GU

Question 1

While performing a comprehensive GU health history, what GU symptoms might you come upon that are “abnormal” or might help you discern there is a problem?

Answer 1

Frequency, urgency, nocturia, dysuria, hesitancy, straining, dribbling

Question 2

What things are you looking for that are out of the ordinary with repro organs?

Answer 2

Lesions, pain, discharge, lumps

Question 3

What are some recommended screenings for reproductive organs?

Answer 3

Pap/pelvic, mammogram

Question 4

What does LMP mean?

Answer 4

Last menstrual period

Question 5

What is atrophic vaginitis?

Answer 5

Thinning of internal genitalia tissue

Question 6

What are some additional things to consider re: health history for aging adults.

Answer 6

• Postmenopausal bleeding
• Atrophic vaginitis (thinning of internal genitalia tissue)
• Uterine prolapse
• Sexual satisfaction

Question 7

Nursing assessment of genitourinary (GU) system focuses on ____________.

Answer 7

bladder function

Question 8

Describe dysuria:

Answer 8

Burning, stinging, itching sensation

Question 9

In older adults mental status change could be a sign of _____.

Answer 9

UTI

Question 10

What is nocturia?

Answer 10

Urinary frequency that occurs at night

Question 11

What is urinary urgency?

Answer 11

Usually abrupt and strong urge to void

Can be a cause of incontinence (leakage of urine)

Question 12

What is oliguria?

Answer 12

The production of abnormally small amounts of urine

Question 13

What would indicate oliguria?

Answer 13

Less than 20-30 mL/hr is of concern, or 400 mL/day, 200/12 hr shift

Question 14

What is anuria?

Answer 14

Failure of the kidneys to produce urine

Question 15

What would indicate polyuria?

Answer 15

VOLUME more than 2.5 L output/day. Frequency will be a factor as well, d/t space for capacity

Question 16

What is stress incontinence?

Answer 16

Leakage of urine with activity or pressure

Question 17

What is urge incontinence?

Answer 17

Leakage of urine with sensation of need to void

Question 18

What is mixed incontinence?

Answer 18

Leakage of urine with activity and desire to void

Question 19

What is overflow incontinence?

Answer 19

Leakage of small amounts d/t lrg volume of retained urine

Question 20

What is functional incontinence?

Answer 20

Incontinence because of barriers to voiding (ambulation, can’t get to toilet, pain, disorientation, neuro issues, etc)

Question 21

If you are able to percuss a distended bladder, you can assume there is at least ______ in it.

Answer 21

150 ml

Question 22

Things to do when assessing for distended bladder:

Answer 22

• Ask when bladder was last emptied
• Lightly palpate (give or take 1 inch depth) between symphysis pubis and umbilicus
• Note size and location of bladder

Question 23

Normally an empty bladder is not _______, a partially filled bladder is ______________.

Answer 23

palpable, smooth and firm

Question 24

What are indications for getting a bladder scan?

Answer 24

Assess for urinary retention, catheter blockage, post void residual

Question 25

If the data from the bladder scan shows at least 250-300 ml, what should you do?

Answer 25

Cath!

Question 26

Ways of describing urine: Clarity.

Answer 26

Cloudy, clear, particles (can be clots), sediment

Question 27

Ways of describing urine: Odor.

Answer 27

Strong (concentrated, dehydration), odor of medication or food, infection, etc.

Question 28

Ways of describing urine: Color.

Answer 28

Tea colored, amber, straw, bloody, pale.

Question 29

If urine is white or cloudy, what might it indicate?

Answer 29

Phosphate crystals, or pyuria (white blood cells)

Question 30

If urine is red/pink, what might it indicate?

Answer 30

``` Red blood cells – renal ds, UTI, urinary stone, malignancy, trauma (procedures) Phenolphthalein (laxative in Exlax) Blackberries, beets, rhubarb Phenytoin, Compazine Chronic lead and mercury poisoning ```

Question 31

If urine is orange, what might it indicate?

Answer 31

Pyridium, rifampin, phenacetin, sulfasalazine, Vitamin C, carrots

Question 32

If urine is blue/green, what might it indicate?

Answer 32

Blue dye – methylene blue (in Trac Tabs, Urised, Uroblue) – used to reduce symptoms of bladder irritation Propofol (blue or pink urine) Amitriptyline, indomethacin, resorcinaol, tramterine, cimetidine, Phenergan and several multivitamins – blue/green tint to urine Inherited form of high calcium (familial hypercalcemia)

Question 33

If urine is brown/black what might it indicate?

Answer 33

Myoglobin or bilirubin Copper or phenol poisoning Large amounts of rhubarb, fava beans or aloe Chloraquine, primaquine, furazolidone, metronidazole, nitrofurantoin, cascara/senna laxatives, methocarbamol and sorbital

Question 34

What is the RNs role in an AFAB GU assessment?

Answer 34

External exam, set up room, have pt empty bladder

Question 35

What is a normal finding in postmenopausal AFAB?

Answer 35

Thin, atrophied labia minor atrophied labia minora

Question 36

What is a normal finding in pregnant AFAB?

Answer 36

Labia majora and labia minora more separated

Question 37

What are some abnormal findings in an AFAB GU exam?

Answer 37

* Inflammation, erythema, lesions, masses, bulges, lesions, masses, bulges, lacerations * Discharge * Swelling, esp bilaterally * Genital warts (Condylomata acuminata) * Uterine Prolapse (Keep it moist! Sterile saline on gauze, etc.) * Yeast infection

Question 38

When should AFAB folks start getting mammograms?

Answer 38

Age 40

Question 39

What are some positions for pts to be in for mammary tissue exams?

Answer 39

* Arms above head * Hands against hips * Extend arms straight ahead while leaning forward * Supine with hand behind head

Question 40

Re: The position of the urethral meatus: What is hypospadias?

Answer 40

Urethral opening underneath lower shaft of penis

Question 41

Re: The position of the urethral meatus: What is epispadias?

Answer 41

Urethral opening above the shaft of penis

Question 42

During a GU inspection on AMAB what could be some abnormal findings?

Answer 42

* Epididymitis * Orchitis * Scrotal Edema * Spermatocele * Hydrocele (fluid around teste, will resolve on its own) * Varicocele (feels like a bag of worms – ropey) * Absent testis; cryptorchidism * Small testis * Testicular torsion (emergency) * Hernias * Herpetic lesion * Genital warts

Question 43

What is a spermatocele?

Answer 43

An abnormal sac (cyst) that develops in the epididymis — the small, coiled tube located on the upper testicle that collects and transports sperm. Noncancerous and generally painless, a spermatocele usually is filled with milky or clear fluid that might contain sperm.

Question 44

What is a varicocele?

Answer 44

An enlargement of the veins within the loose bag of skin that holds your testicles. Feels like a bag of worms – ropey.

Question 45

What is hydrocele?

Answer 45

Fluid around teste, will resolve on its own

Question 46

Most common AMAB cancer?

Answer 46

Prostate. 1 in 8, average age of diagnosis is 66.

Question 47

Less common cancer in AMAB, happens when younger?

Answer 47

Testicular cancer