UTI

-does not require treatment unless pregnant

• Ecoli
• or candida albicans

the narrow area where each ureter joins the renal pelvis

where the ureters insert into either side of the bladder base

sepsis with an origin of the urinary tract

• urnine ph
• complete bladder empty
• hydration

cant go

no urine at all

painfull pee

pus

cant go at all

trouble emptying

6x a day, more than 8 is not

kidneys and ureter

• fever
• chills
• flank pain

pyelonephritis(kidney infection)

upper

bladder and urethra

• dysuria, frequency, urgency, retention, hesitancy, suprapubic pain
• hematuria
• cloudy urine
• usually no systemic manifestations

cystitis(bladder infection)

• -absent
• -confusion
• -non localized abdominal pain

inflammation of the kidney, renal paracheyum and collecting system

• bacteria
• obstruction
• UVJ system

• -mild fatigue
• -fever
• -sudden onset of , chills, N/V, flank pain
• -can include LUTS

ascends from LUTS

• - UA w/ culture
• -CBC
• -CT

• -antibiotics, empiric first
• - antipyretic, analgesic

empiric broad spectrum antibiotics until sensitivity comes back

• -trimethoprim/sulfamethoxazole(TMP/SMX)
• Bactrim/septra
• -Nitrofurantonin
•  Macrodantin, macrobid

• - treat uncomplicated or initial UTI
• -cheap, BID
• -E COLI RESISTANT, SULFA ALLERGIES

• - UTI
• -pulmonary sensitivity(flu like S/S)
•  Neuropathies
•  photosensitivities
•  turn pee brom
•  change stool color
• -monitor I&O

• -combo w/ AB, soothing on urinary tract mucosa
• - urine turns red
• -OTC

highly concentrated urine to crystal formation

• -dehydration
• -summer months
• - immobility
• -genetics
• -diet
• -whites
• -age 20-55
• -men

• calcium phosphate
• calcium oxiate
• uric acid
• cysteine
• struvite

throughout the urinary tract

chronic, painful inflammation of the bladder

unknown

• -similar to lower UTI
• -suprapubic pain
• -urgency and frequency(60x/day)

• rule out similar disorders
• neg urine culture during period of active s/s
• no response to AB

• -water
• -otc dietary prelief
• -bladder instillations
• -antidepressant

more chronic

alkalizes the urine

calcium oxylate

• metabolic
• climate
• diet
• genetic

• -Severe flank/ lower abdomen pain
• -sudden onset
• -N/V

less than 4mm can pass on their own

UPJ and UVJ

pain may be absent

place hand over the kidney and tap on hand

• -a adrenergenic blocker for stones
• - relax ureter and allow stones to pass

• -opioid and NSAIDS
• -flowmax
• -3L/day of fluids, don't over fluid

• cystoscopy
• ureteroscopy
• lithotripsy

passed through urethra into bladder to asses bladder and remove small stones

-crush and pass

inserted via cytoscope to ureter to remove stones from renal pelvis and upper urinary tract

shock waves pulverize the stone

-pass it or surgically removed

• -bladder outlet obstruction(prostate, tumor)
• -deficient detrusor muscle contraction

• - neuromuscular disease
• DM
• over distention
• chronic ETOH

Chronic: incomplete emptying

Acute: total inability, MEDICAL EMERGENCY

50-75ml

over 200 ml

tamsulosin-Flomax

relaxes smooth muscle of the urethra

• stress
• urge
• overflow
• reflex
• functional

• stress and urge
• pregnancy

overflow due to urinary retention from prostate

• -cough.sneeze, laugh
• -sudden, overactive
• -retention
• -neuro problem
• -physical, get lost, dementia,

• caused by sudden increase in intra abdominal pressure
• -SMALL amt of leakage

• caused by uncontrolled contraction of detrusor muscle
• LARGE amt of leakage

• -kegals
• -penile clamp
• -weight loss
• -smoking
• -reduce caf/alcohol

• -pelvic floor muscle excersise
• - decrease dietary irratants
• -condom cath, female pads

• Ditropan/oxybutynin
• anticholenergenic drugs

• anticholenergenic
• relax bladder muscle

• underactive detrusor muscle or bladder outlet obstruction
• -SMALL amt leakage
• -over distention of the bladder overcomes sphincter control

• prostate
• DM neuropathy
• urethral sticture

• bladder remains distended and palpable
• following anesthesia/surgery of lower abdomen

• cath
• PVR
• crede or valsalva maneuver
• -surgery

urecholine/bethanechol- enhance bladder contractions

flowmax/tamsulosin- to relax muscles in prostate and bladder so urine can flow

• enhance bladder contractions
• -OVEFLOW INCONT

to relax muscles in prostate and bladder so urine can flow

OVERFLOW INCONT

neuro impairment or spinal cord lesion above s2

-no warning or stress

self cath

diazapem/valium to relax external sphincter

cog, functional or enviornmental

any type of bladder dysfunction r/t abnormal or absent bladder innervation

• -xray of kidney, ureters and bladder
• -id large radiopaque stones
• -shows size, shape and position

• -intravenous pyelogram
• -xray visualization of urinary tract after iv injection of contrast medium

• asses for iodine allergy
• dye is nephrotoxic

• -cathartic or enema pm prior
• -npo 8hrs prior
• -may cause warmth, flushed face, salty taste
• -force fluids post dye

cath inserted into femoral artery and passed up aorta to renal arteries. contrast dye to outline renal blood supply

visualize and diagnos renal vascular problems

• same as IVP
• observe for bleeding at site
• bedrest and keep affected leg straight
• check peripheral pulse q30-60min
• obsrve for thrombus, hematoma, inflamation

• 0-18
• 0-4
• 0-5
• diabetes
• diabetes
• liver
• upper uti/renal dysfunction
• uti

confirms UTI and ID specific org

• bacterias suceptability to AB
• HCP to see most effective AB

• blood urea nitrogen
• 6-20 mg/dl

-id presence of renal problems because urea is excreted by the kidneys

• -elevated w renal disease
• -can be from non renal factors like infection, fever, trauma

• malnutrition
• liver disease

• 0.6-1.3
• more reliable than BUN as an indicator of renal disease

• elevated with renal disease
• may also be elevated with RA, hyperthyroid, muscle disease

end product of muscle and protein breakdown and released at a constant rate