RENAL (1)

1
Renal and Urologic System Disorders
2

• Impaired Gas Exchange R/T Urinary Tract
  Infection, Secondary to Urosepsis
• Signs and Symptoms
• Appears sleepy and lethargic
• RR 22
• Fine crackles audible on auscultation in the
  bilateral lower lung fields

3
Impaired Gas Exchange R/T Urinary Tract
Infection, Secondary to Urosepsis

• Goals/Desired Outcomes
• Client will experience adequate O2/CO2 exchange
  as evidenced by
• Usual mental status
• Unlaboured respiratory rate within normal limits
  (12-20 per minute)
• Clear chest sounds audible on auscultation

4
Impaired Gas Exchange R/T Urinary Tract
Infection, Secondary to Urosepsis

• Nursing Interventions
• Monitor clients behaviour and mental status.
• Assess respiratory status, particularly,
  respiratory rate, depth and effort.
• Continuously monitor oxygen saturation via
  oximetry.
• Collect and monitor arterial blood gases (ABGs).
• Position client with head of bed elevated, in
  semi-Fowlers (head of bed at 45 degrees in
  supine position.

5
Impaired urinary elimination (incontinence) r/t
Urinary tract infection

• Signs and Symptoms
• Scanty urine
• Dysuria
• Pyuria
• Abdominal tenderness
• Bilateral Flank pain

6
Goals
Client able to empty bladder

• Outcome criteria
• Urine output within normal range
• No signs of fluid retention
• No abdominal distension

7
Nursing Interventions

• Monitor vital signs, intake and output, mental
  status, urine characteristics, skin turgor,
  edema.
• Provide bedpan, assistance during toileting,
  ample amount of time to complete emptying the
  bladder
• Space fluid intake evenly and avoid
  caffeinated/alcoholic beverages

8

• Limit the use of indwelling catheter and provide
  incontinence care
• Administer medications such as antibiotics
  (Incontinence is common in elderly clients with
  UTI)

9
Health Promotion Strategies

• Instruct the client to practice the following
  preventative measures
• Know the causes
• Meticulous cleaning of perineal region
  
• Maintain adequate fluid intake (1oz. per kg of
  body weight per day)
• Empty your bladder completely, or as soon as you
  feel the urge, or at least every 3 hours
• Consume foods high in vitamin C
• If you suspect that you contracted a urinary
  tract infection, notify doctor immediately and
  follow prescribed treatment.

10
Drug Study

• Generic Name Ceftriaxone Sodium
• Brand Name Rocephin
• Class B-lactam Antibiotic, Cephalosporins 3rd
  gen.

11
Mechanism of Action

• Bactericidal
• Indications
• Urinary tract infection and Septicemia

12
Contraindication

• Allergy to cephalosporins and penicillins.
• Use with caution in renal failure
• Dosage
• 1 gram IVPB qAM
• Pharmacokinetics

Route Onset Peak Duration
IV Rapid Immediate 15-18 hours
13
Half life

• 5-10 hours
• Excretion
• Bile and urine

14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
(No Transcript)