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Renal & Genitourinary Disorders Worksheet

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NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Urinary Tract Infections
Urethritis
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Short urethra
predisposes women
-Close proximity of
urethra to rectum Decreased estrogen in
aging women leads to
urethral atrophy
-sexual intercourse,
hygiene sprays,
pregnancy, urinary
catheters can lead to
introduction of bacteria
to the urinary tract
causing infection
Infection induced
inflammation of the
urethra Infectious or due
to post trauma Typically
caused by STD
Clinical
Manifestations
Diagnostic Tests
-Lower back or
abdominal
discomfort over
bladder
-Urinary frequency
and urgency
-Dysuria, bladder
cramping and
spasms
-feeling of
incomplete bladder
emptying
-Hematuria
-Pyuria, fever
-vomiting
-cloudy urine
- Elders→ confusion
Frequently
asymptotic
-Urinalysis and
urine culture and
sensitivity
-Client must clean
catch urine
-Bacteria, sediment
and WBC would be
expected findings
-WBC count -STI
testing
Yellow, brown,
green or bloodtinged discharge
Dysuria, itching,
orchialgia
(heaviness in
genitals-male)
Nursing Interventions and
Collaborative Management
-Teaching proper technique
for collection of clean
-catch specimen -Promote
fluid intake 3L
-Administer antibiotics as
prescribed
-Encourage urination every
3-4 hours instead of
waiting until bladder is
completely full
-Encourage showers daily
-Avoid indwelling U-Cath
-Educate on medications/
antibiotics
Possible Complications
and
Treatments/Interventions
for Complications
-Complications:
obstruction,
pyelonephritis, chronic
kidney disease, septic
shock
-Consult with urology
-Urethral culture
urethral smear
-Purulent urethral
discharge shows
evidence of
urethritis
- STD testing
-Treat with antibiotic
therapy if contracted due
to STD
- Spontaneously resolves
over time
-Have patient avoid
intercourse with multiple
partners as well as
unprotected sex
Complications are
uncommon but they do
exist:
-cystitis
-orchitis
-prostatitis
-epididymitis
-urethral stricture
-Consider urology consult if
recurring
1
NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
Diagnostic Tests
Nursing Interventions and
Collaborative Management
Possible Complications
and
Treatments/Interventions
for Complications
-Follow up care for those
who appeared
symptomatic
Acute Pyelonephritis
-Bacterial invasions of
the renal parenchyma
-Bacteria typically
reaches the kidneys by
ascending the lower
urinary tract
-Fever
-Costovertebral
angle pain
-Nausea/vomiting
-Hematuria
(typically women)
-Elderly
-mental status
change, generalized
deterioration
-Urinalysis through
-Dipstick leukocyte
esterase test (ET)
pyuria
-Nitrate production
test (NPT)
bacteriuria
-CT scan MRI
Antibiotic therapy
(outpatient)
Complicated pyelonephritis
should be managed as
inpatient and treated with
parenteral antibiotics
Monitor urine and blood
culture results
Maintain adequate
hydration
Sepsis
Renal vein thrombosis
Papillary necrosis
Acute renal failure
Emphysematous
pyelonephritis
Surgery if drainage is
necessary due to abscess
Immediate urologic referral
for pediatric patients
Obstetricians consult for
pregnant patients
2
NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
Chronic Pyelonephritis
Renal inflammation and
fibrosis induced by
persistent renal infection
or urinary tract
obstruction Can be
caused due to
neurogenic bladder
dysfunction, risky sexual
activity, pregnancy,
genetic factors, and
bacterial virulence
factors
Most common in children
with major anatomical
anomalies (VUR)
Cause of interstitial
cystitis unknown but may
be due to a defect in the
epithelium of the bladder
May be associated with
chronic pain disorders
such as fibromyalgia or IB
Fever lethargy
nausea/vomiting
flank pain dysuria
Cystitis/Interstitial
Cystitis/Painful Bladder
Syndrome
Pelvic pain
Pain between anus
and vagina/scrotum
Persistent/urgent
need to urinate
