GU/GI Exam Flashcards
(189 cards)
1
Q
What is the average menstrual cycle?
A
24-38 days
2
Q
What are the types of abnormal uterine bleeding?
A
1) Heavy Menstrual Bleeding
2) Intermenstrual bleeding
3) Chronic Abnormal Uterine Bleeding
4) Acute AUB
3
Q
What type of abnormal uterine bleeding is a medical emergency?
A
Acute abnormal uterine bleeding
4
Q
What are the common causes of AUB?
A
1) Uterine fibrosis
2) Polyps
3) Endometriosis
4) Ovulatory dysfunctions
5) Cancer
6) Eating disorders
7) Liver failure
5
Q
What is primary amenorrhea?
A
Have not started cycle by age 16
6
Q
What are causes of primary amenorrhea?
A
1) Chromosomal or congenital
2) Female atheletes (esp gymnasts)
7
Q
What is secondary amenorrhea?
A
When cycle stops for 3-6 months
8
Q
What are causes of secondary amenorrhea?
A
1) Primary ovarian insufficiency
2) Hypothalamic disorders
3) PCOS
4) Hyperprolactinemia
9
Q
What is anovulation?
A
Erratic ovulation after menarche (onset of menses) – typically after 1st period
10
Q
What screenings are diagnostic in AUB?
A
-Pelvic exam
-STD/STI screening
11
Q
What imaging is diagnostic in AUB?
A
-Transvaginal US
-Endometrial biopsy
-Hysterectomy
12
Q
What labs are considered in UAB?
A
1) CBC – anemia
2) Pregnancy test
3) TSH – hormone imbalances
4) Hormone levels – those done at PCP
13
Q
What medications can be given for UAB?
A
1) OCs
2) Tranexamic acid
3) Estradiol valerate/dienogest
4) Mirena IUD
14
Q
Name the med:
1) Helps stim regular shedding of the endometrium
2) Increases risk for blood clot (monitor for chest pain & SOB)
3) Helps with amenorrhea
A
Oral contraceptives
15
Q
Name the med:
1) Used to prevent pregnancy & tx heavy bleeding
2) Suppresses ovulation and thickens cervical mucous to prevent sperm from traveling past the cervix
3) Thins uterine wall so it is
less hospitable for implantation
4) Contains estrogen & progesterone
5) Increased risk for blood clots
A
Estradiol valerate/dienogest (combo OCP)
16
Q
What medication given for abnormal uterine bleeding can only be taken on your period?
A
Tranexamic acid (TXA)
17
Q
Name the AUB medication?
1) Decreased risk for clotting
2) Implantable device
3) Progestin
4) Can last 5 years for pts who take it for heavy bleeding
5) Increases risk of PID if improper implantation
A
Minera IUD
18
Q
What physiological effect do OCs have on the uterus?
A
Thins wall and thickens mucus
19
Q
What are the S&S of toxic shock?
A
1) Fever
2) Vomiting
3) Diarrhea
4) Weakness
5) Aches
6) Rashes
20
Q
What are the risk factors of PID?
A
1) Unprotected sex w/ multiple or new people
2) < 24 years old
3) Pts that regularly vaginal douche
4) Recent cervical manipulation
5) Previous hx of PID
21
Q
Name the problem:
1) D/t untreated STI, sex with multiple partners, infection after terminating pregnancy, pelvic surgeries, and child birth
2) Results in thick white discharge, may go unnoticed d/t mild cold/flu-like sx
A
PID
22
Q
What parts of the body are infected in PID?
A
1) Fallopian tubes
2) Ovaries
3) Pelvic peritoneum
23
Q
What are the S&S of PID?
A
1) Lower back, abdominal, or pelvic pain
2) Heavy vaginal discharge w/ foul odor
3) Painful sex
4) Vomiting or diarrhea
5) Dysuria
6) Spotting w/ sex
24
Q
What are comps assoc w/ PID?
