Week 8: Renal and Genitourinary Disorders Flashcards

Question

Bladder Scan

Answer 1

-Noninvasive, portable ultrasound device that provides: ~a virtual 3D image of the bladder ~the volume of urine retained within the bladder -Safe, painless, reliable **Contraindicated if the patient has wounds in suprapubic area or is pregnant

Answer 2

-Inflammation of the urinary tract may be attributable to a variety of disorders, but bacterial infection is by far the most common, particularly among females -The urinary tract above the urethra is normally sterile -The organisms that usually cause UTIs are introduced via the ascending route from the urethra (E. coli is the most common pathogen leading to a UTI) -An important source of UTIs is health care–acquired infection -Urological instrumentation, particularly with an in-dwelling urinary catheter, is the most common predisposing factor -CAUTI: catheter-associated UTI

Answer 3

-Dysuria -Frequency of urination (>q2h) -Urgency -Suprapubic discomfort or pressure -Hematuria -May contain sediment- cloudy appearance -Flank pain -Chills -Fever: indicating pyelonephritis

Answer 4

Dipstick Urinalysis -Provides chemical analysis of urine, along with a microscopic interpretation Urine Culture & Sensitivity (C&S) -To confirm suspected urinary tract infection & identify causative organisms IVP -The presence, position, size, and shape of the kidneys, the ureters, and the bladder can be evaluated Abdominal CT

Answer 5

Urethritis (lower tract) Cystitis (lower tract) Pyelonephritis (upper tract)

Answer 6

Antibiotics -trimethoprim–sulfamethoxazole (TMP-SMX) (Bactrim) -nitrofurantoin (Macrodantin) -Increase fluid intake -Avoidance of unnecessary catheterization -Early removal of indwelling catheters

Answer 7

Inflammation of the urethra, most commonly from a sexually transmitted bacterial or viral infection -Dysuria & frequency -Feeling the frequent or urgent need to urinate -Difficulty starting urination -Discharge from urethral opening Tx: identify & treat the cause & provide symptomatic relief Trichomonas & monilial infection: esp females Chlamydia Gonorrhea: esp males

Answer 8

Interstitial cystitis (IC) is a chronic, painful inflammatory disease of the bladder -The bladder wall becomes inflamed or irritated -Can cause scarring, stiffening, and bleeding IC should not be confused with common cystitis, a bacterial infection of the bladder -IC is not caused by bacteria, nor does it respond to antibiotics S & S: pain, frequency, urgency Care: to alleviate symptoms -Dietary and lifestyle changes (low acid diet) -Some meds

Answer 9

-Inflammation of the renal parenchyma & collecting system (incl. renal pelvis) -Most common cause is bacterial infection that begins in the lower urinary tract -Commonly starts in the renal medulla & spreads to cortex -Usually a pre-existing factor resulting in backward flow of urine from lower to upper tract

Answer 10

-Mild fatigue, malaise -Sudden onset of chills -Fever -Vomiting -Flank pain -Frequency -Urgency

Answer 11

-Antibiotics 14-21 days -F/U urine culture -Increase fluid intake (8 glasses/d)

Answer 12

-Immune- related inflammation of the glomeruli characterized by: * proteinuria, hematuria (smoky), oliguria & edema -Fluid retention occurs as a result of decreased glomerular filtration -Periorbital edema initially, then spreads -Hypertension related to increased ECF volume Adjust protein intake Sodium & fluid restriction Rest Drugs Diuretics Antihypertensives

Answer 13

-One of the most common genetic diseases in Canada -The cortex and the medulla are filled with thin-walled cysts -The cysts enlarge and destroy surrounding tissue by compression -Filled with fluid and may contain blood or pus

Answer 14

-Symptoms appear when the cysts begin to enlarge -Common early symptom is abdominal or flank pain: steady or abrupt in onset as well as episodic and colicky -This pain is often caused by bleeding into the cysts -On physical examination, palpable bilateral enlarged kidneys are often found -Other clinical manifestations include hematuria (from rupture of cysts), UTI, and hypertension -Usually progress to end- stage renal failure Tx: nothing specific Goal: prevent or treat infections of the urinary tract

