40399340 genitourinary disorders

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Genitourinary Disorders 
A.  Urinary tract infections (UTI) 
1.  Infections, by various agents, of parts of the urinary system 
2.  Etiology 
a.  causative agent enters via urinary meatus 
b.  women are more susceptible 
c.  can be caused by poor voiding habits 
d.  in women, acute infection caused most often by Escherichia coli 
e.  in men, cause is usually obstructive abnormalities 
3.  Findings 
a.  dysuria, frequency, urgency, nocturia 
b.  suprapubic pain 
c.  Findings of hematuria 
4.  Diagnostics 
a.  urine dipstick 
b.  urine microscopy 
c.  urine culture 
5.  Management 
a.  antimicrobial therapy as indicated: 
b.  in uncomplicated infection: 
i.  co-trimoxazole (Bactrim) 
ii.  ofloxacin (Floxin) 
iii.  nitrofurantoin (Macrodantin) 
c.  in complicated infection: 
i.  oral antimicrobials as ordered 
ii.  IV antimicrobials may be indicated 
6.  Complications 
a.  pyelonephritis 
b.  sepsis 
7.  Nursing interventions  
a.  assess: 
i.  history of urinary tract infections (UTIs)  
ii.  voiding habits, personal hygiene, contraceptive methods 
iii.  history of vaginal discharges, itching, irritation, dysuria 
b.  manage pain: 
i.  systemic analgesics and 
ii.  urinary analgesics/antispasmodics 
c.  client teaching   
i.  preventive measures 
•  in the female client, discuss voiding after intercourse  
ii.  nutritional considerations 
•  increase water intake 
•  avoid coffee, tea, alcohol, and colas (carbonated and 
noncarbonated) 

Page 29 of 51

pyelonephritis

Inflammation of the kidney and renal pelvis, usually as a result of a bacterial infection that has ascended from the

urinary bladder.

dysuria

Painful or difficult urination, symptomatic of numerous conditions. Dysuria may indicate cystitis; urethritis; infection

anywhere in the urinary tract; urethral stricture; hypertrophied, cancerous, or ulcerated prostate in men; prolapse of

the uterus in women; pelvic peritonitis and abscess; metritis; cancer of the cervix; dysmenorrhea; or psychological

abnormalities. The condition may also be caused by certain medications, esp. opiates and medicines used to prevent

motion sickness. Pain and burning may be caused by concentrated acid urine. SEE: urinary tract infection

Client teaching regarding UTIs

1. Drink plenty of fluids

2. Avoid coffee, tea, colas and alcohol

3. Void every two to three hours during the day

4. Void immediately after sexual intercourse

5. Take medications exactly as prescribed

6. Shower rather than bathe in a tub

7. Cleanse perineum front to back

Renal calculi

1. Definition - presence of stones in the kidneys

2. Etiology

a. causes:

i. hypercalcemia

ii. hypercalciuria

iii. chronic dehydration

iv. high purine diet (organ meats, yeast, etc.)

v. cystinuria (genetic disorder)

vi. chronic infections (proteus vulgaris)

vii. chronic obstruction with urinary stasis

viii. environmental factor: living in a warm, humid climate

b. epidemiology

i. more prevalent in men

ii. can be anywhere in the urinary system

iii. peak age of onset is 20 to 30 years of age

iv. spontaneous passage occurs in 80% of patients

v. calculi can lodge and cause obstruction. Common sites are:

• bladder neck

• renal pelvis

• ureters

vi. often recur in patients with history of two or more stones

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Genitourinary Disorders A. Urinary tract infections (UTI) 1. Infections, by various agents, of parts of the urinary system 2. Etiology a. causative agent enters via urinary meatus b. women are more susceptible c. can be caused by poor voiding habits d. in women, acute infection caused most often by Escherichia coli e. in men, cause is usually obstructive abnormalities 3. Findings a. dysuria, frequency, urgency, nocturia b. suprapubic pain c. Findings of hematuria 4. Diagnostics a. urine dipstick b. urine microscopy c. urine culture 5. Management a. antimicrobial therapy as indicated: b. in uncomplicated infection: i. co-trimoxazole (Bactrim) ii. ofloxacin (Floxin) iii. nitrofurantoin (Macrodantin) c. in complicated infection: i. oral antimicrobials as ordered ii. IV antimicrobials may be indicated 6. Complications a. pyelonephritis b. sepsis 7. Nursing interventions a. assess: i. history of urinary tract infections (UTIs) ii. voiding habits, personal hygiene, contraceptive methods iii. history of vaginal discharges, itching, irritation, dysuria b. manage pain: i. systemic analgesics and ii. urinary analgesics/antispasmodics c. client teaching i. preventive measures • in the female client, discuss voiding after intercourse ii. nutritional considerations • increase water intake • avoid coffee, tea, alcohol, and colas (carbonated and noncarbonated) Page 29 of 51 pyelonephritis Inflammation of the kidney and renal pelvis, usually as a result of a bacterial infection tha ...
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