A
1) Septic shock
2) Peri-hepatitis
3) Tubo-ovarian abscess
4) Peritonitis
5) Embolism
6) Adhesions/strictures in fallopian tubes
25
Name the comp of PID:
When the infection goes back into the system & crosses into the bloodstream (quick decompensation of the body)
Septic shock
26
Name the comp of PID:
Inflammation of serous lining of the liver & will RUQ pain
Peri-hepatitis
27
Name the comp of PID:
Develop in abdomen & are a problem because when they burst, they leak bacteria into the peritoneum and can lead to peritonitis
Tubo-ovarian abscess
28
Name the comp of PID:
Abdominal pain, may have rigid/hard abdomen
Peritonitis
29
Name the comp of PID:
Pelvic inflammation will trigger an inflammatory response which triggers thrombus formation
Embolism
30
Name the comp of PID:
D/t inflammation causing scarring (lumen size changes, and ovum when it gets released cannot get past tubes when fertilized)
Adhesions and strictures in fallopian tubes
31
What diagnostic testing is done for PID?
-Labs
-EST
-CBC
Pregnancy & urine tests
-Transvaginal US
-Endometrial biopsy or laparoscopy
32
What does a transvaginal US show?
How far the PID infection has traveled
33
What does ESR measure in PID?
Level of inflammation
34
What STIs need to be checked for in PID?
BV, G/C
35
What do corticosteroids do to help PID?
Reduce inflammation in the fallopian tubes
36
Name the problem:
Descent of 1 or more aspects of uterus and vagina
Bladder and rectum can herniate into vaginal space
Uterine & Pelvic Organ Prolapse
37
What are RFs of Uterine & Pelvic Prolapse?
1) Childbirth (esp vaginal) or multiple
2) Obesity -- weakens pelvic floor muscle
3) Coughing/straining
4) Decreased estrogen
5) Chronic constipation
6) CT disorders
38
What are the sx of organ and uterine prolapse?
1) Dyspareunia
2) Backache
3) Incontinence
39
What is dyspareunia?
Painful sex (may c/o dragging or heavy feeling "like something is coming down inside of them")
40
What are the 4 degrees of descent in uterine and pelvic organ prolapse?
1) Cervix into vagina
2) Cervix into introitus (external opening of vaginal canal)
3) Cervix outside of introitus (peeking at vaginal opening)
4) Uterus outside of introitus (see donut)
41
What are the 3 types of pelvic organ prolapse?
1) Cystocele
2) Uterine
3) Rectocele
42
Name the type of pelvic organ prolapse:
Portion of pelvic floor between bladder and vaginal canal that starts to weaken and the bladder prolapses into the vaginal canal
Cystocele
43
Name the type of pelvic organ prolapse:
Downward displacement of the uterus into the vaginal canal
Uterine
44
Name the type of pelvic organ prolapse:
Wall between rectum and vaginal canal weakens and rectum becomes lazy and prolapses into the vaginal canal
Rectocele
45
What are the tx of uterine and pelvic organ prolapse?
1) Kegels (stages 1 or 2)
2) Pessary
3) Surgery (stages 3 or 4)
46
How frequently do kegels need to be done?
10-20x/hr or 50-60/day
*** Consistency = key!!! (can take 4-6 weeks before starting to see results)
-Do in short & long intervals
47
What surgeries can be done to tx uterine and pelvic organ prolapse?
1) Vaginal hysterectomy (repair of vaginal wall)
2) Colporrhaphy
48
What do you need to educate a pt on how to use a pessary & what the risks are?
1) Inserted during day to keep exposed portion in body
2) Remove at night
Risk = infection or injury from scraping of vaginal line
49
What are the sx of BPH?
1) Difficulty starting stream
2) Weaker flow of urine
3) Urinary frequency
50
What are the hormonal changes that contribute to BPH?
1) Decreased testosterone
2) DHT increases prostate growth
51
What structure does an enlarged prostate compress?
