NURSING CARE OF PATIENTS WITH DISORDERS OF THE URINARY SYSTEM Chapter 37.

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Presentation transcript:

NURSING CARE OF PATIENTS WITH DISORDERS OF THE URINARY SYSTEM Chapter 37

Urinary Tract Infections (UTIs) Invasion of Urinary Tract by Bacteria Women Greater Than Men Aging  Older Men Due to Enlarged Prostate  Women Due to Declining Estrogen

UTI Predisposing Factors Stasis of Urine Contamination in Perineal/Urethral Area Instrumentation Reflux of Urine Previous UTIs

UTI Symptoms Dysuria Urgency Frequency Cloudy, Foul-smelling Urine

UTI Urethritis: Inflammation of Urethra Cystitis: Inflammation/Infection of Bladder Wall Pyelonephritis: Infection of the Kidneys

UTI Nursing Data Collection Dysuria, Flank Pain, Fever, Chills, Malaise Urine Examined for Cloudiness, Blood, Foul Odor Predisposing Factors Urinalysis and Culture Results

Nursing Diagnoses Acute Pain Impaired Urinary Elimination Risk for Injury Deficient Knowledge

Nursing Care Monitor Symptoms Monitor Intake and Output Pain Control Teaching  Medications: Take All Antibiotics  Prevention

Urological Obstructions Obstruction of Urine Flow is Always Significant Backup of Urine Destroys Kidney

Urological Obstructions (cont’d) Urethral Strictures  Urethra Lumen Narrowing Due to Scar Tissue Renal Calculi  Hard, Generally Small Stones  Kidney Stones  Nephrolithiasis

Calculi in Urinary Tract

Renal Calculi Pathophysiology  Urinary Salts Settle Out  Calcium Oxalate Most Common

Renal Calculi (cont’d) Etiology  Heredity  Chronic Dehydration  Infection  Immobility  Men Greater than Women

Renal Calculi (cont’d) Signs and Symptoms  Flank Pain  Renal Colic  Dysuria  Costovertebral Tenderness  Hematuria Frequency  Urgency  Enuresis  GI Upset

Renal Calculi (cont’d) Diagnosis  Kidney-Ureter-Bladder X-Ray  Intravenous Pyelogram (IVP)  Renal Ultrasound  Urinalysis

Renal Calculi Therapeutic Interventions Small Stones Passed IV Fluids Pain Control Thiazide Diuretics Allopurinol Lithotripsy

Extracorpeal Shock Wave Lithotripsy

Renal Calculi Surgery Cystoscopy Cystolitholapaxy Cystotomy Ureterolithotomy Nephrolithotomy  Nephrostomy Tube

Renal Calculi (cont’d) Prevention  Foods  Hydration  Exercise

Renal Calculi (cont’d) Complications  UTIs  Hydronephrosis

Renal Calculi (cont’d) Nursing Diagnoses  Acute Pain  Risk for Infection  Deficient Knowledge

Renal Calculi Nursing Care Monitor Symptoms Strain All Urine Intake and Output Pain Control Hydration Teaching

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