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

2. 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

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

4. UTI Symptoms Dysuria Urgency Frequency Cloudy, Foul-smelling Urine

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

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

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

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

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

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

11. Calculi in Urinary Tract

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

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

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

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

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

17. Extracorpeal Shock Wave Lithotripsy

18. Renal Calculi Surgery Cystoscopy Cystolitholapaxy Cystotomy Ureterolithotomy Nephrolithotomy  Nephrostomy Tube

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

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

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

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