Proximal urethra
52
What are the RFs of BPH?
1) Age
2) Obesity/sedentary
3) 1 degree relative
4) High protein diet -- lots of red meat
5) Alcohol/smoking
6) DM
7) ED
53
Name the kind of sx of BPH:
-Nocturia
-Urinary frequency
-Incontinence
-Dysuria
Irritative sx
54
What is the most common reason people seek tx for BPH?
Nocturia
55
Name the kind of sx of BPH:
Can't get urine out d/t narrowing of lumen, decreased urinary force, difficulty starting stream, dribbling, intermittency
Obstructive
56
What are comps of BPH?
1) Acute urinary retention (MED EMERGENCY)****
2) UTI (pyelonephritis or sepsis)
3) Bladder stones
4) Hydronephrosis (leads to renal failure)
57
How do you check for the med emergency of BPH, acute urinary retention?
-Bladder scan, cath, and post-void residual
58
True or false:
Pts who have surgery for BPH are more likely to need another surgery
True
59
What med is important to ask about during assessment of BPH?
Testosterone supplements (pts who had prostate cancer may still be on this)
60
WHat objective assessments need to be done for BPH?
-Age
-Abdominal assessment
-DRE
61
What does a DRE do?
Feels rectal sphinctor tone & prostate
62
What are the dx studies for BPH?
1) UA, Urine C/S
2) Prostate-Specific Antigen (PSA)
3) Serum creatinine
4) Transrectual US (TRUS)
5) Pelvic MRI
6) Prostate biopsy
7) Uroflowmetry
8) Cytoscopy
63
True or false:
PSA levels will be decreased in those with BPH
False- PSA levels will be elevated (doesn't always mean cancer tho)
64
What dx study checks the prostate for BPH?
TRUS
65
What dx study measures how much urine is expelled from the bladder for BPH?
Uroflowmetry
66
What are the conservative tx for BPH?
1) Active surveilance
2) Drug therapy
67
What do you need to avoid if you have BPH?
1) Caffeine, alcohol, carbonated bevs
2) Spicy foods
3) Artificial sweeteners
4) Anticholinergics
5) Decongestants
68
What does active surveilance of BPH consist of?
Lifestyle changes and toileting schedule
69
What is the best drug therapy for BPH?
Combo therapy of 5 alpha reductase inhibitors & alpha adrenergic receptor blockers
70
What do 5 alpha reductase inhibitors do in BPH?
Reduce prostate size (block DHT)
71
What do alpha adrenergic receptor blockers do for BPH?
Relax muscles so they can urinate, but won't grow more
72
What are the SEs of alpha adrenergic receptor blocker?
Dry orgasms, retrograde ejaculation
73
What are Ses of 5ARIs?
Decreased libidio
74
What people do you need to caution when administering 5ARIs?
Pregnant women -- wear GLOVES when administering
75
What 5ARIs are used to tx BPH?
1) Finasteride
2) Dutasteride (combo of 5ARI & AARB)
76
What are the AARBs used to tx BPH?
1) Alfuzosin
2) Doxazosin
3) Prazosin
4) Tamsulosin (Flomax)
5) Silodosin
77
What level of sx of BPH are 5ARIs used to tx?
Moderate to severe sx
78
How long may it take to see improvement of BPH from Finasteride?
up to 6 months
79
What level of BPH sx do AARBs tx?
Mild to moderate -- pts receive relief of obstructive sx quicker
80
What are the erectogenic drugs used to tx BPH?
