EXAM 2 BLUE PRINT .docx - EXAM 2 ADULT HEALTH STUDY GUIDE Renal Neurological Disorders o Regulates removal of electrolytes and fluid in the body o Right

EXAM 2 BLUE PRINT .docx - EXAM 2 ADULT HEALTH STUDY GUIDE...

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EXAM 2 ADULT HEALTH STUDY GUIDE Renal & Neurological Disorders o Regulates removal of electrolytes and fluid in the body o Right kidney is lower than left b/c of the liver o Upper: ureters, kidneys, renal artery o Lower: bladder, urethra Urinary Tract Infection/Cystitis (2 questions) UTI – common bacteria that cause UTI: E. coli, enterococcus, candida albicans, pseudomonas, staphylococcus, klebsiella, Enterobacter, proteus, serratia Risk Factors: o conditions that block urine flow (tumors or 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 Men with enlarged prostate o Catheterization (most common cause) o Incontinence (Use of depends) S/S: o Lower – o Dysuria o Urgency o Frequency o Retention o post void dribbling o intermittency o hesitancy o odorous urine o pelvic pain Bladder Scans? Cystitis: inflammation of the bladder o Non-bacterial – viral, fungal, mycobacterial, chlamydial o Non-infectious – cystitis caused by exposure to radiation, chemical agents or metabolic disorder UTIS in Older Adults: o May be asymptomatic o Nocturia o Incontinence o Confusion/change in mental status* o Lethargy/anorexia o Common s/s: o painful urination o cloudy urine o burning with urination o hematuria 1
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EXAM 2 ADULT HEALTH STUDY GUIDE Nursing Interventions: o Documentation o Ask if they need to void when checking on them o Ask if they need anything What are the 4 P’s? UTI Diagnostic Studies: o Urinalysis o Urine culture o CT o *BUN/CREAT o CBC o Ultrasound o Blood cultures o Test for STDs UTI Treatment: o Antibiotics o Pain relief o *Teaching o Increase fluid intake Minimizing Catheter Related Infections o Assess pts daily for appropriateness of Foley o Strict sterile technique o No more than 10 ml balloon o Collection bags at low level o Perform daily catheter care o Catheter-out initiative: determine appropriate use of Foley catheters and to help prevent catheter related UTIs 2
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EXAM 2 ADULT HEALTH STUDY GUIDE o Alternatives? Pyelonephritis (2 questions) Acute Pyelonephritis – inflammation of the renal parenchyma and collecting system o This is an upper UTI o Bacteria from the bladder ascends into the kidneys o Complications: urosepsis – systemic bacterial infection (in the blood) o Causes: o How is it found? o Tx? Clinical manifestations: o Fever o Chills o N/V o Low back or flank pain o Headache & malaise o Costovertebral tenderness o S/S of lower UTI o Pyuria (pus in urine) o Bacteremia o High WBC count o Patient teaching? Kidney Stones (3 questions) (Nephrolithiasis/urolithiasis) Obstructive uropathies – blockage of ureteral stricture from a foreign body (calculi) Causes: o Calcium Oxalate/Phosphate o What kind of foods contain this?
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