NUR2349 Exam 2 Study Guide
• CBI – continues bladder irrigation used to prevent blood clots
• NSAIDS-what we need to know and what to ask
• Surgical Integrity
• 24 hour urine collection
o Discard the first void
o Everything is on ICE – jug and Foley bag
o Sign above the bed to indicate 24 hour urine is being collected
• Clean catch urine – catch urine mid-stream
• Sterile urine catch – 1st time from the bag, day 3 get from port
• Coude Catheter – for a pt with enlarged prostate – has a bend near the tip
• Normal urine output is 30ml/hr
o If under 30ml/hr and on PO diet – encourage fluids
o If not on PO diet – call the Dr. to get fluids ordered
• Kidney stone (renal calculi) – patient will have a lithotripsy to break up the stones.
Patient will be sedated – monitor HR – expected finding is bruising. The nurse on the
floor – strain the urine and sent to lab to see what the stone is made of.
o Stone made of calcium – diet may need to be modified
o Stone made of uric acid – pt may be given Allopurinol
▪ Pt doesn’t need a lithotripsy – IV pain meds and flushing with fluids
• Post-op for lithotripsy
o Education?
o Strain the urine
o Hematuria-is normal.
• Pyelonephritis – infection in the kidney
o Can lead to urosepsis and death
o Has to be treated with ABX
o S/S: flank pain or pelvis pain, N/V, fever, increased WBC, elevated HR, chills,
fatigue, loss of appetite or malaise
, • UTI – urinary tract infection
o Treated with an ABX –must take the full course – treats the infection
o Given Pyridium for the pain symptoms – stains the urine orange
o S/S : painful, burning, urgency, cloudy urine, odor, frequency, blood in the urine
o Educate patient : cranberry juice, plenty of fluids, proper hygiene, don’t hold
urine, void after sex, no tight clothing, no bubble baths or bath bombs.
o Drink 2-3 liters of water a day while sleeping/resting.
• Pyridium
o Stains urine orange
o Does not treat infection, helps with the symptoms.
• Urinary Retention
o Anything greater than 50ML
o Determined by a bladder scanner or post void residual
o Could straight cath the pt
o Flomax given to help
• Urinary Incontinence
o Temporary or permanent
o Could be caused by diuretics, sedatives, anticholinergics meds or urinary
procedures
o Common diuretic : LASIX (furosemide)
▪ Antihypertensive, loop or high ceiling type of diuretic
▪ Treats acute edema with live cirrhosis, renal impairment of HF
▪ Prevents the reabsorption of sodium and chloride by blocking the
symporter in the loop of Henle
▪ Given : PO, IV , IM
▪ ADVERSE EFFECTS: dehydration , electrolyte imbalance (causes
dysrhythmias), dizziness and syncope (HTN), metabolic alkalosis,
profound diuresis (excessive amount)
▪ CONTRAINDICATION: sulfa allergy, coma, dehydration, electrolyte
imbalance or depletion
▪ DRUG INTERACTIONS: digoxin (decreases K+, increase effectiveness),
lithium (toxicity), alcohol (additional diuretic action)
• Ostomy
o Ileostomy
▪ In the small intestine
▪ Risk for dehydration
▪ Stool will be runny, liquid
▪ Pt must wear bag all the time
o Colostomy
• CBI – continues bladder irrigation used to prevent blood clots
• NSAIDS-what we need to know and what to ask
• Surgical Integrity
• 24 hour urine collection
o Discard the first void
o Everything is on ICE – jug and Foley bag
o Sign above the bed to indicate 24 hour urine is being collected
• Clean catch urine – catch urine mid-stream
• Sterile urine catch – 1st time from the bag, day 3 get from port
• Coude Catheter – for a pt with enlarged prostate – has a bend near the tip
• Normal urine output is 30ml/hr
o If under 30ml/hr and on PO diet – encourage fluids
o If not on PO diet – call the Dr. to get fluids ordered
• Kidney stone (renal calculi) – patient will have a lithotripsy to break up the stones.
Patient will be sedated – monitor HR – expected finding is bruising. The nurse on the
floor – strain the urine and sent to lab to see what the stone is made of.
o Stone made of calcium – diet may need to be modified
o Stone made of uric acid – pt may be given Allopurinol
▪ Pt doesn’t need a lithotripsy – IV pain meds and flushing with fluids
• Post-op for lithotripsy
o Education?
o Strain the urine
o Hematuria-is normal.
• Pyelonephritis – infection in the kidney
o Can lead to urosepsis and death
o Has to be treated with ABX
o S/S: flank pain or pelvis pain, N/V, fever, increased WBC, elevated HR, chills,
fatigue, loss of appetite or malaise
, • UTI – urinary tract infection
o Treated with an ABX –must take the full course – treats the infection
o Given Pyridium for the pain symptoms – stains the urine orange
o S/S : painful, burning, urgency, cloudy urine, odor, frequency, blood in the urine
o Educate patient : cranberry juice, plenty of fluids, proper hygiene, don’t hold
urine, void after sex, no tight clothing, no bubble baths or bath bombs.
o Drink 2-3 liters of water a day while sleeping/resting.
• Pyridium
o Stains urine orange
o Does not treat infection, helps with the symptoms.
• Urinary Retention
o Anything greater than 50ML
o Determined by a bladder scanner or post void residual
o Could straight cath the pt
o Flomax given to help
• Urinary Incontinence
o Temporary or permanent
o Could be caused by diuretics, sedatives, anticholinergics meds or urinary
procedures
o Common diuretic : LASIX (furosemide)
▪ Antihypertensive, loop or high ceiling type of diuretic
▪ Treats acute edema with live cirrhosis, renal impairment of HF
▪ Prevents the reabsorption of sodium and chloride by blocking the
symporter in the loop of Henle
▪ Given : PO, IV , IM
▪ ADVERSE EFFECTS: dehydration , electrolyte imbalance (causes
dysrhythmias), dizziness and syncope (HTN), metabolic alkalosis,
profound diuresis (excessive amount)
▪ CONTRAINDICATION: sulfa allergy, coma, dehydration, electrolyte
imbalance or depletion
▪ DRUG INTERACTIONS: digoxin (decreases K+, increase effectiveness),
lithium (toxicity), alcohol (additional diuretic action)
• Ostomy
o Ileostomy
▪ In the small intestine
▪ Risk for dehydration
▪ Stool will be runny, liquid
▪ Pt must wear bag all the time
o Colostomy