1) Tadalafil
2) Sildenafil (Viagra)***
81
Name the minimally invasive surgery for BPH:
-Laser tx that vaporizes prostate tissue
-Should have immediate relief
-Minimal bleeding, quicker recovery
-Can have slopping (skin sheds off), may have irriation for several weeks, retrograde ejaculation, may need catheter for up to 7 days post-op
-Minimally invasive so less comps post-op
Photo-selective Vaporization of the Prostate (PVP)
82
Name the minimally invasive surgery for BPH:
-Take a laser & shoot beam at prostate to interefere with nucleus being able to produce things out & decrease enlargement
-SEs = retrograde ejaculation & irritation
Laser Enucleation of the Prostate
83
Name the minimally invasive surgery for BPH:
-Put clamps that push back prostate so urethra is open & they can re-establish urine flow
-May have to repeat if it collapses & faila
-Outpatient, minimally invasive, minimal SEs, less chance of bleeding/ED/incontinence/retrograde ejaculation
Prostatic Urethral Lift (PUL)
84
Name the minimally invasive surgery for BPH:
-Heat prostrate
-Cause necrosis — kills off cells
-Delivers a micorwave to tissue to heat prostate & destroy it
-Monitor temp (rectal)
-Cath needed 24-48 hrs post-op, retrograde ejaculation (go home w/ indwelling cath)
-Minimal bleeding, minimal chance of ED, minimal chance of retrograde ejaculation
Transurethral Microwave Thermotherapy
85
Name the minimally invasive surgery for BPH:
-Increases temp of tissue and causes necrosis
-Outpatient, sedation
-Need cath afterwards & most common sx after = urinary retention
-Once cath is removed — they may have urinary retention again (good education for when to seek tx!!)
Transurethral Needle Ablation (TUNA)
86
Name the minimally invasive surgery for BPH:
-“button TURP”
-Electrosurgical modification of TURP (less invasive than TURP)
-Destroy prostate tissue
-Minimal bleeding
-SEs = intermittent hematuria, retrograde ejaculation, irritative sx of BPH may return
Transurethral Vaporization of the Prostate
87
Name the minimally invasive surgery for BPH:
-Heated water to destroy obstructive tissue
-Small prostates
-Catheter for procedure
-Minimal bleeding, still have chance of intermittent hematuria & retrograde ejaculation
-May need cath for a couple days after
Water Vapor Thermal Therapy
88
What are the indications for invasive surgery for BPH?
-Decreased urination (severe)
-Discomfort r/t this
-Persitent residual urine
-May have suffered for numerous bouts of acute urinary retention
-May have hypdronephrosis
89
What determines which procedure should be done for BPH?
Age and degree of prostate size determine which procedure to do
90
Name the type of invasive BPH surgery:
1) Several surgical incisions into the prostate to expand urethra, completed under local anesthesia
2) Relieves pressure on urethra and improves urine flow
3) Outpt, minimal comps, low ED occurrence, cath may be needed
4) Good for those with small or moderately large prostate glands
Transurethral Incision of the Prostate (TUIP)
91
Name the type of invasive BPH surgery:
1) Surgical removal of prostate tissue
2) Resectoscope via urethra
3) 3-way indwelling catheter with 30 ml balloon after procedure for irrigation afterward (if not irrigated for long enough — may develop clots that are difficult to void & may cause repeat urinary retention)
Transurethral Resection of the Prostate (TURP)
92
What is the gold standard tx for BPH?
Transurethral Resection of the Prostate (TURP)
93
What education needs to be given pre-op for BPH?
1) Possibility of sexual dysfunction (retograde or decreased ejaculation, decreased orgasms)
2) When trying to restore urinary drainage, increase fluid intake to 1-2 L/day
3) May have foley for a few days post-op
94
How long after catheter removal post-op of BPH surgery is normal for small clots to be in the urine?
24-36 hrs
95
How long into post-op of BPH surgery is the 3-way cath removed?
2-4 days typically
96
Name the type of nursing management for BPH:
-Using sterile technique & saline to instil 50 mL and withdraw
**Pt may have bladder spasms
Manual irrigation
97
Name type of nursing management of BPH:
1) Continuous inflow of sterile solution
2) Watch for color to lighten to light pink
3) Ensure catheter patency
4) Maintain asepsis
Continuous Bladder Irrigation
98
How much fluid should a post-op pt for BPH be having/how often should they bet voiding?
