GU Flashcards
While performing a comprehensive GU health history, what GU symptoms might you come upon that are “abnormal” or might help you discern there is a problem?
Frequency, urgency, nocturia, dysuria, hesitancy, straining, dribbling
What things are you looking for that are out of the ordinary with repro organs?
Lesions, pain, discharge, lumps
What are some recommended screenings for reproductive organs?
Pap/pelvic, mammogram
What does LMP mean?
Last menstrual period
What is atrophic vaginitis?
Thinning of internal genitalia tissue
What are some additional things to consider re: health history for aging adults.
- Postmenopausal bleeding
- Atrophic vaginitis (thinning of internal genitalia tissue)
- Uterine prolapse
- Sexual satisfaction
Nursing assessment of genitourinary (GU) system focuses on ____________.
bladder function
Describe dysuria:
Burning, stinging, itching sensation
In older adults mental status change could be a sign of _____.
UTI
What is nocturia?
Urinary frequency that occurs at night
What is urinary urgency?
Usually abrupt and strong urge to void
Can be a cause of incontinence (leakage of urine)
What is oliguria?
The production of abnormally small amounts of urine
What would indicate oliguria?
Less than 20-30 mL/hr is of concern, or 400 mL/day, 200/12 hr shift
What is anuria?
Failure of the kidneys to produce urine
What would indicate polyuria?
VOLUME more than 2.5 L output/day. Frequency will be a factor as well, d/t space for capacity
What is stress incontinence?
Leakage of urine with activity or pressure
What is urge incontinence?
Leakage of urine with sensation of need to void
What is mixed incontinence?
Leakage of urine with activity and desire to void
What is overflow incontinence?
Leakage of small amounts d/t lrg volume of retained urine
What is functional incontinence?
Incontinence because of barriers to voiding (ambulation, can’t get to toilet, pain, disorientation, neuro issues, etc)
If you are able to percuss a distended bladder, you can assume there is at least ______ in it.
150 ml
Things to do when assessing for distended bladder:
- Ask when bladder was last emptied
- Lightly palpate (give or take 1 inch depth) between symphysis pubis and umbilicus
- Note size and location of bladder
Normally an empty bladder is not _______, a partially filled bladder is ______________.
palpable, smooth and firm
What are indications for getting a bladder scan?
Assess for urinary retention, catheter blockage, post void residual
If the data from the bladder scan shows at least 250-300 ml, what should you do?
Cath!
Ways of describing urine: Clarity.
Cloudy, clear, particles (can be clots), sediment
Ways of describing urine: Odor.
Strong (concentrated, dehydration), odor of medication or food, infection, etc.
Ways of describing urine: Color.
Tea colored, amber, straw, bloody, pale.
If urine is white or cloudy, what might it indicate?
Phosphate crystals, or pyuria (white blood cells)
If urine is red/pink, what might it indicate?
Red blood cells – renal ds, UTI, urinary stone, malignancy, trauma (procedures) Phenolphthalein (laxative in Exlax) Blackberries, beets, rhubarb Phenytoin, Compazine Chronic lead and mercury poisoning
If urine is orange, what might it indicate?
Pyridium, rifampin, phenacetin, sulfasalazine, Vitamin C, carrots
If urine is blue/green, what might it indicate?
Blue dye – methylene blue (in Trac Tabs, Urised, Uroblue) – used to reduce symptoms of bladder irritation
Propofol (blue or pink urine) Amitriptyline, indomethacin, resorcinaol, tramterine, cimetidine, Phenergan and several multivitamins – blue/green tint to urine Inherited form of high calcium (familial hypercalcemia)
If urine is brown/black what might it indicate?
Myoglobin or bilirubin
Copper or phenol poisoning
Large amounts of rhubarb, fava beans or aloe
Chloraquine, primaquine, furazolidone, metronidazole, nitrofurantoin, cascara/senna laxatives, methocarbamol and sorbital
What is the RNs role in an AFAB GU assessment?
External exam, set up room, have pt empty bladder
What is a normal finding in postmenopausal AFAB?
Thin, atrophied labia minor atrophied labia minora
What is a normal finding in pregnant AFAB?
Labia majora and labia minora more separated
What are some abnormal findings in an AFAB GU exam?
- Inflammation, erythema, lesions, masses, bulges, lesions, masses, bulges, lacerations
- Discharge
- Swelling, esp bilaterally
- Genital warts (Condylomata acuminata)
- Uterine Prolapse (Keep it moist! Sterile saline on gauze, etc.)
- Yeast infection
When should AFAB folks start getting mammograms?
Age 40
What are some positions for pts to be in for mammary tissue exams?
- Arms above head
- Hands against hips
- Extend arms straight ahead while leaning forward
- Supine with hand behind head
Re: The position of the urethral meatus: What is hypospadias?
Urethral opening underneath lower shaft of penis
Re: The position of the urethral meatus: What is epispadias?
Urethral opening above the shaft of penis
During a GU inspection on AMAB what could be some abnormal findings?
- Epididymitis
- Orchitis
- Scrotal Edema
- Spermatocele
- Hydrocele (fluid around teste, will resolve on its own)
- Varicocele (feels like a bag of worms – ropey)
- Absent testis; cryptorchidism
- Small testis
- Testicular torsion (emergency)
- Hernias
- Herpetic lesion
- Genital warts
What is a spermatocele?
An abnormal sac (cyst) that develops in the epididymis — the small, coiled tube located on the upper testicle that collects and transports sperm. Noncancerous and generally painless, a spermatocele usually is filled with milky or clear fluid that might contain sperm.
What is a varicocele?
An enlargement of the veins within the loose bag of skin that holds your testicles. Feels like a bag of worms – ropey.
What is hydrocele?
Fluid around teste, will resolve on its own
Most common AMAB cancer?
Prostate. 1 in 8, average age of diagnosis is 66.
Less common cancer in AMAB, happens when younger?
Testicular cancer
