urinary problems Flashcards
1
Q
stress incontinence
A
urine leaks out at times when your bladder is under pressure
ex) coughing or laughing
2
Q
stress incontinence causes
A
- weakening of the bladder neck supports; associated with childbirth
- intrinsic sphincter deficiency
- acquired anatomic damage to the urethral sphincter
- vaginal prolapse from vaginal birth or aging
3
Q
stress incontinence symptoms
A
- loss of small amount of urine during physical activity or intraabdominal pressure (coughing, sneezing jumping, lifting, exercises)
- normal voiding habits
- postvoid residual usually less than or equal to 50ml
- pelvic exam= hypermobility or urethra or bladder neck with Valsalva maneuvers
4
Q
urge incontinence
A
when urine leaks as you feel a sudden urge to pee, or soon afterwards
5
Q
urge incontinence causes
A
- idiopathic
- neurological disorders
- benign prostatic hypertrophy
- bladder irritants (artiical sweetners, caffeine, alcohol, citric, drugs, nicotine)
- bladder cancer
- medications that cause increased bladder contractibility
6
Q
urge incontinence symptoms
A
- loss of urine preceded by a sudden and severe desire to pass urine
- nocturia
- may have loss of large amounts of urine with occurrence
7
Q
mixed incontinence causes
A
associated with stress and urge incontinence
8
Q
mixed incontinence symtoms
A
- associated with stress and urge incontinence
9
Q
overflow incontinence (reflex incontinence)
A
when your unable to fully empty your bladder which causes frequent leaking
10
Q
overflow incontinence (reflex incontinence)causes
A
- urethral obstruction
- diabetic neuropahy
- some neurologic disorders
- medications side effects
11
Q
overflow incontinence (reflex incontinence) symptoms
A
- bladder distension, constant dribbling of urine
- sense of incomplete emptying of the bladder
- pelvic discomfort
- palpable bladder
12
Q
functional incontinence
A
leakage of urine caused by factors other then disease of the lower urinary tract
13
Q
functional incontinence causes
A
decreased cognition such as with dementia
- impaired mobility
14
Q
functional incontinence symptoms
A
- quantity and timing or urine leakage vary
- patterns difficult to discern
15
Q
urinary incontinence focused assessment
A
- risk factors
- symtoms of urinary incontinence
- assessment of mobility, self care ability, cognitive ability, communication patterns
- assess the environment for barriers to toileting such as a privacy, restrictive clothing and access to the toilet
16
Q
urinary incontinence physical assessment/ s/s
A
- assess abdomen- feeling for distention
- inspect females for uterine prolapse- uterine muscles weakened
- digital rectal exam- both men and women check nerve integrity
- assess for prostate enlargement in men
- lab assessment- urinalysis
- imaging assessment
17
Q
imaging assements
A
- bladder scan
- ct of kidneys and ureters
- voiding cystourethrogram
- urodynamic testing
- electromyography or pelvic muscules
18
Q
urinary incontinence nursing diagnoses
A
- altered urinary elimination related to incontinence
- potential for altered tissue integrity related to incontinence
19
Q
urinary incontinence planning and integrating (nonsurgical management )
A
nonsurgical management
- nutrition therapy
- devices
- electrical stimulation
- magnetic resonance therapy
- pelvic muscle therapy
- vaginal cone therapy
- behavioral interventions
20
Q
urinary incontinence planning and integrating (maintaining tissue integrity)
A
- reduce the risk for skin breakdown
- reduce the risk of pt. developing incontinece- associate dermatits
- educate the pt. on the possibility of using an external device
- discuss the possibility of absorbent pads and breifs with the pt.
- options for functional incontinence include intermittent or long dwelling catheter
21
Q
urinary incontinence care coordination and transit management
A
home care management- bedside comode, clear path
- self-management education- keeping on schedule
- health care resources- estrogen cream, anticholergenics, the importance of diet, drinking lots of fluids, different exercise, legal exercises
22
Q
urinary incontinence evaulating outcomes
A
- maintain optimal urinary elmination through a reduction in the number of urinary incont. ep.
