EXAM 2 ADULT HEALTH STUDY GUIDE Renal & Neurological Disorders oRegulates removal of electrolytes and fluid in the body oRight kidney is lower than left b/c of the liver oUpper: ureters, kidneys, renal artery oLower: bladder, urethra Urinary Tract Infection/Cystitis (2 questions)UTI – common bacteria that cause UTI: E. coli, enterococcus, candida albicans, pseudomonas, staphylococcus, klebsiella, Enterobacter, proteus, serratiaRisk Factors: oconditions that block urine flow (tumors or kidney stones) odecreased bladder emptying conditions (spinal cord injury, decreased tone of bladder after menopause)oImmunosuppression (HIV/AIDS, DM, Cancer tx with chemotherapy) oSexually active women oMen with enlarged prostateoCatheterization (most common cause) oIncontinence (Use of depends)S/S: oLower – oDysuriaoUrgencyoFrequencyoRetentionopost void dribblingointermittencyohesitancyoodorous urineopelvic pain Bladder Scans? Cystitis: inflammation of the bladder oNon-bacterial – viral, fungal, mycobacterial, chlamydial oNon-infectious – cystitis caused by exposure to radiation, chemical agents or metabolic disorder UTIS in Older Adults:oMay be asymptomatic oNocturia oIncontinence oConfusion/change in mental status*oLethargy/anorexia oCommon s/s: opainful urinationocloudy urine oburning with urination ohematuria1
EXAM 2 ADULT HEALTH STUDY GUIDE Nursing Interventions: oDocumentationoAsk if they need to void when checking on them oAsk if they need anything What are the 4 P’s?UTI Diagnostic Studies: oUrinalysis oUrine culture oCT o*BUN/CREAT oCBC oUltrasound oBlood cultures oTest for STDs UTI Treatment:oAntibiotics oPain relief o*Teaching oIncrease fluid intake Minimizing Catheter Related Infections oAssess pts daily for appropriateness of FoleyoStrict sterile technique oNo more than 10 ml balloon oCollection bags at low level oPerform daily catheter care oCatheter-out initiative: determineappropriate use of Foley catheters and tohelp prevent catheter related UTIs 2
EXAM 2 ADULT HEALTH STUDY GUIDE oAlternatives?Pyelonephritis (2 questions) Acute Pyelonephritis – inflammation of the renal parenchyma and collecting system oThis is an upper UTI oBacteria from the bladder ascends into the kidneys oComplications: urosepsis – systemic bacterial infection (in the blood) oCauses: oHow is it found?oTx? Clinical manifestations:oFeveroChillsoN/VoLow back or flank pain oHeadache & malaise oCostovertebral tenderness oS/S of lower UTI oPyuria (pus in urine) oBacteremia oHigh WBC count oPatient teaching?Kidney Stones (3 questions) (Nephrolithiasis/urolithiasis) Obstructive uropathies – blockage of ureteral stricture from a foreign body (calculi) Causes: oCalcium Oxalate/Phosphate oWhat kind of foods contain this?