Chapter 47 1/8/2018. Urinary System Disorders. Urinary Tract Infections. Treatment

Transcription

1 Chapter 47 Urinary System Disorders Urinary Tract Infections Urinary tract infections (UTIs) are common Infection in one area can involve the entire system Microbes enter through the urethra. Catheterization, urological exams, intercourse, poor perineal hygiene, and poor fluid intake are common causes Treatment Doctor orders antibiotics Fluids are encouraged Recommend water, cranberry juice, apple juice Usually instructed to avoid soda (pop), citrus juices, alcohol 1

2 Cystitis Is a bladder (cyst) infection (itis) Caused by bacteria Urinary frequency, oliguria, urgency, dysuria, pain or burning on urination, foul-smelling, hematuria, pyuria, fever. Antibiotics are ordered. Fluids are encouraged, usually 2000ml per day Pyelonephritis Untreated cystitis leads to pyelonephritis Infection is common cause Cloudy urine may contain pus, mucus, & blood Chills, fever, back pain, & nausea and vomiting occur. So do s/s of cystitis Treatment involves antibiotics & fluids. Prostate Enlargement BPH benign prostatic hyperplasia (hypertrophy) After age 60, most men have some symptoms of BPH The enlarge prostate presses against the urethra obstructing urine flow Bladder function is gradually lost 2

3 These problems are common: Weak urine stream Frequent voidings of small amount of urine Urgency & leaking, or dribbling of urine Frequent voiding at night Urinary retention Treatment depends on the problem Mild medication can shrink the prostate or stop its growth Microwave & laser treatments destroy excess prostate tissue Transurethral resection of the prostate (TURP) see postop care/ care plan Urinary Diversions Sometimes the urinary bladder is removed. Cancer & bladder injuries are common reasons. A urinary diversion is a surgically created pathway for the urine to leave the body. Often an ostomy is involved. A pouch is applied over the stoma 3

4 See promoting safety and comfort P. 722 Pouches are usually changed q 5-7 days Urine drains constantly. Empty pouches q 3 to 4 hours, or when 1/3 (one third) full. Heavy pouches can loosen seal between the pouch and the skin & cause skin breakdown Good skin care is needed. Observe and report skin changes around the stoma. Kidney Stones (calculi) Risk factors include bedrest, immobility, & poor fluid intake. Stones vary in size from a grains of sand to golf ball. Signs & Symptoms Severe cramping in the back and side just below the ribs Pain in the abdomen, thigh & urethra Nausea and vomiting Fevers & chills Dysuria Urinary frequency Oliguria Hematuria Foul-smelling urine 4

5 Treatment Medications for pain relief. Increase fluid intake to ml of fluid a day All urine is strained Surgical removal of the stones may be necessary Dietary changes may prevent stones Acute Renal Failure Is sudden. There is a severe decrease in blood flow to the kidneys Causes include severe bleeding, MI, heart failure, burns, infection, and severe allergic reactions Hospital care is needed Signs & Symptoms (s/s) First oliguria occurs. Output is less than 400 ml in 24 hours. Lasts few days to 2 weeks Then large amounts (diuresis) to 5000 ml a day Kidney function improves & returns to normal during the recovery phase This can take 1 month to 1 year. 5

6 Treatment Every system is affected by the buildup of waste products in the blood. Death can occur. It is important get treatment. Medications Restricted fluids Diet therapy (high in carbs, low in protein and potassium) Measuring & recording output qh Treatment (cont) Report output of less than 30 ml per hour to the nurse at once Restricting fluid intake Weigh daily Turn & reposition at least q2h Frequent oral care Prevent pressure ulcers Prevent infection Coughing and deep breathing exercises Measures to meet emotional needs Chronic Renal Failure Kidneys cannot meet body s needs Nephrons of the kidneys are destroyed after many years Hypertension and diabetes are common causes. Infections, urinary obstructions, & tumors are other causes S/S appear when 80%-90% of the kidney function is lost 6

7 Treatment Fluid restictions Diet therapy Medications Dialysis See Care of the Person in Renal Failure P. 724, Box 44-2 Sexually Transmitted Diseases STDs HIV Human immunodeficiency virus The virus weakens a person s ability to fight infections and cancer People with HIV are said to have AIDS (acquired immune deficiency syndrome) when they develop certain infections or cancers or when the their CD4 count is less than

8 Cont. According to the Center for Disease Control and Prevention, in the U.S. the estimated number for people with HIV/AIDS is about 1,185,000, with approx. 25% of them unaware of their infection. The estimated number of new cases of HIV is 42,000 each year. Risk Factors Sharing a needle to take drugs. A tattoo or body piercing by dirty needles Having unprotected vaginal, anal, or oral sex with an infected person. Baby s born to a mother with HIV infection. Also from breast milk. Get tested if you fall into any of the above categories AIDS Signs that HIV is turning into AIDS include: A fever that won t go away Sweating while you sleep Feeling tired all the time (not from stress or lack of sleep) Losing weight Swollen glands (neck, groin or underarms) 8

9 For more information regarding HIV Google World Health Organization, Center for Disease Control, Illinois Department of Public Health 9