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What are some elimination problems?
- Congenital malformation of the urinary tract
- Urolithiasis (renal and uretereal calculi)
- Cystitis
- Pyelonephritis
- Glomerulonephritis
- Benign prostatic hyperplasia
- Urinary diversions
- Acute/chronic renal failure
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Urolithiasis
- Kidney stones; stones in ureter
- -Hematuria, WBCs, and bacteria in urine
- -very painful
- -N/V
- -sweating, chills, fever
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How do you treat kidney stones / stones in ureter?
- Avoid overhydration or underhydration to decrease pain while peassing the stones
- Sttrain urine and check pH of urine
- Manage diet
- -low calcium / vitamin D
- -low sodium (sodium increases calcium in urine)
- -low oxalate
- -decreased purine meats
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What is a dietary oxalate?
- Spinach
- Cola
- Tea
- Chocholate
- Wheat germ
- Peanuts
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What is pyelonephritis?
Inflammation of the kidney caused by bacterial infection
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What is glomerulonephritis?
Damage to the glomerulus caused by an immunological reaction that results in proliferative and inflammatory changes within the glomerular structure
- usually caused by group A beta hemolytic streptococcal infection found elsewhere on the body (URI, skin infection); clamydia, pneumococcal, mmycoplasma or klebsielle pneumonia, autoimmune diseases (i.e SLE, beta-hemolytic streptococcal infection elsewhere in the body)
-occurs 10 days after a skin or throat infection
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How do you treat glomerulonephritis?
- Administer medications to eliminate infection,
- Alter immune balance to alleviate inflammation,
- Treat volume overload and HTN
- Antibiotics
- Corticosteroids
- Anti-HTN
- Immunosuppressiveagents
- Diuretics
Dialysis (uremia) or plasma electrophoresis if renal failure develops (antibody removal)
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What is BPH?
- Benign prostatic hyperplasia - enlargement of the prostate gland; causes urinary flow obstruction, incontinence, possible infection
- -dribbling, weak urinary stream
- -frequency, urgency, dysuria, nocturia
- -hematuria before or after voiding
- Increase in size with age (over 50)
- BUN and Creatinine
- PSA - prostate-specific antigen
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How do you treat BPH?
- MEDICATIONS
- 5-alpha reductive inhibitor
- Alpha-blocking agent
- SUPRAPUBIC CYSTOSTOMY - opening into bladder, drainage via catheter through abdominal wall (temporary measure divert urine)
- -covered with sterile
- -connected to sterile drainage system
- -to test ability to avoid, clamp catheter for 4 hours, have client void, unclamp catheter and measure residual urine; if residual is less than 100ml on 2 occasions (morning and evening), catheter is removed
- -after removal of catether, sterile is placed over site
- PROSTATECTOMY
- 1. Transurethral (TURP)
- 2. Suprapubic resection (through bladder)
- 3. Retropubic resection (through abdomen)
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