CHAPTER 37 Nursing Care of Patients With Disorders of the Urinary System Maureen McDonald
KEY TERMS
LEARNING OUTCOMES 1. Explain the predisposing causes, symptoms, laboratory abnormalities, and treatment of urinary tract infections. 2. Explain the predisposing causes, symptoms, treatment, and teaching for kidney stones. 3. List risk factors and signs and symptoms of cancer of the bladder. 4. List risk factors and signs and symptoms of cancer of the kidneys. 5. Discuss nursing care for a patient with an ileal conduit or continent reservoir. 6. Explain the pathophysiology and nursing care for diabetic nephropathy, nephrosclerosis, hydronephrosis, and glomerulonephritis. 7. Describe the signs and symptoms for patients with acute kidney injury. 8. Describe the signs and symptoms for patients with chronic kidney disease. 9. Plan nursing care for patients with acute kidney injury. 10. Plan nursing care for patients with chronic kidney disease.
anuria (an-YOO-ree-ah) azotemia (AH-zoh-TEE-mee-ah) calculi (KAL-kyoo-lye) cystitis (sis-TY-tis) glomerulonephritis (gloh-MUR-yoo-loh-neh-FRY-tis) hemodialysis (HEE-moh-dy-AH-lih-sis) hydronephrosis (HY-droh-neh-FROH-sis) nephrectomy (neh-FREK-tuh-mee) nephrolithotomy (NEH-froh-lih-THAH-tuh-mee) nephropathy (neh-FROP-uh-thee) nephrosclerosis (NEH-froh-skleh-ROH-sis) nephrostomy (neh-FRAW-stoh-mee) nephrotoxins (NEH-froh-TOK-sins) oliguria (AW-lih-GYOO-ree-ah) peritoneal dialysis (PEAR-ih-toh-NEE-uhl dy-AL-ih-sis) polyuria (PAH-lee-YOOR-ee-ah) pyelonephritis (PY-eh-loh-neh-FRY-tis) stent (STENT) uremia (yoo-REE-mee-ah) urethritis (YOO-reh-THRY-tis) urethroplasty (yoo-REE-throw-PLAS-tee) urosepsis (YOO-roh-SEP-sis)
11. Discuss nursing care for a vascular access site. 12. Plan nursing care for patients on hemodialysis. 13. Plan nursing care for patients on peritoneal dialysis.
Disorders of the urinary tract involve the urethra, bladder, ureters, and kidneys. These disorders include infection, obstruction, cancer, hered- itary disorders, and metabolic, traumatic, or chronic diseases. Some disorders lead to chronic kidney disease (CKD) if not treated.
CHAPTER CONCEPTS
Caring Elimination Fluid and electrolytes Infection Teaching and learning
URINARY TRACT INFECTIONS
The urinary tract is a sterile environment. A urinary tract infection (UTI) is the invasion of the urinary tract by bacteria. UTIs are most often caused by an ascending infection, starting at the external urinary meatus and moving up toward the bladder and kidneys. Most UTIs are caused by the bacterium Escherichia coli , commonly found in feces. Other less common pathogens include Staphylococcus saprophyticus, Klebsiella spp., and Enterobacter . Lower UTIs include urethritis, pros- tatitis, and cystitis. Upper UTIs include pyelonephritis and ureteritis. UTIs are the most common health-acquired infection (HAI). People who have had a UTI often develop repeat infections. It is important that education on how to prevent repeat UTIs is provided.
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