1 / 25

Comprehensive Guide on Urinary Disorders

This comprehensive guide covers urinary tract infections (UTIs), incontinence, urinary retention, urolithiasis, nephrolithiasis, and urinary diversions with nursing assessment, diagnosis, interventions, and patient teaching.

thomasmcooper
Download Presentation

Comprehensive Guide on Urinary Disorders

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 45Management of Patients With Urinary Disorders

  2. Urinary Tract Infections (UTIs) • The second most common reason for seeking health care • A common site of nosocomial infection • Lower UTIs • Cystitis • Prostatitis • Urethritis • Upper UTIs • Pyelonephritis: acute and chronic • Interstitial nephritis • Renal abscess and perirenal abscess

  3. Factors Contributing to UTI • Function of glycosaminoglycan (GAG) • Urethrovesical reflux • Ureterovesical reflux • Uropathogenic bacteria • Shorter urethra in women • Risk factors: see Charts 45-2 and 45-3

  4. Urethrovesical Reflux and Ureterovesical Reflux

  5. Bladder Infection With Long-Term Catherization

  6. Nursing Process—Assessment of the Patient With a UTI • Symptoms include pain and burning upon urination; frequency; nocturia; incontinence; suprapubic, pelvic, or back pain; hematuria; or change in urine or urinary pattern • About half of patients are asymptomatic • Assess voiding patterns, association of symptoms with sexual intercourse, contraceptive practices, and personal hygiene • Gerontologic considerations • Assess urine, urinalysis, and urine cultures • Other diagnostic tests

  7. Nursing Process—Diagnosis of the Patient With a UTI • Acute pain • Deficient knowledge

  8. Collaborative Problems/Potential Complications • Sepsis • Renal failure

  9. Nursing Process—Planning the Care of the Patient With a UTI • Major goals include relief of pain and discomfort, increased knowledge of preventive measures and treatment modalities, and absence of complications

  10. Interventions • Prevention: avoid indwelling catheters; exercise proper care of catheters • Exercise correct personal hygiene • Take medications as prescribed: antibiotics, analgesics, and antispasmodics • Apply heat to the perineum to relieve pan and spasm • Increase fluid intake • Avoid urinary tract irritants such as coffee, tea, citrus, spices, cola, and alcohol • Frequent voiding • Patient education: see Chart 45-4

  11. Urinary Incontinence • An underdiagnosed and underreported problem that can significantly impact the quality of life and decrease independence and may lead to compromise of the upper urinary system • Urinary incontinence is not a normal consequence of aging • Risk factors: see Chart 45-5

  12. Types of Urinary Incontinence • Stress • Urge • Reflex • Overflow • Functional • Iatrogenic • Mixed incontinence

  13. Patient Teaching • Urinary incontinence is not inevitable and is treatable • Management takes time (provide encouragement and support) • Develop and use a voiding log or diary • Behavioral interventions: see Chart 45-7 • Medication teaching related to pharmacologic therapy • Strategies for promoting continence: see Chart 45-8

  14. Urinary Retention • Inability of the bladder to empty completely • Residual urine: amount of urine left in the bladder after voiding • Causes include age (50 to 100 mL in adults older than age 60 due to decreased detrusor muscle activity), diabetes, prostate enlargement, pregnancy, neurologic disorders, and medications • Assessment • Nursing measures to promote voiding

  15. Urolithiasis and Nephrolithiasis • Calculi (stones) in the urinary tract or kidney • Pathophysiology • Causes: may be unknown • Manifestations • Depend upon location and presence of obstruction or infection • Pain and hematuria • Diagnosis: x-ray, blood chemistries, and stone analysis; strain all urine and save stones

  16. Potential Sites of Urinary Calculi

  17. Methods of Treating Renal Stones

  18. Methods of Treating Renal Stones (cont.)

  19. Methods of Treating Renal Stones (cont.)

  20. Patient Teaching • Signs and symptoms to report • Follow-up care • Urine pH monitoring • Measures to prevent recurrent stones • Importance of fluid intake • Dietary teaching • Medication teaching as needed • See Chart 45-11

  21. Urinary Diversion • Reasons: bladder cancer or other pelvic malignancies, birth defects, trauma, strictures, neurogenic bladder, chronic infection or intractable cystitis; used as a last resort for incontinence • Types: • Cutaneous urinary diversion: ileal conduit, cutaneous ureterostomy, vesicostomy, and nephrostomy • Continent urinary diversion: Indiana pouch, Kock pouch, and ureterosigmoidostomy

  22. Cutaneous Urinary Diversions

  23. Continent Urinary Diversions

  24. Nursing Diagnoses—Preoperative • Anxiety • Imbalanced nutrition • Deficient knowledge

  25. Nursing Diagnoses—Postoperative • Risk for impaired skin integrity • Acute pain • Disturbed body image • Potential for sexual dysfunction • Deficient knowledge

More Related