2-3 L/day intake & voiding every 2-3 hrs
99
What causes ED in a younger male?
Stress, drugs, increased anxiety
100
What causes ED in older men?
Comorbidities -- DM, HTN, multiple drug therapy
101
What are the contributing factors to ED?
1) DM
2) Vascular disease
3) Previous surgery
4) Trauma
5) Chronic illness
6) Stress
7) Age-related changes
102
What dx studies are done for ED?
1) DRE
2) BP
3) Perfusion check
4) HA1C
5) Hormone labs (testosterone, prolactin, LH, thyroid)
6) PSA
7) CBC
8) Nocturnal penile tumescence & rigidity
9) Vascular studies
103
What erectogenic meds are given to tx ED?
1) Avafil
2) Sildenafil (Viagra)
3) Tadalafil
4) Vardenafil
104
What do PDE5 (erectogenic) drugs do pathophysiologically for ED?
Dilate vessel & relax smooth muscle (NOT SPECIFIC TO PENIS)
105
What are the SEs of erectogenic drugs (PDE5 inhibitors)?
1) HA
2) Skin flushing
3) Visual problems
4) Erection > 4hrs
106
Name the ED device:
Pulls blood into corporeal bodies (testicles)
Vacuum Erection Devices
107
Name the ED device:
Meds injected or inserted
Intraurethral devices
108
Name the ED device:
-Surgical procedure
-Inflatable devices implanted into corporeal bodies
Penile implants
109
What is the path of urine?
Kidney --> ureter --> bladder --> urethra
110
What make up the upper urinary system?
2 kidneys & 2 ureters
111
What make up the lower urinary system?
-Bladder
-Urethra
-Pelvic muslces
*Ureterovesical unit*
112
How is urine formed?
Glomerular filtration --> renal tubular absorption & secretion --> water conservation
113
What is the capacity of the bladder?
600-1000 mLs
114
What volume does the urge to void come at?
200-250 mLs
115
What volume of urine is discomfort felt at?
400-600 mLs
116
Name the organ:
Detrusor muscle distends into abdomen with filling
Bladder
116
What is the mucosal lining same throughout bladder, ureters, renal pelvis, and bladder neck — prevents reabsorption of urine or waste in urine
Urothelium
117
What are the functions of the urethra?
1) Urine excretion
2) Control voiding (voluntary)
118
What area helps detect when the bladder is stretched?
Sacral area (S2-S4)
119
Where are the impulses to void located?
Thoracic & lumbar (T11-L2)
120
What are the secondary physiologic functions of the kidneys?
1) Control BP
2) Erythropoietin
3) Electrolyte balance
4) Regulate acid-base balance
5) Activate Vitamin D needed for Ca++ absorption
121
What percent of CO goes through kidneys?
20-25%
122
What are the primary functions of the kidneys?
1) Excrete waste
2) Regulate volume & ECF composition
123
What is the process of micturition?
Detrussor muscle contracts --> internal urethral sphincter relaxes --> pelvic floor muscles relax --> voiding --> external urethral sphincter closes
124
What alters the specific gravity of urine?
Hydration, illness, kidney function
125
What does a SGOU of > 0.030 mean and for who?
***More concentrated
Pts with UTI, dehydration, or DKS
126
What does a SGOU of < 1.01 mean and for who?
***Less concentrated, clear/pale
Pts w/ Diabetes insipidus or those on diuretics for HF
127
True or False:
The bladder should NOT be palpable unless distended
True
128
Why is protein found in a UA concerning r/t UTIs?
-Sign or rhabdomyolysis
-Sign of dehydration
-Sign of acute kidney injury
129
Name the type of urine sample:
doesn’t require prep, just first collection of urine in AM — may not be clean
Random urine sample
130
Name the type of urine sample:
te some, then collect midstream, then finish urinate
Clean catch
131
Name the type of urine sample:
needs to be cool, assess creatinine clearance, void & discard & then save all the rest of the urine of the day (don’t want bacteria to grow)
24 urine collection
132
Which imaging requires dye for a UTI?
