Risk factors for urinary infection after retrograde upper urinary lithotripsy: Implication for nursing.

ABSTRACT: There are needs to evaluate the risk factors for urinary infection after retrograde upper urinary lithotripsy, to provide insights into the management and nursing care of patients with retrograde upper urinary lithotripsy.Patients who received retrograde upper urinary lithotripsy with a Foley 20 urinary tube insertion from June 1, 2019 to December 31, 2020 in our hospital were selected. Patients were grouped urinary infection and no infection group according to the culture results of urine, and the clinical data of the 2 groups of patients were collected and compared. Single factor and logistic regression analysis were used to analyze the risk factors of urinary tract infection after retrograde upper urinary lithotripsy.Four hundred ten patients with retrograde upper urinary lithotripsy were included, of whom 62 patients had the urinary tract infection, the incidence of urinary tract infection was 15.12%. There were significant differences in the gender, age, diabetes, stone diameter, duration of urinary tube insertion and duration of surgery between infection and no-infection group (all P < .05). The Escherichia coli (62.90%) was the most commonly seen bacterial in patients with urinary tract infection. Female (odds ratio [OR]: 1.602, 95% confidence interval 95% [CI]: 1.132∼2.472), age >50 years (OR: 2.247, 95% CI: 1.346∼3.244), diabetes (OR: 2.228, 95% CI: 1.033∼3.451), stone diameter ≥2 cm (OR: 2.152, 95% CI: 1.395∼3.099), duration of urinary tube insertion ≥3 days (OR: 1.942, 95% CI:1.158∼2.632), duration of surgery ≥90 minutes (OR: 2.128, 95% CI: 1.104∼3.846) were the independent risk factors for the postoperative urinary tract infection in patients with retrograde upper urinary lithotripsy (all P < .05).The incidence of urinary tract infection in patients undergoing retrograde upper urinary lithotripsy was high, counteractive measures targeted on those risk factors are needed to prevent and reduce the postoperative urinary infection in clinical settings.

The effect of transcutaneous electrical nerve stimulation for pain relief during extracorporeal shock-wave lithotripsy procedure.

The purpose of this study was to investigate the effect of transcutaneous electrical nerve stimulation (TENS) for pain relief during extracorporeal shock-wave lithotripsy (ESWL) procedure. An experimental study with repeated measures design was used in this study. Fifty patients aged 20-65 years receiving ESWL treatment were used for this convenience sample. Two applications were used for each patient: one involving administration of TENS instrument for ESWL treatment and the other without TENS. For effective stimulation, 2 stimulator electrodes were placed paravertebrally at L1 and 2 near the lithotripter shock tube before ESWL. Blood pressure, heart rate, pain intensity, analgesic use, and side effects were measured every 10 minutes during the procedure and after the end of ESWL. Results showed that TENS application decreased patients' intensity of pain and amount of analgesic requests and, related to that, decreased the incidence of side effects and increased patients' satisfaction during ESWL. TENS application is recommended as a pain-relieving technique during ESWL.

Plan de cuidados estandarizados para pacientes con cirugía percutánea (nefrolitotomía) Aplicación en el programa informático Gacela / No disponible

La aparición de nuevas tecnologías trae añadida nuevas formas de abordaje quirúrgico. En el Hospital Universitario «Río Hortega» de Valladolid, desde el año 1988 se han tratado aproximadamente 780 pacientes con cirugía percutánea. Cirugía con abordaje percutáneo se definiría como el acto quirúrgico sobre la estructura, en este caso, renal y ureteral cuya vía de acceso o de entrada al órgano se efectúa a través de la piel, concretamente una nefrostomía. En nuestra Unidad, un 77% de los casos de cirugía percutánea es aplicada en el tratamiento de litiasis renales-ureterales cuando otros tratamientos fallan o no son factibles, por ejemplo litotricias fallidas, cálculos ureterales de mal abordaje, cálculos renales coraliformes, etc. También se aplica en tratamientos tumorales, endopielotomías, etc. A priori esta cirugía es de elección preferente por ser mínimamente invasiva. Por otra parte, la implantación del programa informático GACELA permite estandarizar los cuidados enfermeros, lo que facilita la creación de un plan de cuidados específico para este tipo de pacientes, ya que los diagnósticos y acciones cuidadoras descritas son comunes en un alto porcentaje de casos tratados (próximo al 100%).La taxonomía empleada en la descripción de diagnósticos enfermeros corresponde a la clasificación NANDA y las acciones se encuentran en la base de datos del programa GACELA (AU)

In the University Hospital «Río Hortega» in Valladolid, since 1988 approximately 780 patients have been treated with percutaneous surgery. Surgery with percutaneous approach would be defined as the surgical act on the structure, in this case, renal and uretheral, which access tract to the organ is carried out through the skin, precisely a nephrostomy. In our Unit 77% of the cases of percutaneous surgery it is applied in the treatment of renal lithiasis-uretheral when other treatments fail or are not feasible, for example unsuccessful lithotripsy, ureteral calculus of difficult approach, coralliform kidney calculis, etc. It is also applied in tumoral treatments, endopyelotomy, etc. A priori this surgery is of preferential choice because it is minimally invasive. On the other hand, the introduction of the GAZELLE computer program allows standardizing the Nursing Cares, what facilitates the creation of a specific cares plan for this type of patients, since the diagnoses and care actions described are common in a high percentage of cases treated (close to 100%). The taxonomy used in the description of nursing diagnoses corresponds to the classification NANDA and the actions are found in the database of the GAZELLE program (AU)

