UTI and nephrotic syndrome

1. urge to emty bladder

2. antibacterial properties of urine and tract

3. uterovesical junction competence

4. peristaltic activity to push urine u

body’s defense mechanisms against UTI: [4]

urethra is shorter (anatomy)

why are girls more suseptible to UTIs?

Urinary catheters, especially in and out, pose greater risk for infection (forein body). Need good catheter care to minimize the risk

how can urologic instrumentation increase risk for UTI?

usually around 6.0

pH of urine

intercourse promotes milking of bacteria from perineum and vagina

how can sex cause UTI

if there is a prior injury to the urinary tract

how can UTI result from hematogenous route?

recurrent

UTI that keeps coming back. some people are more prone

persistent

UTi when someone is taking antibiotics but there is still bacteria in the urine

Febrile

UTI accompanied by fever:

1. poor feeding

2. not gaining weight

3. vomiting

4. frequent urination

UTI S+S in neonate [4]

1. can have distended belly

2. severe diaper rash from bacteria in urine sitting in diaper

3. foul smelling urine

4. vomiting

5. fever

UTI S+S in infants:

1. frequency

2. pain

3. abdominal pain

4. bedwetting (accidents from urgency)

5. flank pain

6. dehydration (may stop drinking because it hurts to pee)

UTI S+S in older kids [6]

1. clean perineum

2. pee a little

3. pee in cup

clean catch method

u-bag

bag sticks like a sticker on perineum to collect urine.

suprapubic aspiration

needle inserted into the bladder to take urine sample

1. strip them down and chase with cup

2. fill diaper with cotton balls, take soaked cotton balls in a syringe to drain urine

tricks to get urine sample from toddler:

1. may see mucous or puss

2. can look hazy

how can urine from UTi look?

helps flush everything out. the more you pee the less painful it will be

why encourage lots of water wit a uti?

1. lots of fluids

2. voiding

3. full course of anitbiotics

4. pee after sex

5. wipe front to back

6. don’t hold

7. avoid tight clothing

8. cotton underwear

9. fully empty bladder

10. dont strain BMs

11. no bubble baths with chemicals

how to reduce UTIs:

Urine is acidic and cranberry juice is basic. PEe doesn’t burn as much. Can also get cranberry pills

how can cranberry juice help UTIs?

set up and make urine

filter to let things out into the urine

resonsibility of the glomurulus:

Damage to the glomerulus. Becomes permeable to proteins, proteinurea.

Albumin coming out through urine.

Nephrotic sydrom patho:

1. hyperalbuminurea

2. hypoalbuminemia

3. hyerlipidemia

4. edema, ascites

5. hypovolemia

Characteristics of nephrotic syndrome: [5]

Change in osmotic pressure in the capillaries, pulls fluid and causes edema.

fluid goes into the interstitial space

reason for edema in nephrotic syndrome:

Decreased immunoglobulins

why do patients with nephrotic syndrome have greater risk for infection?

when albumin decreases, liver is stimulated.

why do patients with nephrotic syndrome have hyperlipidemia?

gravity, lying flat. fluid can build up in the face. With movement and gravity they can open eyes

why is facial and eye edema worse in the morning?

•Normally impermeable to large proteins

•Becomes permeable to proteins, especially albumin

•Albumin lost in urine (hyperalbuminuria)

•Serum albumin decreased (hypoalbuminemia)

•Fluid shifts from plasma to interstitial spaces, leading to hypovolemia

changes to glomerular membrane in nephrotic syndrome; [5]

low sodum (already ahve edema)

diet for nephrotic syndrome

2+. Need to come back to hospital.

urine dip of how much protein means nephrotic syndrome has most likely relapsed?

corticosteroids for 6 weeks (prednisone)

treatment of choice for nephrotic syndrome:

1. weight gain and water retention

2. steroid rage

3. increased infection risk

side effects from steroids:

7-21 days

see symptoms of nephrotic syndrome improve after how long on corticosteroids?

1. albumin infusion 25%

2. halfway through albuin infusion, give diuretic

3. then finish infusino of albumin

4. watch vitals q15mins to catch if pressure bottoms out

Diuretic treatment for nephrotic syndrome:

1. corticosteroid

2. immunosupressant

3. diuretic

order of treatment fro nephrotic syndrome:

in the morning after peeing

best time to weigh

laying on BACK. Mark on skin with a marker to know where to measure next time

how to measure abdominal gerth: