Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 9 Genitourinary System^387



  • Chills

  • Frequency, urgency, dysuria due to urinary tract infection

  • Nausea, vomiting, and diarrhea due to infection

  • Increased heart rate due to fever

  • Costovertebral angle (CVA) tenderness


INTERPRETING TEST RESULTS



  • Urinalysis shows leukocytes, bacteria, nitrites, and red blood cells; may see
    white blood cell casts.

  • Urine culture identifies organism.

  • Sensitivity shows which antibiotics the organism is most responsive to.

  • CBC shows leukocytosis.


TREATMENT



  • Administer antibiotics to treat infection—intravenous or oral depending on
    severity of infection and comorbidities of patient:

    • nitrofurantoin

    • ciprofloxacin

    • levofloxacin

    • ofloxacin

    • trimethoprim-sulfamethoxazole

    • ampicillin

    • amoxicillin



  • Administer antipyretics for fever.

  • Administer fluids for dehydration due to vomiting and diarrhea.

  • Administer phenazopyridine for relief of dysuria symptoms.

  • Repeat urine culture after completion of antibiotic course.


NURSING DIAGNOSIS



  • Impaired urinary elimination

  • Nausea

  • Hyperthermia

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