Renal & Urologic Problems Lecture Notes

RENAL UROLOGIC PROBLEMS 1. URINARY TRACT INPECTION CUTI) can progress to urosepsis: bactoria gets into blocosticam diagnosis VAI dip unine Cos uncomplicated UTI normal UTI ·usually only involves bladder complicated UTI STUGerall funcional problems recurrent infection, obstruction, stones, catheter, preg. Risk Factors fernale male "pregnancy, menopause, sexual activity, birth control indwelling catheter douches trise for pyclonephritis (Infection of kidneys), urofepsis, renal damage Nursing Care symptomatic reliet teaching showers better than batης void after intercourse wipe front back no perfumes aroid douching cotton underwear cranberry juice Sis: cloudy urine, nematuria Lower UTI: frequency, urgency, suprapubic pain, burning, fever Upper UTI flank pain, dysuria, pain @ CVA 4 sis: foror, chills UTI: Management local neat Azo: prena zopyridine: turns urine red-orange avoid bladder irritants Lex: ex : alconol, caffeine, chocolart, hot peppers 2. ACUTE PYELONE PHRITIS Inflammation of ronal parenchyma + collecting system. ascends from lower UTI Bis: flank pain CVA Tenderness malalse ferer, N+V chills Diagncent Studies: 3. CHRONIC PYELONEPHRITIS -kidneys inflamed cause scarring loss of renal function. diagnosis : radisogic imaging + biopsy treasment: treat intection prevent end-stage renal disease. urinalysis vrine C+S blood cultore Klancy function teses Ultrasound, CT 4. URETHRITIS Inflammation of the urethra dlu bactorial or viral infection. Treatment antimicrobials Site baths Teaching: avoid vaginal sprays perineal cave no sex 7 days 5. INTERSTITIAL CYSTITIS (IC)/ PAINFUL BLADDER SYNDROME IC chronic, painevi intiammatory disease of the bladder causes Pes more common in wormen. SIS : LUTS, pain coorse wifull bladder, physical exertion, suprapobic pressure intercourse looks like UTI but neg UA+ Culture Treatment avoid bladder irritants. avold tight clothing pain relict wimeds IMMUNOLOGIC DISORDERS OF KIDNEY 1. GLOMERULONEPHRITIS Intiammation of glomeruli causes: HIN, diabetes, lupus may have tubular changes & scarring nephrotoxic drugs: NSAIDs, vanco acutes sudden symptoms, templ reversibu Chronic: slow, progressive, irreversiou 2. ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS (APSGN) common in children, young adults, led yrs develops 1-2wrs after strep Infection Clinical Manifestations "generalized ederna, hypertension, oliguria proteinuria; smoky urine periorbital edema • abdominal/flank pain Diagnosis (confirmation) 3. NEPHROTIC SYNDROME "PALE" HTP, thers, renal biopsy, VA glomerulus permeable to plasma protein proteinuria Prevention. low plasma albumin + tissue caerna sis: weight gain puffy Face prokinuria hyperlipidemia hypoalbuminemla ascites risk for malnutrition 100 sat dict corticosteroids prevent infection Treatment corticosteroids, ACE, ARB, divietics Nursing: daily wt accurate 1+Os avola iniection low sodium ones, mod protein Lsmall, frequent meals early diagnosis; (+) strep antibiotics personal hygiene Management rest restrict Nat fluids administer diuretics restrica prorcint & BUN antibiotics 4. OBSTRUCTIVE UROPATHIES anatomic functional condition that blocks/impedes the flow of urine blockage: calculi or stricture acute urinary retention: emergency: cath wait 6-8 hrs to urinate 5. NEPHROLITHIASIS kidney stones nephrolithasis: kidney stone disease Risk Factors: metabolic: + calcium levels + uric acid levels genetic: warm climate + fluid loss (dehydration) more common in men Kidney Stone Types: 1. Calcium oxalate: most common, small, get trapped in ureter, men > women 2. Calcium phosphate: mixed stones, hyperparathyroidism 3. Cystine: genetic defect; defective absorption of cystine in GI tract; women > men 4. Struvite: magnesium ammonia; associated with UTIs, women > men 5. Uric Acid: men > women, gout Clinical Manifestations: 1st symptom: sudden, severe pain flank area, back, lower abdomen may see N/V, "kidney dance," dysuria, fever, chills common obstruction sites: ureteropelvic junction ureterovesical junction Interprofessional Care DIAGNOSTIC STUDIES: KUB, CT scan, ultrasound removal of stones Management: manage acute attack pain meds eval cause prevention high intake (> 3 L/day) of H2O limit soda, tea, caffeine low-sodium diet