What are the treatments for UTI?
- AntiMicrobials – Bactrim DS & Ciprofloxacin (Cipro)
- Antibacteria too (sulfonamide, fluoroquinolone, cephalosporin and penicillin) - BLADDER ANALGESICS –
1) Pyridium - turn urine orange
2) Macrobid - reduce bacteria - Antispasmodic
What are the PREVENTION/teaching for UTI?
- Female: Front to Back
- No bubble baths!!
- Cotton underwear (breathable)
- Void Before/After intercourse
- Hydration
- DRINK CRANBERRY JUICE
What are the assessment findings for UTI?
- Fever
- Dysuria
- Frequency & Urgency
- Gross hematuria
- Cloudy urine
- Malodorous/ bad odor
- SUPRAPUBIC tenderness
- COSTOVERTEBRAL tenderness
- Vital sings (tachycardia, hypotension = sign of urosepsis)
What is the S/S of UTI in elderly???
- Confusion
- NEW ONSET OF INCONTINENCE!!!!
- Loss of appetite
- Nocturia
What is kidney stones more common in?
More common in CAUCASIAN MEN in the SOUTH EAST U.S. in the SUMMER due to dehydration
What are the assessment findings of kidney stonesr??
- Severe pain: distention & obstruction of urine flow
- Colicky pain WITH N/V !!!
- Pallor/diaphoresis
- Location influences pain location
- Flank vs. Lower Abdominal/genital
- Hematuria!!!!
What are the Treatments for kidney stones??
Diagnosis:
1. Noncontrast CT scan
2. KUB (kidney-ureter bladder x-ray)
3. Ultrasound
(KUB, CT, Ultrasound)
Treatments:
1. 50% of stones <5mm will pass on their own!
“NAh! i Ain’t wAn’t no kidney stones!!!!” 2N’s and 2A’s
2. Narcotics: Morphine, hydromorphone (dilaudid)
3. NSAIDS: Toradol & Ibuprofen
4. Antiemetics: Odansetron/Zofran
5. Alpha-adrenergic blockers: Tamsulosin
6. IF it doesn’t pass 4-6 weeks or develops renal colic, N/V, or signs of UTI = Surgery!!!!
- Stone >10mm, severe obstruction & uncontrolled paisn = surgery
7. LITHOTRIPSY (!!) ( the shockwave thing to pass the stones)
What are the interventions of kidney stones???
- If it’s not too large, patient can: strain urine and Call for fever, chills, N/V, or pain.
- Kidney stones preventions (food related): Hydration, avoid caffeine, low sodium diet, increase intake of citrate, and decrease oxalate (chocolate & nuts)
What drugs cause diarrhea?
Iron (Fe), Antibiotics, and Laxatives
What are drugs that will help with diarrhea?
- Opiates (slow down GI motility):
- Paragoric
- Lomotil and Imodium - Adsorbents:
- Pepto-Bismol - Restores normal flora:
- Lactobacillus acidopillius (in yogurt and granules)
- Kefir (fermented milk)
What are the drugs that cause constipation?
“AAA, MA!!!”
1. ANALgesics: Opiods (narcotics) & NSAIDS!!
2. AntiCHOLINERGICS: Atropine, Anti-psychotics, anti-depressants, Anti-Parkinson’s
3. Antihypertensives
- Minerals: Aluminum (antacids), Iron, Calcium, and Barium
- AntiCONVULSANTS, antiHISTAMINES!!
What are the assessment findings of Bladder cancer???!!!!
1.***PAINLESS HEMATURIA!!!
2. Frequency, Urgency, and Nocturia
What are the treatments for Bladder cancer???!!!!
Removal of bladder and using ostomies instead!
What are interventions for urinary issues???
Health Promotion:
1. Patient education
2. Promoting normal micturition (peein)
3. Promoting complete bladder emptying
4. Preventing infection
Acute Care Setting:
1. Catheterization
2. Suprapubic catheter
3. Texas/condom catheter
4. Urinary diversion
5. meds
Continuing/Restorative Care:
1. Lifestyle changes
2. Pelvic floor muscle training (KEGEL)
3. Bladder retraining
4. Toileting schedules
5. Intermitten catheterization
6. Incontinence-associated dermatitis prevention
What nursing care should you do for condom catheter??
- Assess area
- Assess LATEX allergy
- Take in spiral direction
- Leave 1-2 inches of space
- Make sure tubing is not kinked
What are the S/S of fecal impaction??
- Liquid stool in small amounts
- Frequent urge w/o BM
- Anorexia, N/V
- Abd. distention & cramping
- Digital exam: you can feel the Large hard mass
What is the fecal impaction removal procedure?
Requires DR. Order!!!!!!!***
1. Oil retention enema, allow to remain in for awhile to soften
2. Soap Suds Enema (SSE) or normal saline
3. Digital removal (gently break up the stool w/ your gloved & lubricated finger) & WATCH for VAGAL response!!
What medications help with constipation??? (What are the 5 laxatives classifications)
- Osmotic/Saline laxative:
1) Lactulose
2) Milk of Magnesia (magnesium hydroxide)
3) Fleet Phospho-Soda - Contact/Stimulant/Irritant:
1) Bisacodyl (bisa kok :))
2) Senna tablets
3) Castor oil - Bulk-forming (Fiber):
1) Psylium
2) Methyl-cellulose - Emollients (lubricants):
1) Stool softeners; decussate sodium
2) Mineral oil - Bowel prep/evacuant:
1) CoLye, GoLYTELY
What are the 3 types of enemas?
- Small volume enemas:
1) Osmotic enema: Fleets Phospho-Soda
2) Oil retention enema - Cleansing:
1) Tap water (TWE)
2) Saline (NS)
3) Soap Suds (SSE)
4) “Enema Till Clear”
5) Milk & Molasses (M&M)
