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Quarter 4 > Chapter 66: Care of Patients with Urinary Problems > Flashcards

Chapter 66: Care of Patients with Urinary Problems Flashcards

1
Q

The components of the urinary system are

A

the ureters, bladder, and urethra.

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2
Q

Acute infections in the lower urinary tract include

A

urethritis, cystitis, and prostatitis

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3
Q

upper urinary tract infection

A

pyelonephritis

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4
Q

Cystitis

A

is an INFLAMMATION of the bladder. Common causes are irritation or INFECTION from bacteria, viruses, fungi, or parasites.

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5
Q

Noninfectious cystitis is caused by

A

irritation from chemicals or radiation.

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6
Q

Interstitial cystitis

A

is an inflammatory disease that has no known cause.

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7
Q

Infectious cystitis can lead to

A

complications, including pyelonephritis and sepsis.

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8
Q

common manifestations of a urinary tract INFECTION

A

Frequency,urgency, and dysuria

cloudy, foul-smelling, or blood-tinged urine may occur.

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9
Q

cystitis dx

A

based on history, physical examination, and laboratory data.

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10
Q

___ may be needed to locate the site of an obstruction or the presence of calculi.

A

Urography, abdominal ultrasonography, or computed tomography

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11
Q

Laboratory assessment for a UTI is a ___

A

urinalysis performed on a clean-catch midstream specimen with testing for leukocyte esterase and nitrate.

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12
Q

A urine culture confirms __

A

the type of organism and the number of colonies

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13
Q

A urine culture is indicated

A

when the UTI is complicated or does not respond to usual therapy.

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14
Q

most common factor placing patients at risk for UTIs in hospital and long-term care settings

A

catheters

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15
Q

Drugs used to treat bacteriuria and promote patient comfort include

A

urinary antiseptics or antibiotics, analgesics, and antispasmodics

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16
Q

what can help prevent or reduce cystitis in the general population.

A

Changes in fluid intake patterns, urinary ELIMINATION patterns, and hygiene patterns

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17
Q

Urethritis

A

is an INFLAMMATION of the urethra that causes symptoms similar to UTI.

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18
Q

In men, manifestations of urethritis are

A

burning or difficulty with urination and a discharge from the urethral meatus, usually caused by sexually transmitted diseases (STDs)

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19
Q

In women, urethritis causes manifestations

A

similar to those of bacterial cystitis.

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20
Q

Urethral strictures

A

are narrowed areas that are idiopathic or caused by an STD or result from trauma during catheterization, urologic procedures, or childbirth.

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21
Q

Urethral strictures s/s and tx

A

The most common symptom of urethral stricture is obstruction of urine flow.

•Treatment includes surgery to dilate the urethra, placement of a stent, or urethroplasty

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22
Q

Continence

A

is a learned behavior to control the time and place of urination and is unique to humans and some domestic animals.

•Efficient bladder emptying from coordination between bladder contraction and urethral relaxation is needed for continence

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23
Q

Incontinence

A

is involuntary loss of urine causing social or hygienic problems.

24
Q

stress incontinence

A

is the loss of small amounts of urine during coughing, sneezing, jogging, or lifting.

25
Q

Urge incontinence

A

is the perception of an urgent need to urinate as a result of bladder contractions regardless of the urine volume in the bladder.

26
Q

Mixed incontinence,

A

the presence of more than one type of incontinence, is more common in older women.

27
Q

Overflow incontinence

A

occurs when the bladder has reached its maximum capacity and some urine must leak out to prevent bladder rupture.

28
Q

functional incontinence

A

occurs as a result of factors other than the abnormal function of the bladder and urethra.

common in patients with dementia

29
Q

determine the amount of residual urine by

A

portable ultrasound or catheterizing the patient immediately after voiding.

needs physicians order

30
Q

In women inspect for:

A

external genitalia to determine whether there is apparent urethral or uterine prolapse, cystocele, or rectocele with pelvic floor muscle weakness.

