINENCE
mixed: combo of _____ & ______
- common in______
overflow:
- common in ______
functional: r/t ____ & _____ limitations and an _____ to get to toilet ______
transient: _____ onset that is ______.
mixed: combo of URGE & STRESS
- common in WOMEN
overflow: when bladder is too full
- common in MEN WITH BPH
fx: r/t PHYSICAL & ENVIRONMENTAL limitations and an INABILITY to get to toilet ON TIME
transient: SUDDEN onset that is REVERSIBLE
WHY INCONTINENCE IS A PROBLEM
can cause ____ of the skin
- R___, P___, & I____
- S___, B____, D____
damaged skin is vulnerable to_____.
_____, ____ skin is breeding ground for ____ & _____.
areas at risk: x3
can cause INFLAMMATION of the skin
- redness, pain, itching
- swelling, blisters, dryness
damaged skin is vulnerable to INFECTION
DAMP, WARM skin is breeding ground for BACTERIA & FUNGI.
areas at risk: genitals, between buttocks, inner thighs
ANTI-CHOLINERGIC MEDICATIONS
med:
MOA:
indications:
AE:
can be ____ form.
use in combo with _____.
med: oxybutynin
MOA: block action of acetylcholine
indications: overactive bladder, incontinence
AE: dry mouth, constipation
can be EC form
use in combo with PELVIC FLORR MUSCLE STRENGTHENING
