Exam (elaborations) NURSING 6202 (NURSING6202/NURSING 6202 - Exam 3 Review Questions.

Nursing 6202 Exam 1 Notes


Renal and Urologic Problems

Urinary Tract Infection (UTI)

 Second most common bacterial disease
o Most common bacterial infection in women
o Commonly E. coli
o Urosepsis: can be fatal (bloodstream infection)
 Upper UTI
o Systemic symptoms
 Lower UTI
o Non-systemic symptoms
 S/Sx:
o Dysuria, frequency, urgency, supra-pubic discomfort/pressure, hematuria, or cloudy
urine
o Older adults will not exhibit the same symptoms as younger adults
 Non-localized abdominal pain or cognitive changes such as confusion
 Diagnostic Studies
o UA and culture with sensitivity
 Treatment
o Hydration, antibiotics, and teaching
o Patient tends to not want to drink since urination causes pain, however it is important
that they continue to hydrate
 Health Promotion
o Recognize risk
 Older adults, debilitated patients, immunocompromised patients, those on
corticosteroids or immunosuppressants
o Preventative measures:
 Regular bowel and bladder emptying
 Adequate hydration
 Perineal wiping from front to back
 Cranberry juice or tablets
 Voiding before and after intercourse
 Good urinary catheter care

Pyelonephritis

 Inflammation of the renal parenchyma (Upper UTI)
o Usually caused by a lower urinary infection that has ascended into the renal parenchyma
 Varied symptoms:
o Fatigue, chills, fever, vomiting, malaise, flank pain, lower UTI symptoms (above)
o Costovertebral angle tenderness
 Acute treatment: antibiotics and fluids

Cystitis

, Nursing 6202 Exam 1 Notes


 Inflammation of the bladder (Lower UTI)
 Risk factors:
o Being female
o Urinary catheterization
 S/Sx:
o Urgency, frequency, and cloudy or foul-smelling urine
 Treatment
o Urine acidifiers (cranberry juice)
o Urinary tract analgesic

Glomerulonephritis

 Inflammation of the glomeruli
 S/Sx:
o Hematuria, proteinuria, uremia, edema, hypertension
 Diagnostics
o UA, blood studies (WBC, BUN, Cr), CT or ultrasound of the abdomen or kidneys
 Treatment
o Manage symptoms (HTN, edema, and UTI)
o Low protein, low Na diet
o Fluid restriction, I&O, daily weights
 Teach
o Decrease dietary protein if ↑ BUN
o Daily weight

Urinary Calculi

 Calculus (Stone)
o Calcium oxalate (most common)
 Lithiasis (stone formation)
o Urolithiasis—urinary stone
o Nephrolithiasis—kidney stone
 Risk:
o Men > women, age 20-55
o White > AA
o Family history
o UTI, dehydration
 S/Sx:
o Obstruction of the urine flow
o Abdominal/flank pain
o Hematuria
o N/V, chills
o “kidney stone dance”—cannot get comfortable
o Severe pain
 Diagnostics