31
Q

Initial interventions for stress incontinence include

A

keeping a diary; behavioral interventions, such as diet and pelvic muscle exercise; and drugs or surgery as a last resort.

32
Q

Other interventions for stress incontinence

A

include behavior modification, psychotherapy,
and electrical stimulation devices to strengthen urethral contractions.

may be corrected by vaginal, abdominal, or retropubic surgeries with varying success rates.

33
Q

Interventions for patients with urge incontinence or overactive bladder include

A

behavioral interventions and drugs; surgery is not recommended

34
Q

Interventions for the patient with reflex or overflow incontinence caused by obstruction of the bladder outlet may include

A

surgery to relieve the obstruction.

35
Q

Urolithiasis

A

is the presence of calculi or stones in the urinary tract.
•Stones often do not cause symptoms until they pass into the lower urinary tract, where they can cause excruciating PAIN.

36
Q

Nephrolithiasis

A

is stones in the kidney

37
Q

ureterolithiasis

A

is stones in the ureter.

38
Q

renal colic

A

The major manifestation of stones is severe PAIN, most intense when the stone is moving or when the ureter is obstructed.

39
Q

Oliguria or anuria

A

suggests obstruction, possibly at the bladder neck or urethra.

40
Q

Urinary tract obstruction is __

A

an emergency and must be treated immediately to preserve kidney function.

41
Q

Stones are easily seen on:

A

x-rays of the kidneys, ureters, and bladder; IV urograms; or computed tomography.

42
Q

Stones- Nursing interventions focus on:

A

PAIN management and prevention of INFECTION and urinary obstruction.

43
Q

Lithotripsy, also known as extracorporeal shock wave lithotripsy

A

is the use of sound, laser, or dry shock waves to break the stone into small fragments.

44
Q

stones: Minimally invasive surgical procedures include:

A

stenting, retrograde ureteroscopy, and percutaneous ureterolithotomy and nephrolithotomy

most patients can expel stone themselves

45
Q

Diet: To prevent and treat urolithiasis, patients are encouraged to:

A

drink lots of fluids and eat lots of fruits and vegetables, a low amount of protein, and a balanced intake of calcium, fats, and carbohydrates.

46
Q

Urothelial cancers

A

are malignant tumors of the urothelium, the lining of transitional cells in the kidney, renal pelvis, ureters, urethra, and mostly the bladder.

47
Q

what occur when INFECTION or obstruction is also present

A

Dysuria, frequency, and urgency

48
Q

Urothelial cancer urinalysis findings

A

The only significant finding on a routine urinalysis is gross or microscopic hematuria.

49
Q

Urothelial cancer dx

A

Cystoscopy with retrograde urography is usually performed to evaluate painless hematuria, and a biopsy of a visible bladder tumor can be performed.

50
Q

Therapy for the patient with bladder cancer

A

usually begins with surgical removal of the tumors for diagnosis and staging of disease.

51
Q

Urothelial cancer: to prevent tumor recurrence of superficial cancers:

A

Prophylactic immunotherapy with intravesical instillation of bacille Calmette-Guérin, a live virus compound, is used

52
Q

Tumors confined to the bladder mucosa are treated by

A

simple excision, whereas those that are deeper but not into the muscle layer are treated with excision plus intravesical chemotherapy.

53
Q

large, invasive bladder cancers tx

A

Complete bladder removal with additional removal of surrounding muscle and tissue offers the best chance of a cure

54
Q

cancer additional tx to surgery

A

chemo and radiation

55
Q

Four alternatives are used after cystectomy (bladder removal):

A

ileal conduit, continent pouch, bladder reconstruction (also known as neobladder), and ureterosigmoidostomy.

56
Q

Bladder Trauma

A

other than a simple contusion, requires surgical intervention.

•Psychosocial support is critical for patients who have sustained traumatic injuries. Refer them to counseling resources to assist in dealing with psychosocial issues.

57
Q

adequate fluid intake

A

a minimum of 1.5 to 2.5 L daily, unless another health problem requires fluid restriction.

Quarter 4 (6 decks)

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