Question

Chapter 55: Management of Patients with Urinary Disorders

Conditions to Know: UTIs, Nephrolithiasis (Kidney Stones)

1. What are some risk factors for the development of UTIs?
2. What are some factors that contribute to the development of UTIs in older adults?
3. What are the signs and symptoms of a UTI?
4. How are UTIs diagnosed?
5. How are UTIs treated?
6. Describe the nursing interventions that are necessary when caring for a patient with a UTI.
7. What are some teaching points you would want to include in your patient education regarding the prevention of UTIs?
8. What are some clinical manifestations of kidney stones?
9. What are the goals of management for a patient diagnosed with a kidney stone?
10. Describe the nursing care necessary when caring for a patient with a kidney stone.
11. If a patient is unable to pass a stone on their own, what other procedures or surgical interventions may be necessary to eradicate the stone?

What are some teaching points you would want to include in your patient education regarding the prevention of kidney stones?

Answer 1

ANSWER.

Risk factors fir developing Urinary tract infections:-

* Abnormalities of urinary tract .
Example :- kidney stones.
* immunosupression due to any medications.
* Instrumentation of the urinary tract.
Like :- catheterization.
* sexual intercourse.
* shorter urethra in females than males.
* Diabetes.

Factors that contribute to develop Urinary tract infections in older adults:-

* This include changes in immune system.
* exposure to hospital.
* having prior urinary infections.
* catheterization.
* Changes in urinary system way of working.Signs and symptoms of UTI:-

* Nausea.

* Vomiting.

* Pain in back, bladder, groin, pelvis.

* Pain may occur during urination and sexual activities.

* Fatigue, malaise.

* Cramping.

* Urge to urination.

* frequent urination.

* Blood in urination,etc.

Urinary tract infection diagonosis:-

Urinalysis is the test by which doctors find the infection causing pathogens or white blood cells in urine.

Urinary tract infection treatment:-

Treatment consists of antibiotics like penicillin. This stops growth of bacteria or kill specific type of pathogen to stop urinary tract infection. The doctor may commonly recommend sulfamethoxazole or ceftriaxone, etc.

Education:-

* teaching includes :- explain the patient important of fluids and advise to take more fluids and water.

* advice to take Vitamin- c rich diet.

* Maintainance of Hygienic practices.

Clinical manifestations of Nephrolithiasis.

* Severe back, abdominal pain.

* Pain in side part of the body.

* Nausea.

* Vomittings.

* Sweating.

* Blood in urine.

* Fewer and chills.

* Pain during urination,etc.

Management of Nephrolithiasis:-

* Giving lot of water(that help to pass out the stone).

* Give lot of other fluids like lemon,apple, pomegranate juice,etc.

* Giving pain relievers.

* Giving anti-inflammatory drugs.

* Giving diuretic drugs.

* Maintain a low salt diet.

* Take fresh fruits.

* Limit the intake of meat,etc.

Nursing care:-

* Encourage the patient to take plenty of fluids .

*provide IV fluids if patient can't take oral fluids.

* Encourage Ambulation.

* Urine output should be monitored carefully.

* Patient condition should be monitored carefully. Patient may have abdomen pain,fever,etc. This should be treated carefully.

Medical and surgical Management :-

medical.

* Alkaline citrate salts or sodium bicarbonate.

* Allopurinol.

These are uesd to dissolve stone.

Surgical.

* Shock wave lithotripsy.

* Ureteroscopy.

* Open surgery.

* Procedure :- Percutaneous nephrolithotomy or percutaneous nephtolithotripsy.

Education:-

* Advice the patient to take more fluids and water.

* advice the patient to reduce high protein diet and add calcium rich diet .

* Decrease salt intake,etc.