Answer 15

Uncontrolled loss of urine that is of sufficient magnitude to be a problem -The prevalence is higher among older women and older men, but it is not a natural consequence of aging

Answer 16

Inability to empty the bladder despite micturition or the accumulation of urine in the bladder because of the inability to urinate -obstruction leads to urinary retention when the blockage (i.e. enlarged prostate) prevents bladder evacuation MEDICAL EMERGENCY

Answer 17

-Tube inserted into bladder to drain urine -Promoting comfort when unable to use other means (weakness, disabilities, dying) -Specimen collection -Measuring exact urine output -Before, during, and after surgery -LAST resort for incontinence

Answer 18

Closed system for indwelling catheters Sterile environment Tubing + drainage bag

Answer 19

-Surgically inserted through abdomen into bladder Indicators for use: -Gynecological surgeries -Long-term catheterization -Urethral injury or obstruction

Answer 20

Simple: "in & out" Indwelling: foley Indwelling: 3 way (for bladder irrigation)

Answer 21

-Indicated to maintain catheter patency and prevent blockages in patients with significant hematuria -Fluid (0.9% saline) is continuously administered into the bladder via 3-way catheter and allowed to drain

Answer 22

Surgically created route to allow urine passage after cystectomy INCONTINENT: -diversion to the skin, requiring an appliance CONTINENT: -intra-abdominal urinary reservoir that is catheterizable or has an outlet controlled by the anal sphincter Contributing Factors -Cystectomy for cancer treatment -Cystectomy following injury

Answer 23

Ureterostomy -Ureter(s) brought directly to abdominal surface -One stoma for each ureter -Simplest Ileal Conduit -Section of intestine links ureters to abdominal surface -Construction of an artificial bladder

Answer 24

-Internal pouch created from the ileum, ileocecal segment, or colon -Pt must self-catheterize q4-6h -No need for external appliance -Does not leak involuntarily

Answer 25

Previously known as acute renal failure -sudden onset after severely decreased blood flow to the kidneys -usually affects people with other life-threatening conditions Can Be Caused By: -Severe bleeding -Heart attack -CHF -Burns -Infections -Severe allergic reactions

Answer 26

Phase 1: -oliguria (urine output <400ml in 24h) -lasts few days to 2 weeks Phase 2: -diuresis (output 1000-5000 ml in 24h) Recovery increase kidney function improves and returns to normal: -Can take 1 month - 1 year -Some don't recover: chronic renal failure

Answer 27

-Decreased urine output -Edema: legs, ankles, feet -shortness of breath -Confusion -Nausea -Flank pain -Fatigue, weakness

Answer 28

Dialysis Treatment of underlying issue Medications Two Possible Outcomes -Kidney function returns to normal without permanent damage -Chronic renal disease develops

Answer 29

Technique in which substances move from the blood through a semipermeable membrane (dialyzer) and into a dialysis solution (dialysate) -to correct fluid and electrolyte imbalances -to remove waste products in renal failure PERITONEAL DIALYSIS HEMODIALYSIS

Answer 30

Diffusion -movement of solutes from an area of greater concentration to an area of lesser concentration Osmosis -movement of fluid from an area of lesser to an area of greater concentration of solutes Ultrafiltration -water & fluid removal results when there is an osmotic gradient or pressure gradient across the membrane

Answer 31

Thin tube into the peritoneal cavity -Peritoneal catheter -Space between abdominal wall and bowel Fills peritoneal cavity with solution -Absorbs waste and excess fluids -Wastes move from high to low concentration Solution + waste drains from the body Daily (minimum): 30-40 mins each time

Answer 32

Blood removed from body -Access port in the arm Filtered by machine (artificial kidney) Returned to body 3 times/week: 4 h each time

Week 8: Renal and Genitourinary Disorders Flashcards

(56 cards)