KAPLAN - Elimination Problems

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  1. 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
  2. Urolithiasis
    • Kidney stones; stones in ureter
    • -Hematuria, WBCs, and bacteria in urine
    • -very painful
    • -N/V
    • -sweating, chills, fever
  3. 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
  4. What is a dietary oxalate?
    • Spinach
    • Cola
    • Tea
    • Chocholate
    • Wheat germ
    • Peanuts
  5. What is pyelonephritis?
    Inflammation of the kidney caused by bacterial infection
  6. 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
  7. 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)
  8. 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
  9. How do you treat BPH?
    • 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

    • 1. Transurethral (TURP)
    • 2. Suprapubic resection (through bladder)
    • 3. Retropubic resection (through abdomen)
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KAPLAN - Elimination Problems
KAPLAN - Elimination Problems
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