lOMoAR cPSD| 63316909
Concept of Elimination
• Renal Calculi
• Calcium oxalate
• Proteins and blood cells are not filtered by the kidney
• CRYSTAL – Consuming foods high in oxalates, Recurrent UITs, hYpercalcemia, Structural
bondage of stasis urine, Too much uric acid, Absorption problems or acquired through
genetics, Low activity-urine staying stagnant in the kidney Always remember to help
the patient maintain fluids!
• Keep patient as mobile as possible to help move that stone along.
• Stay hydrated
• Too much sodium in the urine prevents calcium from being reabsorbed.
o Risk factors
Male
Decreased urine flow
Metabolic defects (decreased renal excretion of calcium)
Dehydration o Findings
Sever pain (renal colic)-dull, deep, aching pain
• Description of pain depends of the location of the stone
Fever
Sweating
Nausea/vomiting
Hematuria
Tachycardia
Cloudy urine o Laboratory tests
UA
o Diagnostic procedures
XR, CT, MRI
Renal ultrasound or cystoscopy o Nursing Interventions
Strain all urine
Encourage ambulation to help pass the kidney stone
Encourage oral fluid intake of 3L a day o Other Info:
Diet
• Restrict protein
• Limit purines o Red meat, organ meat, beer
• Benign Prostatic Hyperplasia o The prostate gland enlarges and obstructs the flow of
urine.
o Biggest finding is urinary retention
PVR above 200ml
o Medication risks
Tricyclic antidepressants
, lOMoAR cPSD| 63316909
• May cause urinary retention
Diuretics
• This may increase the volume of the urine but the urine may have
a hard time getting all out
Antihistamines
• Decongestants, MOA affects the muscle of the prostate causing
weakened bladder contractions
o
o Risk factors Genetics
African American
Increased consumption of caffein and coffee
Smoking
Increased age
Chronic alcohol use
Sedentary lifestyle
Western diet (high-fat, protein, carbohydrate, low-fiber)
Diabetes and heart disease o Findings
Urinary frequency, urgency, incontinence
Dribbling post void, diminished force of urinary stream o Lab
tests
UA, CBC, BUN, PSA o Diagnostic
Digital rectal exam
Ultrasound Blood tests o Nursing interventions
Frequent ejaculation helps to release prostatic fluid
Avoid bladder stimulants (coffee, alcohol)
Avoid constipation
Continuous bladder irrigation
• This applies pressure and irrigation to stop bleeding
limit fluid intake before bed
Avoid drinking large amounts of fluid at one time
• Medications o Muscarinic antagonist - BPH
M3 receptor selective: oxybutynin
Inhibit muscarinic receptors of the detrusor muscle of the
bladder, which prevents contractions of the bladder and
the urge to void
Used for overactive bladder
Complications
• Anticholinergic effects: constipation, dry mouth, blurred vision,
photophobia, tachycardia o Client education: Increase dietary
fiber, consume 2 to 3 L/day fluid from beverage and food sources,
Concept of Elimination
• Renal Calculi
• Calcium oxalate
• Proteins and blood cells are not filtered by the kidney
• CRYSTAL – Consuming foods high in oxalates, Recurrent UITs, hYpercalcemia, Structural
bondage of stasis urine, Too much uric acid, Absorption problems or acquired through
genetics, Low activity-urine staying stagnant in the kidney Always remember to help
the patient maintain fluids!
• Keep patient as mobile as possible to help move that stone along.
• Stay hydrated
• Too much sodium in the urine prevents calcium from being reabsorbed.
o Risk factors
Male
Decreased urine flow
Metabolic defects (decreased renal excretion of calcium)
Dehydration o Findings
Sever pain (renal colic)-dull, deep, aching pain
• Description of pain depends of the location of the stone
Fever
Sweating
Nausea/vomiting
Hematuria
Tachycardia
Cloudy urine o Laboratory tests
UA
o Diagnostic procedures
XR, CT, MRI
Renal ultrasound or cystoscopy o Nursing Interventions
Strain all urine
Encourage ambulation to help pass the kidney stone
Encourage oral fluid intake of 3L a day o Other Info:
Diet
• Restrict protein
• Limit purines o Red meat, organ meat, beer
• Benign Prostatic Hyperplasia o The prostate gland enlarges and obstructs the flow of
urine.
o Biggest finding is urinary retention
PVR above 200ml
o Medication risks
Tricyclic antidepressants
, lOMoAR cPSD| 63316909
• May cause urinary retention
Diuretics
• This may increase the volume of the urine but the urine may have
a hard time getting all out
Antihistamines
• Decongestants, MOA affects the muscle of the prostate causing
weakened bladder contractions
o
o Risk factors Genetics
African American
Increased consumption of caffein and coffee
Smoking
Increased age
Chronic alcohol use
Sedentary lifestyle
Western diet (high-fat, protein, carbohydrate, low-fiber)
Diabetes and heart disease o Findings
Urinary frequency, urgency, incontinence
Dribbling post void, diminished force of urinary stream o Lab
tests
UA, CBC, BUN, PSA o Diagnostic
Digital rectal exam
Ultrasound Blood tests o Nursing interventions
Frequent ejaculation helps to release prostatic fluid
Avoid bladder stimulants (coffee, alcohol)
Avoid constipation
Continuous bladder irrigation
• This applies pressure and irrigation to stop bleeding
limit fluid intake before bed
Avoid drinking large amounts of fluid at one time
• Medications o Muscarinic antagonist - BPH
M3 receptor selective: oxybutynin
Inhibit muscarinic receptors of the detrusor muscle of the
bladder, which prevents contractions of the bladder and
the urge to void
Used for overactive bladder
Complications
• Anticholinergic effects: constipation, dry mouth, blurred vision,
photophobia, tachycardia o Client education: Increase dietary
fiber, consume 2 to 3 L/day fluid from beverage and food sources,
