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NR 325 Adult Health II Test 2 (Chapters_ 11, 16, 51-55, 45-47) (1)
NR 325 Adult Health II Test 2 (Chapters_ 11, 16, 51-55, 45-47) (1)
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NR 325 Adult Health II Test 2 (Chapters: 11, 16,51-55, 45-47)
You need to know, understand, comprehend, analyze, synthesize, and be able to apply and
evaluate etiology, concepts, context, including but not limited to clinical manifestations,
diagnostic tests, nursing management/collaborative, interventions, treatments, medications,
complications, patient education for the following disorders::
* Incontinence - ANS-Incontinence is NOT a normal sign of aging
Common Causes of Transient Incontinence:
Delirium
Infection
Atropic Urethritis
Pharmaceuticals
Psychologic
Excess Urine Output
Restricted Mobility
Stool Impaction
You need to know, understand, comprehend, analyze, synthesize, and be able to apply and
evaluate etiology, concepts, context, including but not limited to clinical manifestations,
diagnostic tests, nursing management/collaborative, interventions, treatments, medications,
complications, patient education for the following disorders::
* Urinary Tract Infections - ANS-most common bacterial infection in women.
E. coli is the most common pathogen causing UTI.
Fungal and parasitic UTIs uncommon, but usually in patients who are immunosuppressed, have
DM, or have taken multiple courses of antibiotics.
Classified by location- upper or lower UTI.
Upper UTI (renal parenchyma, pelvis, and ureters) commonly causes fever, chills, flank pain.
example: pyelonephritis.
Lower UTI usually no systemic manifestations. example: cystitis, urethritis.
further classification such as pyelonephritis, cystitis, urethritis, urosepsis.
Uncomplicated UTI- occur in an otherwise normal urinary tract and usually only involve the
bladder
Complicated UTI- infection w/ coexisting obstruction, stones, or catheters; the existence of DM
or neurologic diseases
Pathophysiology:
,organisms that cause UTIs are usually introduced by way of the ascending route from the
urethra (catheterization, cystoscopic examination, sexual intercourse, hematogenous route).
Most infections are caused by gram-negative aerobic bacilli. common healthcare associated
infection.
Clinical Manifestations:
dysuria, frequent urination, urgency, suprapubic discomfort or pressure, nonlocalized abdominal
discomfort, hematuria, sediment in urine, cloudy appearance of urine, flank pain, chills, fever
Diagnostic Studies:
dipstick urinalysis - identifies presence of nitrates, WBCs, leukocyte esterase
urine culture with sensitivity
CT urogram or ultrasound - when obstruction is suspected
Drug Therapy:
uncomplicated cystitis treated with short term course of antibiotics (typically 1 to 3 days).
Trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim) or Nitrofurantoin (Macrodantin).
Fluoroquinolones (ciprofloxacin [Cipro], levofloxacin [Levaquin], gatifloxacin [Tequin]). ampicillin,
amoxicillin, and cephalosporins.
urinary analgesic phenazopyridine (Pyridium)
You need to know, understand, comprehend, analyze, synthesize, and be able to apply and
evaluate etiology, concepts, context, including but not limited to clinical manifestations,
diagnostic tests, nursing management/collaborative, interventions, treatments, medications,
complications, patient education for the following disorders::
* Pyelonephritis - ANS-
You need to know, understand, comprehend, analyze, synthesize, and be able to apply and
evaluate etiology, concepts, context, including but not limited to clinical manifestations,
diagnostic tests, nursing management/collaborative, interventions, treatments, medications,
complications, patient education for the following disorders::
* Interstitial Cystitis - ANS-Chronic, painful inflammatory disease
Autoimmune process; infection triggered
Pain and lower urinary tract symptoms are most common
Can be misdiagnosed as UTI
Diagnosis of exclusion
Painful Bladder Syndrome (PBS) is suprapubic pain related to bladder filling
Pathophysiology:
etiology of IC/PBS remains unknown, but some possible causes are neurogenic hypersensitivity
of the lower urinary tract, alterations in mast cells in the muscle and/or mucosal layers of the
bladder, infection with an unusual organism, or production of a toxic substance in the urine.
, the bladder wall may be irritated and inflamed and can become scarred.
Clinical Manifestations:
pain and bothersome lower urinary tract symptoms (frequency, urgency..)
Diagnostic Studies:
history and physical examination are used to rule out other disorders
cytoscopic examination
Collaborative Care:
no single treatment consistently reverses or relieves symptoms
lifestyle changes
dietary changes - elimination of irritants such as caffeine, alcohol, citrus, aged cheeses, nuts,
vinegar, hot peppers, and foods or beverages likely to lower urinary pH
relaxation techniques - application of hot and cold therapy, sitz baths
surgical intervention - such as urinary diversion
Drug Therapy:
OTC dietary supplement calcium glycerophosphate (Prelief) alkalizes the urine and can provide
relief from the irritating effects of certain foods
tricyclic antidepressants - reduce burning pain and urinary frequency. amitriptyline (Elavil) and
nortriptyline (Aventyl).
Several agents can be instilled directly into the bladder through a small catheter. Dimethyl
sulfoxide (DMSO) acts by desensitizing pain receptors. Heparin and hyaluronic acid enhances
the protective properties of the glycosaminoglycan layer of the bladder to relieve symptoms.
You need to know, understand, comprehend, analyze, synthesize, and be able to apply and
evaluate etiology, concepts, context, including but not limited to clinical manifestations,
diagnostic tests, nursing management/collaborative, interventions, treatments, medications,
complications, patient education for the following disorders::
* Urethritis - ANS-Inflammation of the urethra
caused by bacterial or viral infection
STDs in men primary cause
Clinical Manifestations:
in men: purulent drainage indicates gonococcal urethritis. clear discharge indicates
nongonococcal urethritis. lower urinary tract symptoms such as dysuria, urgency, frequency
in women: difficult to diagnose. bothersome lower urinary tract symptoms, but discharge may
not be present.
Treatment:
organism specific agents
symptomatic relief
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