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Urologic Disorders

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Urologic Disorders NPN 200 Medical Surgical Nursing I Function of the Urinary System Maintain homeostasis Remove metabolic wastes Kidneys regulate the volume, acid ... – PowerPoint PPT presentation

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Title: Urologic Disorders


1
Urologic Disorders
  • NPN 200
  • Medical Surgical Nursing I

2
Function of the Urinary System
  • Maintain homeostasis
  • Remove metabolic wastes
  • Kidneys regulate the volume, acid base balance,
    and electrolyte balance
  • Responsible for detoxification of the blood
  • Aides in erythropoiesis
  • Helps to regulate B/P
  • Regulates serum potassium, calcium, and phosphate

3
Anatomy and Physiology of Urinary System
  • Components of system
  • Kidneys
  • Ureters
  • Bladder
  • Urethra

4
Anatomy
5
Data Collection
  • Subjective symptoms
  • Problems with elimination
  • Changes in voiding habits
  • Discharge from the urethra
  • Pain in the supra-pubic area or back
  • Burning sensation on voiding

6
Data Collection
  • Objective systems
  • Bladder distention (rigid, tender abdomen)
  • Urine color, odor, cloudiness, presence of mucus,
    sediment, blood, casts, bacteria
  • Genital irritation
  • Amount of urine output
  • Electrolyte studies
  • Edema of extremities
  • Vital signs

7
Data Collection
  • History
  • Previously normal urinary habits
  • Health problems with urinary system
  • Presence and location of edema
  • Medications
  • Food or medicine allergies
  • Spasms or pain or both in the bladder region or
    flank area
  • Presence of discharge

8
Physical Examination
  • Color of skin and crystals on skin
  • Skin turgor
  • Look for edema of eyes, sacrum and extremities
  • Observe respirations for signs of acidosis, fluid
    overload,
  • Check heart rate and rhythm
  • Palpate abdomen for distention and flank for pain
  • Examine genitals

9
Diagnostic Exams
  • Blood and Urine
  • Urinalysis, and culture and sensitivity, glucose,
    protein, ketones
  • Creatinine clearance
  • BUN
  • Serum creatinine
  • Serum electrolytes
  • X- rays
  • Flat plate of ABD/ KUB
  • IVP
  • Renal scan
  • Renal Angiogram
  • MRI
  • CT

10
Diagnostic Exams
  • Renal biopsy
  • Cyctoscopy and retrograde pyleograms
  • Cystogram uses dye into bladder
  • Cystometrogram evaluates bladder tone
  • Bladder scanners (estimates bladder volume

11
Urinary Tract Infections
  • More common in women
  • Most prevalent nosocomial infection
  • Are ascending or descending
  • Are described by their location in the tract
  • Lower
  • Urethritis
  • Cystitis
  • Prostatitis
  • Upper
  • Pyelonephritis
  • Site and type of bacteria determines treatment

12
Factors Contributing to UTIs
  • Invasive procedures catheters
  • Obstruction bacteria can grow in pool of urine
  • Stones obstructs and irritates mucosa
  • Vesicoureteral reflux urine goes up into
    kidneys
  • Diabetes- glucose is food for bacteria
  • Gender closes to bacteria
  • Age not emptying, neuromuscular, medications
  • Sexual activity irritation, increased bacteria
    in area

13
Urethritis
  • Inflammation of the urethra
  • In men
  • Usually burning, or difficulty with urination
  • Most common cause is an STD
  • In women
  • Burning, pain and difficulty voiding
  • Irritation from vaginal deodorants and bubble bath
  • Treatment
  • Treat STD
  • Treat with antibiotics if bacteria present
  • Sitz baths
  • Wipe front to back
  • Void before and after sex
  • Decrease bubble baths
  • And vaginal deodorants

14
Cystitis
  • Inflammation of the bladder
  • More common in women
  • S/S burning, frequency, urgency, hematuria,
    incontinence, pain, fever, cloudy urine
  • Diagnosis urinalysis and a CS
  • Treatment antibiotics, analgesics, Pyridium,
    Urispas
  • Interventions
  • Sitz baths
  • Analgesics
  • fluid
  • Teach
  • avoid tight clothing
  • showers over tub
  • no caffeine
  • wipe front to back
  • cranberry juice

15
Interstitial Cystitis
  • Chronic inflammation of the bladder
  • Cause unknown
  • More females
  • Severe pelvic pain with urinary frequency and
    urgency
  • Bladder becomes stiff and scarred, with ulcers
    and bleeding
  • Treatment is mostly out patient
  • Pain management
  • Antidepressants
  • NSAIDS
  • Antispasmodics

16
Pyelonephritis
  • Acute or chronic (chronic usually caused by long
    term UTIs)
  • One or both kidneys
  • May be ascending or blood borne
  • May lead to renal failure

17
Pyelonephritis, cont.
  • S/S
  • High fever, N/V, dysuria, severe back and flank
    pain, fatigue
  • Treatment
  • Antibiotics may be long term
  • Antispasmodics
  • Analgesics

18
Pyelonephritis, cont.
  • Nursing Care
  • Give pain RX
  • Assist with
  • ADLs
  • Ensure adequate diet
  • Provide IV fluids and oral fluids up to 2-3
    liters/day

19
Drugs Used for Urinary Tract Disorders
  • Diuretics
  • Antihypertensives
  • Phosphate binders
  • Vitamins and mineral supplements
  • Antibiotics
  • Urinary antiseptics
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