Genitourinary/Reproductive

Question 1

What should be assessed for the female reproductive system?

Answer 1

History, menstrual and obstetric. Self-exams? Meds, sexually active, problems, symptoms, discharge, pain, ADLs, culture

Question 2

Incidence of this in young women is increasing. Can cause abnormal cervical cells which lead to cancer.

Answer 2

Human papilloma virus (HPV).
Lesions found in vagina, anus, skin.
Prevention

Question 3

What are examples of female diagnostic studies?

Answer 3

Papanicolaou (PAP) smear, laparoscope, hysterosalpingography, ultrasonography, mammography

Question 4

What should be avoided before a Pap smear?

Answer 4

Douching, intercourse, vaginal creams, during menstrual cycle

Question 5

What can cause vaginal fistulas? s/s?

Answer 5

Damage from surgery, vaginal delivery, radiation, IBS, cancer.
Depends on the area of the fistula. Fecal/urinary drainage via vagina.

Question 6

s/s of pelvic organ prolapse cystocele/bladder?

Answer 6

Pelvic pressure, urinary incontinence, frequency, urgency, dyspareunia

Question 7

s/s of pelvic organ prolapse rectocele/rectum?

Answer 7

Rectal pressure, constipation, uncontrollable gas, fetal incontinence, dyspareunia

Question 8

s/s of pelvic organ prolapse uterine?

Answer 8

Pressure, urinary incontinence, urinary retention, dyspareunia

Question 9

Pre-op and post-op hysterectomy?

Answer 9

Pre-op: Avoid blood thinners, pregnancy test, prophylactic antibiotic, body image/anxiety
Post-op: Prevent infection, assess for hemorrhage, DVT, assess bladder function, pain management, constipation, hormone therapy

Question 10

What are anterior and posterior colporrhaphy surgeries for? Post-op?

Answer 10

Anterior is for a prolapsed bladder, while posterior is for a prolapsed rectum
Post-op: prevent infection, decrease pressure to the incision, avoid lifting

Question 11

What are organic causes of erectile dysfunction?

Answer 11

Cardiovascular disease, endocrine disease, kidney failure, GU disorders, hematologic conditions, neurologic disorders, trauma, alcohol/smoking/drug use, medications

Question 12

What is asked when assessing for ED?

Answer 12

Sexual and medical history, physical exam, meds, alcohol, drugs, labs, blood flow study, psychological evaluation

Question 13

Psychogenic causes of erectile dysfunction?

Answer 13

Fatigue, depression, pressure, body image, trust, decreased desire

Question 14

S/s of testicular torsion and treatment?

Answer 14

Sudden pain in testicle, nausea, lightheadedness, swelling of scrotum
Treatment is surgery

Question 15

bacterial infection of kidney
usually begins in lower urinary tract & moves upward
acute or chronic

Answer 15

pyelonephritis

Use antibiotics, analgesics, hydration, and possible surgery

Question 16

s/s of acute pyelonephritis?

Answer 16

nausea/vomiting, fever/chills, malaise/fatigue, pain, leukocytosis, WBC in urine: pyuria, pus in the urine
tachycardia/tachypnea, nocturia, burning/urgency/frequency

Question 17

Diagnostic tests for pyelonephritis?

Answer 17

Radiologic studies
Ultrasound 
Intravenous Pyelogram (IVP)
Kidney Ureter Bladder (KUB)
Cystoscopy
Urine cultures

Question 18

Complications of pyelonephritis?

Answer 18

Permanent kidney damage, chronic kidney disease and failure, hypertension, sepsis

Question 19

Nursing care for pyelonephritis?

Answer 19

Patient education
Pain management
Voiding schedule
Daily weights
Force fluids to 3-4L/day if not contraindicated 
Strict I&O
Vitals Q4h & PRN
Antibtiotics

Question 20

Why is the patient taking phenazopyridine (pyridium)? Implications?

Answer 20

Urinary tract analgesic, non-opioid.
Stains urine orange. Drink 3-4L a day. Evaluate BUN/creatinine.
Worry about renal and hepatic toxicity

Question 21

Nitrofurantoin?

Answer 21

Urinary tract antibiotic. Monitor urinalysis and creatinine. May cause brown urine. Drink 3-4L a day. Worry about hepatotoxicity and CDT diarrhea

Question 22

ciprofloxacin?

Answer 22

Antibiotic for UTI. Can be used for a wide variety of infections, given PO or IV. Avoid in kids under 18. Photosensitivity. Worry about dizziness, confusion, seizures, severe sunburn, C diff

Question 23

What can cause renal calculi?

Answer 23

Anything that causes an increase of calcium in the urine, including dehydration, urinary retention and stasis, infections, genetics, kidney disorders

Question 24

What are s/s of urolithiasis and nephrolithiasis? Interventions?

Answer 24

Asymptomatic, severe pain (renal colic), pallor, diaphoresis, fever, chills, urinary frequency, possible hydroephrosis
Strain urine, cranberry juice, thiazides diuretics, the usual

Question 25

Signs and symptoms of benign prostatic hyperplasia?

Answer 25

Urinary retention, recurrent UTI, hematuria, straining to void, fatigue, anorexia

Question 26

anti-androgen agents like finasteride and dutasteride

Answer 26

Shrinks prostate.

Question 27

Intake and output with CBI, continuous bladder irrigation?

Answer 27

Input is 4000 mL of irrigation solution, output is 4800 mL in bag