急性肾盂肾炎幻灯ppt课件
感染 途径
直接感染 淋巴感染
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Defence mechanism
尿路通畅时尿液能冲走绝大部分细菌
尿路粘膜可分泌IgG、IgA
尿液含高浓度尿素和有机酸,pH值低
男性排尿时前列腺液有杀菌作用
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Risk factors
Female:
Both:
➢Short, straight ureth➢raA; ging;
Assess the functional health status.
Determine priority nursing diagnoses and select nursing intervetions.
Plan and provide appropriate teaching for
prevetion and self-care.
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Nursing Assessment
Physical examination
(2)Acute Pyelonephritis 急性肾盂肾炎
➢ Vomiting;
➢ Diarrhea;
➢ Acute fever;
➢ Shaking chills;
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Nursing Assessment
Physical examination
Upper urinary tract infection
上尿路感染
(Pyelonephritis) (肾盂肾炎) UTI
Lower urinary tract infection
下尿路感染
(Cystitis/Urethritis )(膀胱/尿道炎)
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Route of infection
最常见
上行感染 血行感染
急、尿痛,于当地医院确诊为“左肾结石,肾盂肾炎”,给予静脉
滴注抗生素治疗(具体不详),情况缓解。后反复发作,平均每月
发作1次。期间多次接受“左肾结石碎石”治疗。
体检:T 38.8℃,P 98次/分,BP 125/80mmHg。左肾区有叩痛。
实验室检查:尿蛋白(+),亚硝酸盐阳性,白细胞脂酶(+++)
(2)Acute Pyelonephritis 急性肾盂肾炎
➢ Urinary irritation symptoms; ➢ Flank pain; ➢ Costovertebral tendernesment
Physical examination
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Situation
张女士入院当天傍晚叫来了护士,询问到“我和3 床的刘女士都得的是尿路感染,可是我们除了尿频、 尿急、尿痛差不多,别的表现都不一样呢?我发热还 腰痛,她却没有呢?你们会不会搞错啦?”
同学们,如果你是护士,你能帮助张女士解
除她的疑惑吗?你觉得是医生搞错了吗?
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Nursing Assessment
• Health History
– frequency,urgency,burning on urination
– color,clarity,and odor of urine
– other manifestations:
– duration of symptoms and any treatment
➢Proximity to vag➢inDaecarnedasaenoufs;defence;
➢Sexual in➢teUrcrionuarrsyet;ract obstruction;
➢Pregna➢nVcyesicoureteral reflux;
Male: ➢Genetic factors; ➢Prostatic hyper➢trCoapthhyeterization
(3)Asymptomatic bacteriuria 无症状细菌尿
➢ No urinary infection symptoms; ➢ True bacteriuria; ➢ Commonly found in pregnant women and elderly
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Nursing Assessment
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Overview
• 尿路感染(urinary tract infection,UTI) 是指各种病原微生物在尿路中生长、繁殖而引起的 炎症性疾病。
• Common in young women, and unusual in men under the age of 50.
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Classification
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Lecture 3
Nursing Care of Patients with a Urinary Tract Infection
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Learning Outcomes
Identify population at risk for UTI.
Explain the pathophysiology of UTI.
中段尿培养:大肠埃希菌。
B超:左肾多发性结石。
入院诊断:尿路感染。入院后给予碳酸氢钠碱化尿液、静脉滴注
美罗培能治疗。由于病情反复发作,患者情绪不佳。
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Thinking
• What is urgent urination,frequency, and dysuria?
• Is nocturia(夜尿增多) the same as frequency?
Chapter 5
Nursing Care of Patients with Urinary System Disorder
医学与健康学院护理系 樊星
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Case Analysis
患者张女士,54岁。因反复发热,伴尿急、尿频、尿痛1年入院
,患者于1年前首次出现发热至39.0℃、伴左侧腰部疼痛,并有尿
– history of previous UITs and their frequency
– possibility of pregnancy
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Nursing Assessment
Physical examination
(1)Cystitis 膀胱炎
➢ Urinary irritation symptoms; ➢ Urgent urination,frequency,and dysuria ➢ Suprapubic discomfort;耻骨上不适 ➢ Hematuria;30% 血尿