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Cystitis
Inflammation of the bladder 90% of infections caused by bacteria from the GI tract Urinary catheters most common cause in the hospital setting TERM 2
Common causes Cystistis
DEFINITION 2 Obstruction Calculi Diabetes Mellitus Gender Age Sexual Activity TERM 3
S/Sx Cystitis
DEFINITION 3 Frequency Dysuria Urgency Low back pain Hesitancy Urinalysis: +leukocyte esterase WBCs RBCs Culture- confirm type of organism TERM 4
S/Sx Pyelonephritis
DEFINITION 4 Fever Chills Nausea Vomiting Malaise Flank pain TERM 5
Risk factors for UTIs in older adults
DEFINITION 5 High incidence of multiple chronic medical conditions Frequent use of antimicrobial agents Presence of infected pressure ulcers Immunocompromise Cognitive impairment Immobility and incomplete emptying of the bladder Use of a bedpan rather than a commode or toilet
S/Sx UTIs in older adults
Altered mental status Frequent unexplained falls Sudden onset of incontinence Fever Tachycardia Tachypnea Hypotension Loss of appetite Nocturia Dysuria TERM 7
Management of UTIs
DEFINITION 7 Antibiotics Antispasmotics Diet Increase fluids Cranberry juice Avoid coffee, tea, colas, other urinary tract irritants. TERM 8
Urinary Incontinence
DEFINITION 8 Stress (cough/sneeze- leakage) Urge Mixed Overflow (bladder not emptying completely) Functional (not able to get to the bathroom in time) TERM 9
Incidence/Prevalence of Urinary incontinence
DEFINITION 9 Women are most affected (85%) Twice as often in women over 65 when compared to men More common in older adults 15-30% of community dwelling adults 50% of nursing home residents Never to be considered normal TERM 10
Contributing factors to urinary incontinence
DEFINITION 10 Medications Disease Depression Inadequate Resources
Surgical mgmt for stress incontinence
Involves repositioning the bladder and urethra or adding bulk or support to the periurethral area Usually done outpatient Patients d/c'd within 24 hours TERM 17
Non-surgical mgmt for urge incontinence
DEFINITION 17 Drug therapy Anticholinergics TCAs Diet therapy -- avoid bladder irritants Behavioral modification Bladder training Habit training Exercise therapy --- Kegels Electrical stimulation TERM 18
Urolithiasis
DEFINITION 18 Presence of calculi in the urinary tract system Nepholithiasis-- kidney stone Ureterolithiasis-- ureter stone TERM 19
S/sx Renal Colic
DEFINITION 19 Flank pain N/V Pallor Diaphoresis Oliguria Anuria Hematuria TERM 20
Lab/radiographic assessment in urolithiasis
DEFINITION 20 UA Appearance may be rusty
- RBCs May have WBC's and bacteria KUB IVP CT
Non-surgical mgmt of urolithiasis
Mainly aimed at pain mgmt Drug therapy Alternative therapy Lithotripsy: Ultrasonic waves dissolve stones TERM 22
Surgical mgmt of urolithiasis
DEFINITION 22 Stenting Retrograde ureteroscopy Percutaneous Ureterolithotomy TERM 23
Prevention of obstructiong from urolithiasis
DEFINITION 23 Drug therapy -- NSAIDS Diet therapy Decrease protein and sodium Avoid oxylate containing foods Increase fluid intake Activity Avoid excess sweating and dehydration Teaching
