NR 328 Exam #2 Renal Dysfunction(questions and answers)

What is one important thing to assess with health hx of the renal system? -Urinary hygiene (i.e., wiping front to back) -Patterns of elimination (i.e., constipation, holding it too long) Signs and symptoms of UTIs -N/V, anorexia, chills, nocturia, urinary frequency, urgency -Suprapubic or lower back pain, bladder spasms, dysuria, burning on urination -Objective data: fever; hematuria; foul-smelling urine; tender, enlarged kidney; leukocytosis; positive findings for bacteria Why are UTIs more difficult to diagnose in infants? They might just be irritable, not eating, diaper rash. *Teach parents to wipe front to back and watch for constipation Diagnostic studies for UTIs -UA -Urine culture and sensitivity -BUN, creatinine -Ultrasound, CT, renal scan -GFR and uric acid Normal characteristics of urinalysis -pH 5-9 -Specific gravity 1.001 to 1.035 (hydrated = 1.020) -Protein 20 mg/dL -No glucose, ketones, casts, nitrates, RBC/WBC -Clear/light yellow (depending on age) urine color Causes of UTIs -Escherichia coli is the most common pathogen Describe upper urinary tract infections -Involves renal parenchyma, pelvis, and ureters -Usually no symptomatic manifestations -Pyelonephritis: may involve kidneys -Glomerulonephritis: immunologic; follows streptococcal infection Describe lower urinary tract infections -Involves lower urinary tract -Typically causes fever, chills, flank pain -Cystitis: contained in bladder -Urethritis: possibly leads to upper UTI Risk factors for UTIs •Urinary stasis •Urinary tract anomalies •Reflux in the system •Constipation (treat the issue) •Onset of toilet training •Uncircumcised males (hygiene) •Females – urethra in close proximity to rectum •Synthetic; tight underwear & wet bathing suits •Sexual activity •Bubble baths If you're caring for a sexually active teen, what should you teach them to do before and after intercourse? Empty bladder before and after What is a recurrent UTI? Repeated episodes; nonresponsive to treatment &/or can become subacute What is a persistent UTI? Bacteriuria despite antibiotics treatment or noncompliance with treatment &/or can become subacute