- maintain tissue integtiry of the skin and mucous membranes in the perineal area
- demonstrate knowledge of proper use of drugs and correct procedures for self catheterization, use of artificial sphincter or care of an indwelling urinary catheter
- demonstrate effective use of the selected exercise or bladder training program
- select and use incontinence interventions, devices, and products
23
Q
cystitis
A
inflammatory conditon of the bladder
- usually refers to inflammation from infection of bladder
24
Q
cystitis causes
A
- irritants without infection
- complication of other disorders (gynecologic cancers, pelvic inflammatory disorders, endometriosis, chrons disease, diverticulitis, lupus, tb)
- infectious cystitis caused by pathogens from bowel or vagina, viruses, mycobacteria, parasites, yeast
25
cystitis physical assessment and s/s
- frequency, dysuria, urgency
- fever, chills, nausea= infection
- assess catheter
- have pt. void for urine examination
- vital signs, lower abdomen, bladder palpation
26
cystitis lab assessment
- clean cach urine specimen (urinalysis, culture, and sensitivity)
- serum wbc with differential
27
cystitis other diagnostic assessment
- pelvic ultrasound or ct
- voiding
- cystourethrography
- cystoscopy
28
cystitis nonsurgical managment
- drug therapy
- fluid intake
- comfort measures such as pain relief
29
cystitis surgical managemnt
- treat conditions that increase risk for utis
- removal of obstructions
- removal of vesicoureteral reflux
- removal of calculi
30
cystitis health promotion and maintenance
- sterile technique when inserting catheters
- clean technique when using intermittent catheters at home
- single-use catheter recommended for home settings
- national pt. safety goal- CAUTI prevention: removal of catheter as soon as possible
- liberal intake of water
31
cystitis care coordination and transition management
- assess level of clients understanding
- teach to take prescribed drugs
- address concerns associated with intimacy and recurrent utis
32
urethritis
- inflammation of urethra
- highest incidence is adults aged 20-24
- sit is the most common cause
- symptoms include mucopurulent or purlent discharge, dysuria, discomfort
33
interpofessional collaborative care
- urinalysis may show pyuria (a urinary condition characterized by an elevated number of white blood cells in urine
- test for sti
- usually resolves spontaneously
34
urolithiasis
presence of calculi in the urinary tract
35
nephrolithiasis
formation of calculi in kidney
36
ureterolithiasis
formation of the calculi in the ureter
37
urolithiasis causes
- metabolic probelms (hypercalcemia, hyperoxaluria, hyperuricemia, struvite, cystinuria)
- DEHYDRATION IS THE MOST COMMON RISK FACTOR THAT INCREASES CHANCE
- risk factors: family history, obesity, diabetes or gout, diet (high sodium)
38
urolithiasis s/s
- severe pain
- flank pain
- nausea, vomiting, pallor, diaphoresis
- frequency and dysuria
- oliguria and anuria
39
urolithiasis assessment criteria
- history of urologic stones
- diet
- past treatment
- recognize urinary tract obstruction
- assess for bladder distension
urinalysis
40
urolithiasis managing pain (nonsurgical)
- drug therapy
| - lithotripsy
41
urolithiasis managing pain (surgical management)
minimally invasive surgical procedures
| - open procedures
42
urolithiasis preventing infection
- drug therapy- antibiotics
| - lab test (urine sample, C&S test, urine cultures)
43
urolithiasis preventing obstruction
- high fluid intake (3l/day or more)
- accurate measurements of intake and output
- drug therapy
- nutrition therapy/ diet modification
44
urothelial cancer patho
malignant tumors of urothelium linning of transitional cells in kidney, renal pelvis, ureters, urinary bladder, and urethra
45
urothelial cancer cause
direct cause unknow
- GREATEST RISK FACTOR IS TABACCO
-exposure to toxins, family history, schistosoma haematobium infection, use of drugs
46
urothelial cancer physical assessment and s/s
- ask about active and passive exposure to cig smoke
- ask about hobbies and occupation
- ask change in urine habit
- assess skin color, nutrition status abdomen
- examine urine color and clarity
BLOOD IN URINE IS FIRST INDICATION OF BLADDER CANCER
47
urothelial cancer psychosocial assessment
- assess pt. emotions, including response to possibly having bladder cancer
- assess pt. coping mechanism
- available support groups
48
urothelial cancer diagnostic assessment
- urinalysis showing gross or microscopic hematuria (blood in urine)
- bladder wash specimens and bladder biopsies
- cytoscopy, cystoureterography, ct scans, ultrasounds, MRI
49
urothelial cancer intervention/management
prophylatic immunotherapy with BCG
| - multiagent chemotherapy; radiation therapy
50
urothelial cancer surgical managment
- depends on type and stage of cancer
- complete bladder removal
- alternatives for urine elimination
51
urothelial cancer health promotion maintenance
- smoking cessation
- use ppe around dry, liquid, gaseous chemicals
- shower or bathe, change clothing
52
urothelial cancer care coordination and trainsition management
- self-management education
- united ostomy assoication
- wound, ostomy, continence nurses society
