Genitourinary and Nephrology

Question 1

IF the urinary flow is obstructed in a 3-way continuous bladder irrigation set-up, what should be the nurse’s first action?

Answer 1

manual irrigation with sterile NS until there are no clots or the urine is clear/pink

Question 2

What is the purpose of belladona-opium suppositories (oxybutynin) after TURP?

Answer 2

used for bladder spasms, an expected complication of surgery

Question 3

What are the causes of post-op pain from TURP usually due to?

Answer 3

general post-op pain, bladder spasms, kinked/blocked catheter

Question 4

Peritoneal dialysis - what are signs of peritonitis?

Answer 4

Cloudy outflow, tachycardia, low grade fever

Question 5

What does blood fluid indicate in peritoneal dialysis?

Brown fluid?

Answer 5

bloody - may indicate intestinal perforation or menstruation

brown - may indicate fecal contamination from performation

Question 6

At what rate would we be worried about urine output?

Answer 6

less than 30mL/hour

Question 7

TURP
- describe the colour of the irrigatnt during the first 24 hours-36 hours
- the nurse is expected to adjust the irrigation rate so that the urine appears like what?
describe total foley output

Answer 7

urine colour changes from reddish-pink to pink in the first 24 hours; small clots are expected for up to 36 hours after surgery

the nurse should adjust the irrigation rate so that the urine remains light pink without clots

total foley output > CBI input
- if this is not the case, an obstruction is most likely present

Question 8

Clients with BPH are at greater risk for what?
Describe treatment.
What are symptoms?

Answer 8

UTIs

sx - urinary urgency, frequency, hesitancy, dribblinb, nocturia, urinary retention

Tx - lifestyle modification (e.g. voiding schedule, avoiding caffeine and anti-histamines), medications (e.g. finasteride, flowmax), potentially surgery (e.g. TURP)

Question 9

Describe the process for getting clean catch urine for a female.

Answer 9

1. Perform hand hygiene and open the specimen container, leaving the sterile side of the collection lid positioned upward to prevent contamination
2. Spread the labia using the index finger and the thumb of the nondominant hand so that the specimen cp can be held in the dominant hand
3. Cleanse the vulva in a front-to-back motion with antiseptic wipes, using a new towelette with each wipe to prevent contamination
4. Initiate the urinary stream to flush any remaining microbes from the urethral meatus before passing the container into the stream for the collection of 30-60mL of urine
5. Remove the specimen container from the stream before the urinary flow ends and the labia are released to prevent contamination.
6. Replace the sterile cap without contaminating it and repeat hand hygiene.

Question 10

What hormone spike precedes ovulation?

Answer 10

LH - luteinizing hormone