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PAR3012 - Extended Care > Week 6 > Flashcards

Week 6 Flashcards

1
Q

what is in the upper urinary system?

A
  • kidneys

- ureters

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2
Q

what is in the lower urinary system

A
  • urinary bladder
  • urethra
  • urethral meatus
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3
Q

which kidney sits lower and why?

A

Right lower than left because the right one sits under liver

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4
Q

What vertebrae are the kidneys located at?

A

Approx T12-L3

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5
Q

What is a visual landmark for T12

A

approx level of of umbillicus

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6
Q

Where are the adrenal glands what what do they secrete?

A 
Sit on top of kidneys
secrete:
- Catecholamines
- Androgens
- Corticosteroids
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7
Q

What is the urinary bladder?

A

Hollow organ to hold urine before excretion

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8
Q

What is commonly injured from the lower seat-belt in MVA?

A

Urinary bladder

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9
Q

What is the difference between the male and female urethra?

A

Urethra is longer in male
18-23 cm

Urethra is considerably shorter in females (3-8cm)

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10
Q

What causes an increase in the size of prostate?

A

Puberty

- @40 it begins to grow again called Benign Prostatic Hyperplasia

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11
Q

What is Benign Prostatic Hyperplasia?

A

Growth of prostate after the age of 40

  • Causes problems with urinary retention/infection
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12
Q

What is Hypospadias?

A

Abnormality of the penis and urethral meatus.

Opening of urethra is abnormally positioned on the ventral surface affecting urine stream/erections

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13
Q

What is one of the main reasons for increased UTI’s in females?

A
  • Smaller urethra

- proximity of meatus to vagina and anus

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14
Q

What happens with a vaginal prolapse?

A

Common problem where th ebladder, uterus or bowel protrudes in to the vagina

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15
Q

What is the largest cause of vaginal prolapse?

A

pregnancy

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16
Q

What are some indications for a colostomy or ileostomy?

A
  • bowel obstruction
  • Trauma
  • Ischaemic bowel
  • Perforated bowel
  • Infection
  • IBS
  • Diverticulitis
  • Colorectal/anal cancer
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17
Q

What are some indications for an ileal conduit?

A
  • bladder cancer and cystectomy
  • traumatic bladder injurt
  • severe urinary incontinence
  • neurogenic bladder
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18
Q

What are some indications for a faecal diversion system

A
  • burns
  • sacral pressure injuries
  • infective diarrhoea
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19
Q

What is inflammatory bowel disease/crohns disease?

A

subacute and chronic transmural inflammation of the bowel

  • commonly develops in adolescents
  • occurs more commonly in women
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20
Q

What is ulcerative collitis?

A

recurrant ulcerative and inflamatory disease of the mucosal and submucosal layers

  • begins in rectum and then spreads proximally
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21
Q

What are some key differences found in Chrohns disease compared to ulcerative colitis?

A 
Location: Ileum, ascending colon
Bleeding: Unusual
Fistulas: Common
Rectal involvements: 20%
Diarrhoea: Mild (2-5 motions)
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22
Q

What are some key differences found in Ulcerative collitis disease compared to Chron’s disease?

A 
Location: Rectum, decending colon
Bleeding: Common and severe
Fistulas: Rare and mild
Rectal involvements: 100%
Diarrhoea: Severe (10-20 motions)
23
Q

what are the three types of bladder cancer?

A
  • urothelial carcinoma
  • squamous cell carcinoma
  • adenocarcenoma
24
Q

what is the most common symptom of bladder cancer?

A

Haematuria

blood in urine

25
What is the most common injury to the bladder? What symptoms would be seen?
Blunt trauma Pt presents with: - gross haematuria - suprapubic pain
26
What is diarrhoea?
Increased fluidity or frequency of bowel motions
27
What is a gastrointestinal stoma?
opening into the abdominal wall to allow evacuation of doo doo following bowel surgery
28
What type of gastrointestinal stomas can be used?
- Colostomy | - Ileostomy
29
What happens with a renal stoma?
ureters are resected from the bladder and anastomosed to a resceted part of the ileum - known as urostomy
30
what are the differing types of colostomies and ileostomy?
Single barrelled/double barrelled / loop
31
How do you visually identify a urostomy?
- Flatter appearance - round shape stoma - right hand side of umbilical - urine output
32
How do you visually identify a colostomy?
- shorter in length - round shaped - left hand side of umbilicus - has soft output
33
How do you visually identify an ileostomy?
- Longer in length - cone shaped - right side of lower abdomen - liquid output
34
What is the actual name for a bag attached to a stoma?
Ostomy pouch or ostomy appliance
35
What type of ostomy appliance is common for colostomy?
one piece
36
what type of ostomy appliace is common for an ileostomy?
two piece
37
What can cause stoma necrosis ? and when is it most common?
venous or arterial insufficiency Most common: first 5 days post op
38
What is stomal prolapse?
when the bowel is externally displaced.
39
what are some considerations for the assessment and managment of a stoma as paramedics?
Call stoma support nurse - always ask about normal stoma appearance/function and output - has patient attempted to resolve problem - listen for bowel sounds with stethoscope to confirm peristalsis - assess stoma for colour, warmth, activity, mucous and odour
40
what to consider when caring for a patient with a urinary catheter?
- past medical history - reason why catheter was inserted - where abouts was it inserted - when - what type - what size?
41
what are the different types of urinary catherterisaton techniques?
Intermittent - drains urine in bladder Continuous - semi-permanent for output monitoring Suprapubic - long-term inserted through abdomen Condom - condom with draining tube basically
42
What are the indications for intermittent urinary catheters?
- drains urine remainign in bladder after voiding - prevents urinary incontinence - post-operatively - used in community to avoid continuous - specimen collection in elderly - enlarged prostate
43
What are the indications for continuous urinary catheters?
- measure hourly output - allows draining is meatus is swollen - used for patients with epidural /spine block - pts with neurogenic bladder problems - autonomic dysreflexia
44
What are the indications for supra-pubic urinary catheters?
- failed urethral catheter insertions - long term or permanent urinary catheterisation required - pt wants to maintain sexual relationship - sustained urethral trauma
45
What are the indications for condom urinary catheters?
- non-invasive - easily applied - wants sexual relationship - palliative care with urinary incontinence - pts with sacral pressure wounds
46
What are the contraindications of urinary catheterisation?
- recent urological trauma - recent urological surgery - has previously been know to be difficult to catheterise - known urethral stricture or narrowing - urethral meatus bleeding or current frank haematuria - male with phimosis that prevents meatus visualisation
47
what is phimosis?
tight foreskin making visualisation of meatus difficult
48
what size catheter do you use for males and females?
Male - 14 - 16 french gauge | Female - 12 - 14 french gauge
49
What can cause difficult urinary catheter insertion?
- Prostatic urethra | - Urethral spasm
50
What is the most common complication of urinary catheterisation?
UTI
51
What is paraphimosis?
foreskin retracted to insert catheter, then not returned... becomes a surgical emergency
52
What are common causes of blocked urinary catheter?
``` bladder neck spasm sediment and encrustation blood clots low flow granulation tissue ```
53
What can a blocked catheter and distended bladder cause?
autonomic hyperreflexia in spinal cord lesions above T5
54
What should you do to dislodge any sediment in a urinary catheter?
rotate 360 degrees

PAR3012 - Extended Care (12 decks)

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