Frequent small
urination amounts
Pain during
intercourse
Diagnostic Tests
Ultrasound
CT scan
Pelvic exam Urine
test
Cystoscopy
Bladder biopsy
Nursing Interventions and
Collaborative Management
Possible Complications
and
Treatments/Interventions
for Complications
Antibiotic therapy for kids
until they hit puberty if
urine reflux is occurring
Renal injury can be
reduced with protein
restriction
Monitor renal function
Stress importance of
adhering to antibiotic
therapy
Surgery is suggested for
those with persisting
reflux after puberty
Treatment based around
alleviating symptoms
NSAIDS Antihistamines
may relieve urinary
frequency and urgency
Tricyclic antidepressants
can help relax the bladder
and block pain
Acute Renal failure
Hematuria
Chronic or recurrent UTI
Candidemia
Sepsis
Bladder rupture
Dietitian to help
understand a low
protein diet
Observe for progressive
renal scarring as it may
lead to end stage renal
disease
Consult a social worker or
therapist to help patient
deal with emotional stress
and depression from
chronic pain Physical
therapy may help alleviate
3
NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
Diagnostic Tests
Nursing Interventions and
Collaborative Management
Possible Complications
and
Treatments/Interventions
for Complications
pelvic pain TENS and sacral
nerve stimulation
Kidney Cancer
Bladder Cancer
Mutations in the DNA of
kidney cells causing the
abnormal cells to rapidly
reproduce forming a
tumor. Factors include
smoking, obesity,
hypertension, dialysis
patients, family history,
and old age
One of the most common
cancers affecting men
more than women.
Frequently develops in
the urothelial cells that
line the bladder.
Mutated cells form a
tumor and can be caused
by smoking, parasitic
infections, radiation
exposure, and chronic
irritation in the lining of
the bladder
Hematuria Back
pain Anorexia
Unexplained weight
loss Fatigue Fever
CT scan MRI Kidney
tissue biopsy
Blood/urine test
Cryoablationfreezes cancer cells
Radiofrequency
ablationused to
heat and burn
cancer cells
Radiation therapy
Immunotherapy
drugs
Hematuria
Pelvic pain
Painful urination
Back pain Frequent
urination
Cystoscopy Bladder
biopsy Urine
cytology CT scan,
MRI, and bone
scans can
determine the
extent of the nodes
Surgery is the main
treatment to remove the
tumor or affected area of
the kidney Treat and
alleviate symptoms Help
patient understand their
diagnosis and provide
comfort and an
opportunity to listen to the
patient’s feelings
Support groups help
patients and their families
to cope with this diagnosis
Provide coping and support
for the patient Provide
information for support
groups Alleviate symptoms
of cancer treatment
regimen and for
symptomatic pain
Hypertension
Hypercalcemia
High red cell blood count
Liver and spleen
problems
Spread of the cancer
Death
Anemia
Swelling of ureters
Urethral stricture
Collaborative:
Chemotherapy Radiation
therapy Immunotherapy
Surgical removal of tumor
Bladder reconstruction for
4
NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
Diagnostic Tests
Nursing Interventions and
Collaborative Management
Possible Complications
and
Treatments/Interventions
for Complications
new release of urine
Mental health counseling
Urinary Incontinence
Urinary Retention
Urethral Diverticula
The loss of bladder
control. Can be
categorized as stress,
urge, or functional
incontinence. Can be
caused by underlying
physical or medical
conditions, pregnancy,
obstruction, prostate
cancer, neuro disorders,
or temporary based on
certain foods/drinks
stimulating the bladder
Bladder retention due to
infection, neurogenic
bladder, prostate
enlargement, post-op
etc.
outpouching forms next
to urethra
Stress- urine
leakage when
pressure exerted on
the bladder by
coughing, sneezing,
laughing UrgeIntense sudden urge
to urinate followed
by involuntary urine
loss Functionalphysical or mental
impairment that
keeps you from
making it to the
toilet
Unable to fully
empty bladder. May
not be able to void
at all or only small
amounts.
