Adult Health Study Guide 2 Renal and Urological Disorders Infectious and Inflammatory Diseases- pg. 1574-1575 chart 55-1 - UTI Classification o Upper o Lower o Complicated o Uncomplicated o Acute o Chronic - LUTI o Bacterial cystitis o Bacterial prostatitis o Bacterial urethritis - UUTI o Pyelonephritis o Interstitial nephritis o Renal Abscesses UTI - Common bacteria o Common bacteria o E. coli o Enterococcus o Candida albicans o Pseudomonas o Staphylococcus o Klebsiella o Enterobacter o Proteus o Serratia - Risk factors o Conditions that block urine flow Tumors, kidney stones o Decreased bladder emptying conditions Spinal cord injury, decreased tone of bladder after menopause o Immunosuppression HIV/AIDS DM Cancer tx with chemotherapy o Sexually active women o Women who use diaphragm for birth control o Men with enlarged prostate o Catheterization o Incontinence—Use of “Depends” - Non-bacterial, Non-infectious Cystitis o Non-Bacterial
Cystitis from non-bacterial causes Viral, fungal, mycobacterial, Chlamydial o Non-infectious Cystitis caused by exposure to radiation, chemical agents or metabolic disorder - Signs and Symptoms o Lower Dysuria Urgency Frequency Retention Post void dribbling Intermittency Hesitancy Odorous urine Pelvic pain o UTIs in older adults May be asymptomatic Nocturia Incontinence Confusion/Change in mental status Lethargy Anorexia - Diagnostic Studies o Urinalysis (UA) Nitrites—bacteriuria WBC Leukocyte esterase urine culture of > 10 5 colonies per milliliter (in women) o Urine culture Helps guide treatment o CT Most effective if blockage is causing UTI o BUN/Creatine o CBC Leukocytosis with left shift o Ultrasound Less expensive than CT, most useful for blockages o Blood cultures o Test for STDs Gonorrhea/Chlamydia - Treatment o Antibiotics Trimethroprim-sulfamethoxazole (Bactrim) Nitrofurantoin (Macrodantin) Ciprofloxin/Levafloxin Ampicillin/gentamicin
o Pain relief Phenazopyridine (Pyridium OTC) o Teaching Prevention o Increase fluid intake Minimizing Catheter Related Infections - Assess patients daily for appropriateness of foley catheter - Consider alternatives - Use aseptic technique when handling catheters - Select small size catheter (14-18 fr) - Strict sterile technique when inserting - No more than 10 ml in balloon - Maintain a closed system - Avoid routine catheter irrigation - Keep collection bags below level of the bladder - Secure the catheter to the patient’s thigh (women) or lower abdomen (men) - Perform daily catheter care - Consider use of hydrophilic or silver coated catheters Catheter-out initiative - Initiative to determine appropriate use of foley catheters and to help prevent catheter related UTIs Catheter Use - Acceptable Indications o Acute urinary retention or obstruction o Perioperative use in selected surgeries o Assist healing of perineal and sacral wounds in incontinent patients o Hospice/comfort/palliative care o
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- Spring '16
- Kim McCarron
- Diabetes, Blood sugar, Glucose tolerance test, Cystitis