1 / 87

Chapter 3 7

Chapter 3 7. Nursing Care of Patients w ith Disorders of the Urinary System. 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.

Download Presentation

Chapter 3 7

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Chapter 37 Nursing Care of Patients with Disorders of the Urinary System

  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

  23. Hydronephrosis • Obstruction in Urinary Tract • Kidney Enlarges as Urine Collects • Treat Cause

  24. Hydronephrosis (cont’d)

  25. Hydronephrosis (cont’d) • Signs and Symptoms • Frequency • Urgency • Dysuria • Flank and Back Pain • Kidney Disease

  26. Hydronephrosis Therapeutic Interventions • Treat Cause • Urinary Catheter • Stents • Nephrostomy Tube • Intake and Output • No Clamping

  27. Cancer of the Bladder • Most Common Urinary Tract Cancer • Men Greater than Women • Ages 50 to 70 Years • Etiology • Smoking • Industrial Pollution

  28. Cancer of the Bladder (cont’d) • Signs and Symptoms • Early • Painless • Hematuria

  29. Cancer of the Bladder (cont’d) • Signs and Symptoms (cont’d) • Late • Pelvic Pain • Lower Back Pain • Dysuria • Inability to Void

  30. Cancer of the Bladder (cont’d) • Diagnosis • Urinalysis • Telomerase • Urine for Cytology, Culture • Cystoscopy and Transurethral Biopsy • IVP

  31. Cancer of the Bladder (cont’d) • Therapeutic Interventions • Chemotherapy • Bacille Calmette-Guérin Vaccine • Photodynamic Therapy

  32. Cancer of the Bladder (cont’d) • Therapeutic Interventions (cont’d) • Surgery • Cystoscopy and Pyelogram with Fulguration • Laser • Robotic Laparoscopic Radical Cystectomy • Urinary Diversion

  33. Cancer of the Bladder (cont’d) • Therapeutic Interventions (cont’d) • Incontinent Urinary Diversion • Ileal Conduit

  34. Cancer of the Bladder (cont’d) • Therapeutic Interventions (cont’d) • Continent Urinary Diversion • Kock Pouch • Indiana Pouch • Mainz Pouch • Florida Pouch

  35. Cancer of the Bladder (cont’d) • Therapeutic Interventions (cont’d) • Othotopic Bladder Substitution • Studer Pouch • Hemi-Kock Pouch • Ileal W–Neobladder

  36. Cancer of the Bladder (cont’d) • Nursing Care • WOC Nurse • Monitor Urine Output • Education • Pre-op and Post-op Care

  37. Cancer of the Kidney • Rare • Risk Factors • Smoking • Obesity • Hypertension • Long-term Kidney Dialysis

  38. Cancer of the Kidney (cont’d) • Risk Factors (cont’d) • Radiation Exposure • Asbestos • Industrial Pollution

  39. Cancer of the Kidney (cont’d) • Later Signs and Symptoms • Hematuria • Dull Pain in Flank Area • Mass

  40. Cancer of the Kidney Diagnosis • IVP • Cystoscopy and Pyelogram • Ultrasound • CT Scan • MRI • Renal Biopsy

  41. Cancer of the Kidney (cont’d) • Therapeutic Interventions • Radical Nephrectomy • Nephron-sparing Surgery • Radiation Therapy • Immunotherapy • Chemotherapy

  42. Cancer of the Kidney (cont’d) • Nursing Care • Monitor Urine Output • Education • Pre-op and Post-op Care

  43. Renal Trauma • Flank pain • Hematuria • Treat injury

  44. Renal Trauma (cont’d) • Nursing Care • Intake and Output • Vital Signs • IV Fluids • Pain Control

  45. Polycystic Kidney Disease • Multiple Cysts in the Kidney • Signs and Symptoms • Dull Heaviness in Flank/Back • Hematuria • Hypertension • UTI

  46. Polycystic Kidney Disease (cont’d) • Progressive • No Treatment

  47. Diabetic Nephropathy • Long-term Complication of Diabetes • Most Common Cause of Chronic Kidney Disease • Atherosclerotic Changes Decrease Blood to Kidney • Smaller Doses of Insulin as Progresses • Chronic Kidney Disease Develops

  48. Diabetic Nephropathy Therapeutic Interventions • Early • Control Blood Glucose and Blood Pressure • Restricted-protein Diet • Later • Dialysis • Kidney Transplant

  49. Diabetic Nephropathy (cont’d) • Nursing Care • Education on Glucose and Blood Pressure Control

  50. Nephrotic Syndrome • Large Amounts of Protein Lost in Urine • Increased Glomerular Membrane Permeability

More Related