Chapter 16 Urinary And Reproductive Diseases.

Question 0

Some symptoms patients with BPH May see include?

Answer 0

Hesitancy in urinating, decrease in the force of the urine stream, trickling, and the sensation of incomplete Bladder emptying. In severe cases urinary tract infections and Hydronephrosis may occur.

Question 1

An age-related enlargement of the prostate gland that constricts the urethra and prevents the outflow of urine

Answer 1

Benign prostatic hypertrophy. BPH.

Question 2

Diagnostics for BPH include?

Answer 2

Urinalysis, digital rectal exam, abdominal ultrasound, and serum prostate specific antigen (PSA)to rule out malignancy.

Question 3

The following medications can make the symptoms of BPH worse.

Answer 3

Decongestants such as Sudafed and anti-cholinergics such as Benadryl

Question 4

The following medications are used to reduce the symptoms of BPH.

Answer 4

Alpha blocker such as Flomax, Hytrin, and Cardura.

Question 5

Treatment of BPH besides medications may include?

Answer 5

Surgical intervention such as ablative transurethral techniques, intra Proststatic stents, or transurethral prostatectomy

Question 6

This is the most common form of cancer in older American men.

Answer 6

Prostate cancer

Question 7

The most common sites of prostate cancer metastasis?

Answer 7

The bones and pelvic lymph nodes. Bone pain and pathological fractures are indications of metastatic disease.

Question 8

Definitive diagnosis of prostate cancer is done bye?

Answer 8

A prostate biopsy

Question 9

Bladder cancer occurs most predominantly at what age group and sex?

Answer 9

Men, ages 50 to 70.

Question 10

Signs and symptoms of bladder cancer include?

Answer 10

Painless hematuria, dysuria, urgency, and frequency.

Question 11

Most bladder cancers are sporadic; however 20% of them occur in individuals with exposure to?

Answer 11

Industrial dies, rubber, chemicals, benzene, and paint. Cigarette smoking is thought to be a risk.

Question 12

Nursing management of patients with bladder cancer centers on?

Answer 12

Patient education, psychosocial support, and pain control.

Question 13

For patients treated with BCG chemotherapy For bladder cancer, what kind of follow-up is recommended?

Answer 13

Follow up Cystoscopy is required for several years after successful cancer treatment.

Question 14

This occurs in 30% of older adults with rates being higher in women and is a frequent major reason for admission to a nursing home.

Answer 14

Urinary incontinence.

Question 15

Two types of Urinary incontinence include?

Answer 15

Acute and chronic.

Question 16

Common causes of acute urinary incontinence

Answer 16

UTIs, immobility, fecal impaction, delirium, diabetes, alcohol use in excess, and medications.

Question 17

What are the five different types of chronic incontinence?

Answer 17

Stress incontinence, urge incontinence, overflow incontinence functional incontinence and mixed incontinence.

Question 18

This type of incontinence can occur because of multiple pregnancies, vaginal deliveries, trauma during the surgical procedure, obesity, or chronic coughing.

Answer 18

Stress incontinence. These individuals leak urine when exerting themselves for example with exercise, lifting, coughing, sneezing, or laughing.

Question 19

This type of urinary incontinence is usually associated with abnormal bladder contractions and is sometimes referred to as overactive bladder.

Answer 19

Urge incontinence

Question 20

This type of incontinence is seen in those taking anticholinergic medications, with spinal cord injuries, or with an obstruction to emptying the bladder such as an large prostate or uterine prolapse. A chronically full bladder obtains a high enough pressure to voluntarily empty itself.

Answer 20

Overflow incontinence

Question 21

This type of incontinence is the involuntary loss of urine that occurs because of inability or unwillingness to get to the toilet. Patients with physical problems may not be able to ambulate to the bathroom in a timely fashion or have cognitive issues and not recognize that they need to urinate.

Answer 21

Functional incontinence

Question 22

A combination of two or more types of incontinence is known as?

Answer 22

Mixed incontinence

Question 23

For patients who are cognitively intact interventions for urinary incontinence may include?

Answer 23

Bladder retraining (Voiding schedule), pelvic floor muscle exercises (kegel), Pelvic floor electrical stimulation and bio feedback Can be useful to help male patient’s post prostatectomy.

Question 24

This type of toileting for patients with cognitive impairments means that patients are taking to the bathroom on a preset schedule.

Answer 24

Scheduled toileting

Question 25

With this type of toileting a patient’s normal voiding patterns are identified and the patient is been assisted in the act of voiding at specific times.

Answer 25

Habit training

Question 26

This type of toileting is best used in patients with cognitive impairment who still understand what the urge to avoid is. The goal is to help patients understand this urge and to increase their ability to use the toilet themselves with a verbal cue.

Answer 26

Prompted voiding

Question 27

What things should the nurse educate patients on regarding urinary incontinence at night?

Answer 27

Restricting large amounts of fluids late in the day. Encourage patients to drink most of their fluids before dinner. For patients with peripheral edema, spending several hours late in the day with the legs elevated will decrease the amount of edema at bedtime and thus reduce the amount of nocturia

Question 28

This maneuvers used by patients with overflow incontinence. In this maneuver the patient gently applies pressure to the suprapubic area while voiding

Answer 28

Crede Maneuver

Question 29

Nurses should remember what about urinary tract infection symptoms in older patients?

Answer 29

Older patients often present atypically when they have infections and may present with atypical symptoms such as anorexia, falls, and altered mental status.

Question 30

Sildenafil should not be taken with what because of the potentiating effects on vasodilation and side effects including changes in vision, back pain, muscle pain, and prolonged erections.

Answer 30

Nitrates

Question 31

Testosterone is contraindicated in what?

Answer 31

Breast or prostate cancer.

Question 32

What does the PLISSIT model stand for and what is it used for?

Answer 32

Permission, limited information, specific suggestions, intensive therapy. It is used to intervene with patients who have sexual dysfunction

Question 33

What is the average age of female menopause in the United States and what are the symptoms?

Answer 33

Age 51. Many women suffer mood swings, hot flashes, and depression at the time of menopause.

Question 34

What are the physical changes after cessation of menstruation for one year?

Answer 34

That Vaginal atrophy and osteoporosis.

Question 35

Use of hormone replaceplacement therapy after menopause should be used with caution due too?

Answer 35

Increased risk of coronary heart events, strokes, thromboembolic disease, breast cancer, and gallstones.

Question 36

Nursing management and assessment for post menopausal women include?

Answer 36

Provide information about weight-bearing exercise and adequate calcium and vitamin D. Information related to changes in sexuality should also be discussed. Symptomatic therapies include vaginal lubricants for atrophic tissues and OTC Melatonin to help with sleep.