CT
133
If getting a CT scan for a UTI, what should the nurse assess for first?
Allergies to iodine or shellfish
134
Name the type of dx imaging for a UTI:
Conscious sedation vs. general anesthesia
Consent required (more invasive )
Visualization of interior of bladder
IV fluids with general anesthesia
Cytoscopy
135
136
What pt education for a cytoscopy?
1) Expect some pink tinged urine for a while
2) May feel more urinary frequncy/burning with urination d/t probe insertion
3) Should not be copious amts of bright red bleeding, S&S of ortho hypoTN
4) Pain can be releived with mild analgesics (tylenol, sitx bath or warm pads)
137
Name the UTI dx imaging:
1) Contrast is instilled into bladder
2) Pt teaching (same as cystoscopy)
3) Pt may need to be pre-treated w/ fluids (esp if they have low GFR) to flush out dye
Cystogram
138
Name the UTI dx imaging:
1) X-ray of urinary tract after IV injection of contrast media.
2) Assess for allergies to iodine or shellfish (contrast)
3) Structural evaluation
4) Show if pt has decreased renal function — will also have trouble getting dye out (pre & post treat with saline)
IV pyelogram
139
What's the most important thing to assess for in someone having a voiding cystourethrogram (VCUG)?
DYE ALLERGY
140
Name the UTI dx testing:
Bladder filled with contrast media
X-ray done
Patient void
Repeat X-ray to evaluate residual urine
VCUG
141
What antbx can be given for a UTI?
1) TMP/SMX (trimethoprim/sulfamethoxazole; Bactrim)
2) Cephaloxin
3) Nitrofurantoin
4)Ciprofloxacin
5) Metronidazole
6) Levofloxacin
142
What antifungals can be given for a UTI?
Fluconazole
143
What analgesics can be given for a UTI?
Phenazopyridine
144
Why are anticholinergics given to someone for a UTI?
Helps with spasming
145
What anticholinergic is given for a UTI?
Botox
146
What are the body's natural defenses to prevent UTIs?
1) acidic pH
2) Downward peristalic movement
3) Complete bladder emptying
4) Highly concentrated urea
147
What are the general lower UTI sx?
1) Pain
2) Discomfort
3) Hesitancy
4) Frequency or incontinence
5) Strong Smell
6) Burning w/ urination (may not have this)
7) Suprapubic pain
**DM pts may have higher BG/change in color
148
What are the lower UTIs?
1) Urethritis
2) Cystitis
149
What is the upper UTI?
Pyelonephritis
150
What does it mean if you have an uncomplicated UTI?
Only involves bladder
151
What does it mean if you have a complicated UTI?
Structural or functional problems (DM, kidney stones, caths, obstructions)
152
What is cystitis inflammation of?
Bladder
153
What are sx of a lower UTI?
1) Dysuria
2) Frequency
3) Discomfort/pressure
4) Hematuria
5) Cloudy urine
154
What are sx of an upper UTI?
1) Fever/chills
2) Flank pain
3) Fatigue, anorexia
155
What are geriatric sx of UTIs?
1) Non-localized abdominal discomfort
2) Afebril (get good rectal temp)
3) Altered mental status
4) Clinical deterioration
156
What can cause urethritis?
STIs (trich, g/c), monilial infection (yeast)
157
What causes cystitis?
1) E. coli (bad hygiene wiping)
2) Candida albicans
3) Fungal (not common)
AKA "UTI"
158
What is the 2nd most common infection in women?
Cystitis
159
Name the type of pyelonephritis:
-Inflammation of kidneys
-Bacteria migrated up ureters to kidneys
Acute
160
Name the type of pyelonephritis:
-Typically d/t structural abnormalities/recurrent infection/didn't finish antbx tx
Chronic
161
What are complications of chronic pyelonephritis?
