Hematuria

Toxicology. The acute oral and dermal toxicity of naphthalene is low with LD q values for rats from 1780—2500 mg/kg orally (41) and greater than 2000 mg/kg dermally. The inhalation of naphthalene vapors may cause headache, nausea, confusion, and profuse perspiration, and if exposure is severe, vomiting, optic neuritis, and hematuria may occur (28). Chronic exposure studies conducted by the NTP ia mice for two years showed that naphthalene caused irritation to the nasal passages, but no other overt toxicity was noted. Rabbits that received 1—2 g/d of naphthalene either orally or hypodermically developed changes ia the lens of the eye after a few days, foUowed by definite opacity of the lens after several days (41). Rare cases of such corneal epithelium damage ia humans have been reported (28). Naphthalene can be irritating to the skin, and hypersensitivity does occur. 

Renal—hematuria, cystitis, elevated blood urea nitrogen, polyuria, dysuria, oliguria, and acute renal failure in those with impaired renal function... 

The adverse reactions seen with penicillamine include pruritus, rash, anorexia, nausea, vomiting, epigastric pain, bone marrow depression, proteinuria, hematuria, increased skin friability, and tinnitus. Penicillamine is capable of causing severe toxic reactions. 

The nurse should immediately report evidence of bleeding in any patient receiving heparin bleeding gums epistaxis (nosebleed), easy bruising, black tarry stools, hematuria (blood in the urine), oozing from wounds or IV sites or decrease in blood pressure. 

Fever, rash, paresthesias, photosensitivity, crystalluria, acidosis, urticaria, pruritus, hematuria, weakness, malaise, anorexia, hematologic changes, convulsions... 

Hot flushes, hypertension, dizziness, paresthesia, insomnia, rash, constipation, nausea, diarrhea, nocturia, hematuria, peripheral edema, bone pain, dyspnea, general pain, back pain, asthenia, infection... 

Nausea, diarrhea, stomatitis, hypotension, anorexia, bone marrow depression, pulmonary congestion, dyspnea, oliguria Dysuria, urinary frequency, cystitis, hematuria, urinary incontinence... 

Clinical signs of bleeding include bloody stools, melena, hematuria, hematemesis, bruising, and oozing from arterial or venous puncture sites. 

Hematuria/red blood cell casts (glomerular disease or bleeding in urinary tract)... 

Other markers for structural kidney damage that can be used in place of proteinuria include abnormalities in urinary sediment, such as hematuria, or abnormalities in imaging studies or kidney biopsy.1... 

Upper and lower urinary tract infection, urosepsis, urinary incontinence refractory urinary retentions chronic, renal failure, bladder diverticuli, bladder stones, or recurrent gross hematuria. 

Urinalysis to rule out infection as a cause of the patient s voiding symptoms also check urinalysis for microscopic hematuria, which typically accompanies benign prostatic hyperplasia. 

Intravenous pyelogram (IVP) will show retention of radio-contrast in the bladder if the patient has bladder outlet obstruction due to an enlarged prostate only indicated in patients with recurrent hematuria, recurrent urinary tract infection, renal insufficiency, and urolithiasis... 

Gross hematuria Possible bladder or other genitourinary cancer... 

HbAS) Females may have frequent urinary tract infections Microscopic hematuria occurs rarely Gross hematuria can occur spontaneously or with heavy intensity exercise Normal Hgb values... 

HbSC) and occur later in life Assocated with painless hematuria Aseptic necrosis of bone is a rare occurrence Other complications include ocular disease and pregnancy-related problems Mild anemia (Hgb 1 0-14 g/dL) (1 00-140 g/L or 6.2-8.7 mmol/L)... 

Genitourinary Renal papillary necrosis, hematuria, hyposthenuria, proteinuria, nephritic syndrome, tubular dysfunction,... 

Hematuria, hyposthenuria (inability to concentrate urine maximally), tubular dysfunction, enuresis during early childhood, acute renal failure can also occur... 

Nonspecific findings such as thrombocytopenia, elevated erythrocyte sedimentation rate or C-reactive protein, and abnormal urinalysis (i.e., proteinuria or microscopic hematuria)... 

Most women present with hematuria however, this is not a presentation restricted only to UTIs. 

Dysuria, suprapubic heaviness, gross hematuria, urinary frequency, and nocturia... 

Bleeding episodes Pis Onset Few weeks Symptoms TSpontaneous bleeding tendency (in joints, muscles, soft tissues, and hematuria) PI use in hemophiliac patients TPV and anticoagulants (risk of intracranial hemorrhage) Consider using a NNRTI-based regimen May require increased use of factor VIII products... 

Nephrolithiasis/ urolithiasis/ crystalluria IDV Onset Any time after initiation of therapy, especially if 4- fluid intake Symptoms Flank pain and/or abdominal pain, dysuria, frequency pyuria, hematuria, crystallauria rarely, Tserum creatinine and acute renal failure 1. History of nephrolithiasis 2. Fhtients unable to maintain adequate fluid intake 3. High peak IDV concentration 4. tDuration of exposure Drink at least 1.5-2 L of non-caffeinated fluid per day Tfluid intake at first sign of darkened urine monitor urinalysis and serum creatinine every 3-6 months Increased hydration pain control may consider switching to alternative agent stent placement may be required... 

Presentation may be mild (microscopic hematuria) or severe (massive hemorrhage) and develops during or shortly after chemotherapy infusion. 

Suprapubic pain and cramping, urinary urgency and frequency, dysuria and burning, hematuria Urinary retention leading to hydronephrosis and renal failure may occur if large blood clots obstruct the ureters or bladder outlet. 

Urinalysis reveals more than three RBCs per high-power field and microscopic hematuria. 

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