Urinary
Published on Aug 16, 2017
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PRESENTATION OUTLINE
Urinary
Traci Boren, RN, MS, CNOR
UTI Review
- Most common bacterial infection in women
- E. coli is most common pathogen
- Can be complicated or uncomplicated
Lower UTIs
*Typically no systemic manifestations
Upper UTIs
*Fever, chills, flank pain common
Risk Factors
- Obstructions/Foreign bodies
- Anatomic Factors
- Immune Factors
- Functional Disorders
- Personal Factors
Contributors to UTI
*CAUTIs are the most common HAI
Older Adult Considerations
Photo by r.nial.bradshaw
Acute Pyelonephritis
*inflammation of renal parenchyma and collection system
Pyelonephritis
- Most common = bacteria
- Migrates from lower to upper (retrograde urine) - BPH, stricture, stone
- CAUTIs
- Pregnancy changes
- Can lead to UROSEPSIS
Clinical Manifestations:
Hesitancy, Frequency, Urgency, Retention, Incontinence, Retention
Hematuria, Sediment, Fatigue/anorexia, CVA Pain, Fever/Chills
Diagnostics
Ultrasound, CT Scans, Labs
+Nitrates
+WBCs/Casts
+Leukocyte Esterase
+Blood
Treatment
- Antibiotics (IV, Oral)
- Fluids
- NSAIDS
- phenozopyradine
Health Promotion
Renal Calculi
One major type of obstructive uropathy
Renal Calculi
- More common in men 20-55
- More frequent in white clients
- More frequent with family hx.
- "Stone season" = summer
- Diet and Lifestyle Factors
Incidence of Stone Types
Clinical Manifestations
- PAIN (renal colic)
- Nausea/vomiting
- Hematuria
Diagnostics
CT, Ultrasound, UA, Stone Analysis
Treatment
- Manage pain/infection
- Relieve obstruction
- Prevention teaching
- Cysto, Lithotripsy, Surgery
- Nutrition therapy
- Stone analysis
*Fluids
*Mobility
*Dietary Restrictions
*Pain Management
*Medications
*Strain Urine
BPH
Benign Prostatic Hyperplasia
Risk Factors
- Aging
- Smoking/alcohol
- Obesity
- Diabetes
- Lack of physical activity
- Family history
- ED
Clinical Manifestations
Irritatitive & Obstructive
Complications
- UTI
- Acute urinary retention
- Bladder Stones
- Hydronephrosis
- Pyelo/Renal Failure
Diagnostics
DRE, H&P, UA, Creatinine, PSA, TRUS, Post-void residual, Uroflowmetry, Cysto
Treatments
- Active surveillance
- Dietary Changes
- Avoid certain meds
- Restrict evening intake
- Timed voiding/double voiding
MEDICATION THERAPY
5 alpha-reductase inhibitiors (-eride)
alpha-adrenergic receptor blockers (-osin)
Minimally Invasive Treatments & Surgery
Untitled Slide
Erectile Dysfunction
Inability to attain or maintain an erection
Risk Factors
- Vascular
- Drug-Induced
- Endocrine
- GU
- Neurologic
- Psychologic
- Aging