1) Fibrosis (scarring)
2) Kidney atrophy
3) Alteration in renal filtration
162
What confirms pyelonephritis?
Imaging
163
What dx study checks the loss of function d/t pyelonephritis?
Renal biopsy
164
What are S&S of pyelonephritis?
1) Fever/chills
2) N/V, malaise
3) Flank pain
4) WBCs in urine
5) Hematuria
165
How do you tx urosepsis (progression of pyelonephritis)?
-IV antbx
-Wt-based fluids
-Monitor for septic shock
166
True or False:
Pts do not get reimbursed for HA-CAUTIs
True
167
What are comps of indwelling caths?
1) Bladder spasms
2) Periurethral abscesses
3) Chronic pyelonephritis
4) Urosepsis
5) Trauma
6) Fistula/stricture formation
168
What are the dx tests of UTI?
1) H&P
2) UA (&c/s)
3) Clean catch urine sample
4) urine dipstick
169
Name the type of incontinence:
Not r/t pathology or problem in urinary system — may be physicla or cognitive impairment — Alzheimers, head injury, immobility
Functional
170
Name the type of incontinence:
Frequent dribbling over urine d/t incomplete/ineffective emptying of bladder
-Spinal cord injury, DM, enlarged prostate
Overflow
171
Name the type of incontinence:
R/t fact that pt urinates during activity (pregnancy, multiple childbirths, menopause, or surgical trauma)
Stress
172
Name the type of incontinence:
Sudden need to urinate w/ large volume loss of urine (even though bladder is not full) — prgnancy, tauma, childbirth, neuro disorder (Parkinsons)
Urge
173
Name the type of incontinence:
when bladder is spastic (fills with urine & involuntary reflex will cause it contract while bladder is trying to empty — spinal cord injury (around T12) — can cath, can use non-invasive urine collection devices
Reflex
174
What are the NIs for functional incontinence?
1) Thorough skin assessment
2) Consider consulting specialty services (e.g., wound RN)
3) Evaluate mobility and accessibility
4) Be aware of patient safety!
5) Assistance with hygiene
175
What are the NIs of Overflow incontinence?
1)Consider intermittent catheterization
2) If prolapsed uterus is cause; consider pessary to support
176
What are the NIs of Stress incontinence?
1) Consider pelvic floor exercises
2) Cessation of smoking
3) Estrogen replacement
4) Weight loss (if obese)
177
What are the NIs of urge incontinence?
1) Treat underlying causes
2) Meds (may lead to retention)
3) Pelvic floor exercises
4) Absorbent products (poise or depends)
178
What type of meds are given for UTIs?
1) Anticholinergics
2) Muscarinic Receptor Blockers
3) Botox
178
What type of incontinence can be tx with injection of bulking agents?
Stress
179
What do anticholinergics do for UTIs?
help reduce bladder contractions/spasms so bladder can fill more before voiding
180
What do muscarinic receptor blockers do for UTIs?
help relax bladder muscle so pt can void
181
What does botox do for UTIs?
helps reduce bladder contrx so bladder can fill to capacity — SE = urinary retention (freezes/hardens muscle so it does not contract quickly)
182
Name the problem:
-immediately happens (MED EMERGENCY)
-If they start to feel pain or like bladder is going to explode — seek tx ASAP
-Usually deficient detrussor muscle that is not contracting properly or enlarged prostate
Acute urinary retention
183
Name the problem:
d/t something else going on that is preventing them from completely emptying their bladder — enlarged prostate/obstruction, alcoholism, trauma
Chronic urinary retention
184
What is the dx study for urinary retention?
Post-void residual
185
What is a normal post-void residual?
50-75 mLs remaining
186
True or False:
In acute urinary retention, you perform a post-void residual 2x
False- only 1x
187
What post-void residual result requires further evaluation?
> 200 mL on 2 separate occasions
