Urinary System Disorders-3 PDF

Alterations in Urinary Elimination: ----------------------------------- **Structures and Functions of Urinary System:** - - - - - - - - - - - **[Microstructure:]** The functional unit of a kidney is the **nephron.** It contains the: - - - - - - -...

Alterations in Urinary Elimination: ----------------------------------- **Structures and Functions of Urinary System:** - - - - - - - - - - - **[Microstructure:]** The functional unit of a kidney is the **nephron.** It contains the: - - - - - - - - - - - - **Gerontologic Considerations: Effects of Aging on Urinary System** - - - - - - - - - - **[Assessment of Urinary System]** Subjective Data: - - Medications: - - Health Perception--Health Management Pattern: - - Procedures: - - **[Diagnostic Studies:]** [ ] Urinalysis: +-----------------------+-----------------------+-----------------------+ | **Diagnostic Test:** | **Description:** | **Therapeutic | | | | range/test | | | | findings:** | +=======================+=======================+=======================+ | **BUN/creatinine:** | Detect renal | BUN:10-20 | | | problems; regulated | | | | by the **rate at | Cr:.01-.09 | | | which urea is | | | | excreted** | | +-----------------------+-----------------------+-----------------------+ | **Creatinine | Waste product of | Male: 107--139 mL/min | | Clearance:** | protein breakdown; | | | | Approximates the | Female: 87--107 | | | filtration rate of | mL/min | | | glomerulus | | +-----------------------+-----------------------+-----------------------+ | **Culture/Sensitivity | Test to see if | Should be | | :** | bacteria is present | unremarkable | | | in the urine | | +-----------------------+-----------------------+-----------------------+ | **Urine Cytology:** | Takes biopsies of the | Should be | | | bladder is there is a | unremarkable | | | suspicion of bladder | | | | cancer | | +-----------------------+-----------------------+-----------------------+ | **KUB X Ray:** | Looks at kidneys, | Should be | | | ureters, and the | unremarkable | | | bladder | | +-----------------------+-----------------------+-----------------------+ | **IVP(intravenous | Evaluates size of the | Should be | | pyelogram):** | kidneys bladder and | unremarkable | | | ureters after iodine | | | | injection. Can be | | | | nephrotoxic to pt; | | | | hydration is | | | | important!! | | +-----------------------+-----------------------+-----------------------+ | **Ultrasound/CT:** | | Should be | | | | unremarkable | +-----------------------+-----------------------+-----------------------+ | **Urinalysis:** | General examination | Color of urine should | | | of urine to examine | be yellow, no traces | | | baseline info | of proteins, glucose, | | | | ketones, bilirubin, | | | | RBCs, WBCs, or casts | | | | | | | | \*any indication or | | | | trace of these shows | | | | kidney filtration is | | | | compromised or | | | | infection is | | | | present(WBCs) | +-----------------------+-----------------------+-----------------------+ **Urinary Tract Infection** *Description* - - - - **[Classification of Urinary Tract Infection:]** - - - - - - - - - - - - - - - - - - - - - - **[Clinical Manifestations:]** +-----------------------------------+-----------------------------------+ | **Lower:** | **Upper:** | +===================================+===================================+ | - | - - - - - - - - - | | | | | | | | | \*\***older adults don't show | | - - - - - - - | typical signs! They\'ll have some | | | generalized abdominal pain along | | | with confusion!** | | | | | - - - | | +-----------------------------------+-----------------------------------+ **[Diagnostic Studies:]** - - - - - **[Management:]** - - - - Prevention of CAUTI - - - **Patient & Caregiver Teaching: Urinary Tract Infection** When teaching a patient and caregiver measures to prevent a recurrence of a urinary tract infection (UTI), include: 1\. Take all antibiotics as prescribed. Symptoms may improve after 1--2 days of therapy, but organisms may still be present. 2\. Practice appropriate hygiene, including: Carefully clean the perineal region by separating the labia in females, or in males pulling back the foreskin if present when cleansing. Wipe from front to back after urinating. Cleanse with warm soapy water after each bowel movement. 3\. Empty the bladder before and after sexual intercourse. 4\. Void regularly, about every 3--4 hours during the day. 5\. Maintain adequate fluid intake. 6\. Avoid vaginal douches and harsh soaps, bubble baths, powders, and sprays in the perineal area. 7\. Report to the HCP symptoms or signs of recurrent UTI (e.g., fever, cloudy urine, pain on urination, urgency, frequency). **[Acute Pyelonephritis]** - - - - - - - - - - - - - **[Severe Symptoms:]** Hospitalization **Adequate fluid intake (parenteral initially; switch to oral fluids as nausea, vomiting, and dehydration subside)** NSAIDs or antipyretic drugs to reverse fever and relieve discomfort Follow-up urine culture and imaging studies **[Drug Therapy:]** **broad-spectrum antibiotics:** ampicillin, fluoroquinolones (ciprofloxacin, levofloxacin) **Chronic Pyelonephritis** - **[Glomerulonephritis:]** - - - - - - - **[Acute Poststreptococcal Glomerulonephritis:]** - - - - - - **[Management:]** - - - - **[Chronic Glomerulonephritis: ]** - - - - - - - - - - - - - - - - - - - - - - - **[Obstructive Disorders:]** - - - - - - - - - - - - - - - - - - - - - - - **[Nephrolithiasis:]** - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - **[Benign Prostatic Hyperplasia:]** - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - **Kidney Cancer** - - - - **Manifestations and Diagnostics** - - - - **Treatment:** - - - - **[Bladder Cancer]** - - - - - **[Manifestations:]** - - - - **[Diagnostics:]** - - **[Management:]** - - - - **Intravesicular:** - - **Urinary Diversion** - - - image **Nursing Management: Urinary Diversion** - - - - - - - - -