-dysuria
-frequency
-urgency
-pain with sex
-dribbling after
voiding
Urinalysis Bladder
diary
Post-void residual
measurement
Cough stress test
Treatment is based on type
of incontinence Bladder
training Scheduled toileting
Double voiding
Explain importance of selfcare hygiene to reduce the
possibility of skin
breakdown and infection
Anticholinergics can help
to calm an overactive
bladder
Skin problems: rash, skin
infections, sores
Bladder scan
-insert straight Cath
-insert foley Cath
-strict I&Os
Extended bladder =
urine leaking
UTI
Kidney damage
-urologist
-surgeon
-Primary care provider
-Voiding
-foley care
cystourethrography -suprapubic catheter care
-ultrasound
-administer meds as
-MRI
ordered
Urethrovaginal fistula
-surgeon
5
NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
Diagnostic Tests
-recurrent UTIs
Renal Tuberculosis
Glomerulonephritis /
APSGN
Nephrotic Syndrome
human tubercle bacillus,
M. tuberculosis, bovine
tubercle bacillus, M.
bovis
Immune mediated
kidney disorder due to
genetic factors or other
health disorders like
Lupus or diabetic
nephropathy
-acute usually occurs
after an infection Chronic is insidious (2030y)
Caused by damage to the
clusters of small blood
vessels in the kidneys
causing them to excrete
too much protein in the
urine
Vague, rarely show
regular TB
symptoms
Repeated UTI,
increased urinary
frequency -Dysuria,
flank pain
Nursing Interventions and
Collaborative Management
Possible Complications
and
Treatments/Interventions
for Complications
-urologist
PPD CBC
Erythrocyte
sedimentation rate
Serum chemistry
CPR
Anorexia, Nausea
Dysuria, Oliguria Fatigue
Hypertension,
difficulty breathing Crackles, S3 heart
sounds -weight
gain, cola colored
urine
Urinalysis GFR- will
be decreased
Blood, skin, throat
cultures serum
blood urea
Antistreptolysin-O
Electrolytes
Edema around eyes,
ankles, and feet
Foamy urine Weight
gain due to fluid
retention Fatigue
Anorexia
Urinalysis Kidney
tissue biopsy
Serum creatinine
and blood urea
Blood protein
albumin levels
- Strict I & O, fluid therapy,
goal is to preserve renal
function -Management of
comorbid disorders Complication: infertility,
superinfection, renal
hypertension
Nephrologist
-Radiology
-Surgeon
Coordinate care to
conserve client energy
Administer antibiotics as
ordered Monitor
respiration status Monitor
fluid and electrolytes
Treat underlying medical
condition Diuretics, ACE
inhibitors, and statins to
decrease symptoms
Calcium deposits in the
kidney
Deterioration of kidney
function
Hypertension
Development of cellular
changes called
keratinizing squamous
metaplasia
Acute kidney failure
High blood pressure
Nephrotic syndrome
Blood clots
Acute kidney injury
Infections
Chronic kidney injure
Dietitian to assist patient in
choosing lean protein,
6
NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Urinary Tract Calculi
Stricture
Ureteral
Urethral
Nephrosclerosis
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
Diagnostic Tests
Calculi/stones can
develop in the urinary
tract when the bladder
does not empty
completely and urine
crystals form.
Obstruction, infections,
and conditions affecting
the bladder's ability to
hold urine can be a cause
of stone formation
Lower abdominal
pain, Hematuria
Burning during
urination Cloudy or
abnormally dark
urine
Physical exam
Urinalysis CT,
ultrasound, XRAY
scarring that narrows the
tube that carries urine
out of your body that
then restricts the flow of
urine from the bladder
urinary retention
hesitancy
urgency
-endoscopic
examination
-radiology imaging
- ultrasound
Progressive kidney
damage as a result of
uncontrolled
hypertension
-Loss of appetite
- Nausea
-Vomiting
- Itching
-Confusion
Renal biopsy
Blood test
Nursing Interventions and
Collaborative Management
reducing fat and
cholesterol in diet, and low
sodium diet
UTI’s and chronic bladder
dysfunction can develop if
calculi aren’t expelled.