Planes de cuidados de enfermería en litotricia extracorpórea por ondas de choque / No disponible

El diagnóstico médico ya nos viene dado por el médico que lo remite a nuestra unidad, y es el de litiasis renal o ureteral y sus distintas localizaciones. Pero el diagnóstico enfermero es otro muy distinto, pues se basa en la conducta del paciente frente a la enfermedad y al tratamiento, y en otros factores que influyen negativamente o tienen la posibilidad de afectar perjudicialmente a la obtención de un resultado óptimo del tratamiento de ondas de choque. Para que las actuaciones de enfermería sean llevadas a cabo mediante un método científico y el resultado del tratamiento a lo más eficaz posible, hay que hacer en un principio la identificación de las alteraciones que presenta el paciente, es decir, hacer un diagnóstico, para posteriormente describir las actuaciones que se deben llevar a cabo según los diagnósticos, y finalmente hacer una valoración de los resultados obtenidos. Así, realizando el método científico mediante la NANDA, el NIC y el NOC, haremos los siguientes diagnósticos y actuaciones (AU)

No disponible

Planes de cuidados de enfermería en litotricia extracorpórea por ondas de choque / No disponible

El diagnóstico médico ya nos viene dado por el médico que lo remite a nuestra unidad, y es el de litiasis renal o ureteral y sus distintas localizaciones. Pero el diagnóstico enfermero es otro muy distinto, pues se basa en la conducta del paciente frente a la enfermedad y al tratamiento, y en otros factores que influyen negativamente o tienen la posibilidad de afectar perjudicialmente a la obtención de un resultado óptimo del tratamiento de ondas de choque. Para que las actuaciones de enfermería sean llevadas a cabo mediante un método científico y el resultado del tratamiento sea lo más eficaz posible, hay que hacer en un principio la identificación de las alteraciones que presenta el paciente, es decir, hacer un diagnóstico. Para posteriormente describir las actuaciones que se deben llevar a cabo según los diagnósticos, y finalmente hacer una valoración de los resultados obtenidos. Así, realizando el método científico mediante la NANDA, el NIC y el NOC, haremos los siguientes diagnósticos y actuaciones (AU)

The medical diagnosis or comes dice by the doctor who sends to our unit, and is a renal or ureteral litiasis and its different locations. But the diagnosis nurse is very different other, because it is based as opposed to on the conduct of the patient the disease and to the treatment, and in other factors that influence negatively or have the possibility detrimentally of affecting the obtaining of an optimal result of the treatment of shock waves. So that the infirmary performances are carried out by means of a scientific method and the result of the possible most effective treatment, it is necessary to make at first the identification of the alterations that presents the patient, that is to say, make a diagnosis. Later to describe the performances that are due to carry out according to the diagnoses, and finally to make a valuation of the obtained results. Thus, making the scientific method by means of the NANDA, the NIC and the NOC we will make the following diagnoses and performances (AU)

Management of the extracorporeal shock wave lithotripsy patient.

Over 2 million Americans experience kidney and urinary stone disease each year. Early treatments resulted in high mortality and morbidity rates. With the advent of extracorporeal shock wave lithotripsy less than 20 years ago, treatment for this disease has become far safer with more rapid recovery and fewer complications. The selection of patients eligible for extracorporeal shock wave lithotripsy is dependent on the location and size of the stones and the overall health of the patient. This article discusses the different treatment modalities used for stone disease and the different methods currently available for extracorporeal shock wave lithotripsy. Preprocedure preparation of the patient and postoperative care for this population is reviewed in detail.

[Precautionary education against extracorporeal shock wave lithotripsy complication].

The purpose of precautionary education against Extracorporeal Shock Wave Lithotripsy complication in urinary system is to help patients build knowledge, trust, and collaboration. The methods of the education include 1) group education--reading pamphlet which we specially provide and receiving regular information, 2) individual education--giving advice prior to treatment and something special to the patient's needs. Educational content include drinking water, physical adjustment and postural drainage. Three years clinical practice showed that precautionary education could reduce unnecessary complication after Extracorporeal Shock Wave Lithotripsy and it needs further attention in this field.

Improving quality of care based on evaluation of the Western Ontario Provincial Lithotripsy Program by patients and their families.

A survey is an effective method for evaluating quality of care and generating cost-effective ideas for quality improvement. This article describes a survey of 138 patients and their families to evaluate the quality of care provided by a regional lithotripsy program. Although patients and their families generally gave high ratings to the care they received, areas for improvement were documented. The results were ultimately used to support change in nursing practice and care of patients and their families. The survey process described incorporates principles of research, quality assurance, and quality improvement.

Mechanical lithotripsy.

Endoscopic lithotripsy is a procedure used for the removal of large stones in the common bile duct that cannot be removed after sphincterotomy. This procedure causes fragmentation of large stones, which allows easier retrieval of stones by other instruments such as balloons or baskets. There are currently two types of mechanical lithotripsy: one type uses an instrument called a mechanical lithotriptor, and the second type uses an electrohydraulic lithotriptor. This article focuses on mechanical lithotripsy. Since it is vital for the operator of this equipment to understand its function, assembly, disassembly, and maintenance, specific guidelines are provided.

Percussion after extracorporeal shock wave lithotripsy.

ESWL does not remove the kidney stone, but pulverizes it into tiny particles so that it can be excreted with the urine. Drainage and percussion treatment after ESWL helps excrete particles from the kidney to the ureter much more rapidly and with less trauma, pain, and blood urine, and fewer medications for pain are needed as the particles pass through the urine. Teaching the principles behind this treatment will lead to greater patient compliance and success.