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
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