Encourage patient to drink
plenty of fluids
Surgical removal of stones
is needed if they cannot
pass on their own
Cystolitholapaxy can be
used as a laser is inserted
with a cystoscope and
breaks calculi into smaller
pieces to pass
- catheterization
-monitor I&Os
surgeon
urology
Monitor fluid and
electrolytes
Monitor I&O
Administer ace inhibitors
Possible Complications
and
Treatments/Interventions
for Complications
Urinary fistula
Extravasation
Urosepsis
Ureteral scarring and
stenosis
Voiding and storage
issues
Acute urinary retention
Urethral carcinoma
Renal failure
Fournier’s gangrene
Bladder acontractility
Renal failure
Heart failure
Myocardial infection
Cardiologist
7
NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
Diagnostic Tests
Nursing Interventions and
Collaborative Management
Possible Complications
and
Treatments/Interventions
for Complications
Dialysis
Dietitian
Polycystic Kidney Disease
Acute Kidney Injury
inherited disorder in
which clusters of cysts
develop primarily within
the kidneys
-Sudden cessation of
renal function that
occurs when blood flow
to the kidneys is
significantly
compromised
High blood pressure
● Back or side pain
● Headache ●
feeling of fullness in
abdomen ●
Increased size of
your abdomen due
to enlarged kidneys
● Blood in your
urine ● Kidney
stones ● Kidney
failure ● Urinary
tract or kidney
infections
Ultrasound
CT
MRI
-FVO, edema Crackles, decreased
02, shortness of
breath
-Change in urine
output
-Serum creatinine
-BUN
-Urine specific
gravity
-Serum electrolytes
-Hematocrit
Monitor I&O
Monitor for signs of
infection
Monitor pain level
Monitor kidney levels
Cardiologist
Dialysis
Dietitian
-Identify, correct
underlying cause
-Monitor I & O strictly
-Review labs, report
abnormal, changes
-Assess for edema
Growth of cysts in the
liver
Pregnancy complications
Colon problems
Heart valve
abnormalities
Development of an
aneurysm in the brain
High levels of potassium
in the blood
Fluid in the lungs
Metabolic acidosis
8
NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Chronic Kidney Disease
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
-occurs abruptly
-Prerenal: occurs as
result of prolonged
volume depletion
-Intrarenal: occurs as a
result of direct kidney
damage
- lack of oxygen Postrenal: result of
bilateral obstruction
Progressive, irreversible
kidney disease
Can be secondary to
another disease process
-lethargy, muscle
twitching, seizures
-Dry skin,
Diagnostic Tests
-Urinalysis
-ABG
Nursing Interventions and
Collaborative Management
Possible Complications
and
Treatments/Interventions
for Complications
-restrict fluid intake
-assess for flank pain,
nausea, vomiting
-EKG
-Adhere and educate on
dietary recommendations
Dietician/ nutritionist Nephrologist
-fatigue
-high blood
pressure
-edema
-F&E imbalance
-changes in urinary
pattern
Bun
Creatine
GRF
Proteinuria
Monitor
I&Os
BP
Assess for edema
F&E status
Administer medications as
ordered (diuretics, BP,
another meds)
Gout
Metabolic acidosis
Bone disease
Heart disease
Hyperkalemia
Fluid build up
-dialysis
References: Gersch, Carolyn J., et al. Medical-Surgical Nursing Made Incredibly Easy! Wolters Kluwer, 2017.
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NR 325 Renal and Genitourinary (Urologic) Disorders – Worksheet
Student Name:
Date: 09/12/2021
Assignment Week/Day:
Please fill-up the columns below with major take-away or focus points for each topic/disorder. Review materials from previous courses such as Pathophysiology, etc.
Disorder/s
Etiology/Pathophysiology
(Possible Causative and
Risk Factors)
Clinical
Manifestations
Diagnostic Tests
Nursing Interventions and
Collaborative Management
Possible Complications
and
Treatments/Interventions
for Complications
Textbooks
Online Resources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241064/figure/i1524-5012-11-4-325-f01/
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