exam 3 GI/GU

UTI cystitis symptoms
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Terms in this set (61)
UTI cystitis symptoms
urgency and frequency, nocturia, dysuria, suprapubic heaviness, hematuria
How does patient get UTI
E.Coli
Dx, Tx and teachings for UTI
DX- Urine Dipstick
Tx-Bactrim
--do not give until culture has confirmed, take with large glass of water, take full course of antibitoics
Polynephritis
inflammation of the renal pelvis and the kidney, following cystitis
S&S of polynephritis
fever of 103, urine loaded with pus and blood, FLANK PAIN
Dx of polynephritis
UA, CNS, xray bladder, KUB
Tx of Polynephritis
prompt tx of cystitis, bed rest, antipyretics, culture specific antibiotics

Meds-Ceph, Cipro, Bactrim, gentmyacin
Nursing Management for Polynephritis
Fluids, I&0, IV to flush kidneys
Labs to monitor for kidneys
Bun 7-20 (hydration)
Creatine 0.8-1.2 (kidney function)
what is a bladder scan used for?
it indicates urinary retention
-bladder holding over 300 CC urine
-no urine output all shift
Cauticatheter associated urinary tract infectionoverflow incontinencer/t poor contractibility of female prolapse, BPHstress incontinencethe inability to control the voiding of urine under physical stress such as running, sneezing, laughing, or coughingurge incontinencer/t infectioninterventions for incontinenceKegals, toilet programs, focus on safety (falling), limit fluids at night, meds, depend change q2, peri care, barrier cream, repositionrenal calculikidney stones, r/t increased uric acid and increased urinary oxonateS&S of renal calculisevere pain, flank pain if renal RADIATING TO THE GROIN/TESTICLES, abdominal distention, fever, chillslithotripsysurgical crushing of a kidney stonetx of kidney stonesincrease fluids, cranberry juice, decrease caffeine and uric acid, strain all urine, pain managementglomerulonephritisinflammation of the glomeruli of the kidney, R/T strep infection, decreased GFRs/s of glomerulonephritisedema, fever, gross hematuria, flank pain, HTN, proteinuria, FACIAL EDEMA!!!Tx of glomerulonephritisMethylprednisone, decrease protein intake, increase carbs, decrease sodium and water, monitor pt daily weightglomerulonephritis focus pointsreduction in GFR, increased proteinuria, hematuria, decrease in functional nephronsGastritis causesinflammation of the stomach, r/t drinking excess alcohol, food contamination, drug use, nsaid useStomatits, S&S, causes, txSores within the mouth S&S-increased salivation, excessive dry mouth Causes-ill fitting dentures, poor oral hygiene, drinking, smoking, alcohol, radiation therapy tx- nystatin (thrush) Oral swish/rinseliverproduces bile, upper right quadrant, stores glycogen, alterations in ammoniaBactrim DStx gram negative and positive organism, broad spectrum, #1 go to for UTIBPH (benign prostatic hyperplasia)Age-associated prostate gland enlargement that can cause urination difficulty.What are kidney stones caused by?Inadequate fl intake, immobility, obesity, gout, HTNoverflow incontinencer/t female organ prolapse, BPHappendectomysurgical removal of the appendixAppendectomy considerationsavoid heat to abdomen (may cause burst), prophylactic antibiotics, need to avoid peritonitis, IV replacement, NG Tube, antibiotics, fluidsPeritonitis "Hot Belly"inflammation within peritoneal cavityGastritis causes and tx in order of priorityInflammation of stomach lining cause by alcohol, food poisoning, NSAIDS, pt is at risk for bleeding ulcers, Hyplori Priority Care 1) NPO 2) Fluids 3) ZofranWhat procedure is completed when a pt is suspected of internal bleeding?ERCPTx to decrease stomach acid?PPI'stx for h pylori2 ABx w/ adj agent (metronidazole, tetracycline, amox, clarithro) w/ (PPI, Bismuth) ----think antibioticsPeptic Ulcer Disease causechronic NSAID, Alcohol usetx of peptic ulcer diseaseH2 blockers proton pump inhibitors combo therapy of both Surgery (vancotomy)Vanctomoysurgical removal of the Vagus nerve, it will no longer secrete any acidstomach perforation-rigid abdomen/severe pain in upper right quadrant -tachycardia -rebound tenderness ---happens when a hole forms and stomach juices leak outAppendcitisinflammation of the appendixwhat happens if appendicitis bursts?at risk for peritonitis (hot belly)S/S of appendicitisPersistent RLQ Pain, pain in umbilical region(mcburney's point), rupture of appendix: sudden severe painTX/Nursing management appendicitis?Tx-removal w/in 24 hr management-NPO, Do not use heat (will rupture abdomen), monitor rigitidy, monitor surgical site for infectionperitontitis, S&S, nursing cares, txinflammation within peritoneal cavitiy S&S-severe N/V, abdominal pain, pallor, tachycardia -at increased risk for shock, monitor WBC, NG tube needed to suction (decompress stomach) 1) identify cause, tx w/ antibiotics, give IV fluids -patient at risk for collapsed lung, get them up and moving ASAP/ incentive spirometerBowel obstruction Mechanical VS Paralytic, S&S, TxMechanical- tumor, adhesion, twisting of bowel, hernia Paralytic- immobility, narcotics, extreme constipation S&S-N/V, (may vomit bile if the extreme case), extreme pain Dx-CT Tx-NG tube to rid excess contents, temporary colostomyIBS (name the two types)Irritable Bowel Syndrome Ulcerative Colitis & ChrohnsUlcerative colitis, S&S, dx, txinflammation/ulcers on colon S&S-several bloody stools, abscesses Dx-colonoscopy -monitor for hemorrage, at risk for colon cancer, affects jewish and smokersChrohn's disease, txchronic inflammatory process involving any portion of the GI tract from the mouth to the anus S&S-severe diarrhea tx-methotrexate, immunothrion,neprhotic syndrome-advanced kidney disorder, affects glomerulus -leads to decreased serum albumin (protein storage) S&S-severe anemia, periorbital edema, all over welling tx-rest, skin care, diet compliance, diruetics, I&O, daily weightulcerative colitis dietAcute- NPO progress diet clear liquids --> low fiber, high protein, vitamins & supplements Avoid gas forming foods- dairy, whole wheat grains, raw fruits and veggies, pepper, etoh, caffeinewhat is a guiac test used for ?looking for blood in stoolCholilithiasisgall stones in gallbladder -r/t DMII, sedentary lifestyle monitor for jandice, clay colored stools -pt may need their gallbladder removedcholedeocholithiasisgallstones in the common bile duct (neck of gallbladder)acute cholecystitisinflammation of the gallbladder -pain LASTING 2-6 hours -monitor for increased WBC & ESRchronic cholecystitis S&S, dx, tx, medsS&S-intermitten back pain raditating to the shoulder, Nausea, jaundice dx- ultrasound/ CT tx-low fat diet, weight loss, decreased alcohol, small spaced out meals meds-urosodiol ( if meds don't work pt will need ECP/ERCP)cholecystectomy, nursing interventionssurgical removal of the gallbladder --laproscopically- minimally invasve --open (semi fowlers, jp drain, monitor draininage) --pt will be NPOERCP (endoscopic retrograde cholangiopancreatography) nursing caresMonitor gag reflex before giving anything POHepatitis B and C viruses-Cause liver infections that can develop into liver cancer -1/3 of all liver cancer causes -Spread through blood or un-protected sex meds-lactolose (prevents encephaopaly) Spirolocatone (potassium sparing diueritc) --at risk for ascities, may need pericentitsishepatitis a & B teachingsdont share razors, toothbrushes, have people in close contact get vaccinated, no sex