GU Flashcards
Urolithiasis
stones found in the urinary tract
Affects ability of the bladder muscles to tighten or release due to nerve damage. Problem controlling the bladder from nerve damage
Neurogenic Bladder
Results from recurrent urinary tract infection.
Pyelonephritis (kidney infection)
This may occur as a result of long-term dialysis, use of NSAIDs, kidney stones, and hepatitis C.
renal cancer
Urine drains automatically through opening created in the abdominal wall and skin. Fastest and simplest to perform and care for.
noncontinent ileal conduit
S/S: Severe, acute pain accompanied by n/v
ureteral calculi
S/S: Urinary urgency, frequency, lower back pain, foul-smelling urine
Cystitis
S/S: May be painless with intermittent hematuria. Pelvic of flank pain in metastasis
bladder cancer
S/S: Hematuria, blood in the semen, reduction in urine stream, back pain
prostate cancer
S/S: Dull, aching pain in flank or abdomen, colicky, hematuria, or palpable mass in the flank
renal cancer
Cystoscope is introduced into the bladder for direct visualization of the bladder and urethra
cytoscopy
Placed with a guide wire under fluoroscopy to open areas of blockage by renal calculi and allow urine to drain
stent
Treatment with analgesia, hydration, and dietary management
renal calculi
Noninvasive procedure in which renal and ureteral stones are pulverized into smaller fragments by shock waves.
Extracorporeal Shock Wave Lithotripsy (ESWL)
Surgery done to remove part of the prostate gland, amount of tissue to be removed is relatively small. Requires no incision. Gland is removed in small chips.
Transurethral Resection of the Prostate (TURP)
Medication: Patients are instructed not to take this 48 hours prior to and after receiving contrast dye.
metformin (Glucophage)
Medication: Urinary anesthetic used to treat urinary tract infections.
pyridium (Phenazopyridine)
Medication: Improves flow, relax the smooth muscle of the bladder neck and prostate.
alpha-adrenergic blocking agents (Hytrin, Cardura, FloMax)
Medication: Treatment for recurrent urinary tract infection and contraindicated for sulfa allergies, asthma. Should not be used if received in the past 3 months.
TMP-SMZ (Bactrim DS)
Sulfanomides, Fluroquinolones, and Penicillins.
Treat UTI’s
A document that permits the Urologist to perform a Cystoscopy
informed consent
Drink 2-3 L of water daily, wipe perineum from front to back, and avoid bubble baths.
Prevent UTI
Monthly examination of the testicles to identify masses and any changes.
testicular self examination
Semen storage after diagnosis, before radiation therapy and chemotherapy
testicular storage
What are the components of co-trimoxazole
Co-trimoxazole is a combination of trimethoprim and sulfamethoxazole and is in a class of medications called sulfonamides.
What is the rationale for combining the components of co-trimoxazole?
work better to disrupt FOLATE SYNTHESIS
If patient is also on warfarin (Coumadin), what effects does co-trimoxazole have on Coumadin?
Would you expect the Coumadin dose be increased or decreased?
I would expect it to be decreased due to this medication increasing the effects of Coumadin.
KUB. Used to diagnose stones
X-ray of kidneys, urtreters and bladder
Nurses role in IVP (intravenous pylogram)
assess allergies to iodine and shellfish , pregnant? nursing?, impaired renal function? metformin?
diagnosing stones
KUB, pyleogram, 24 hour urine, U/S, CT scan,
When analyzed, most stones are
calcium oxalate or calcium phosphate.
Manifestations of UTI -
Blood in the urine (hematuria), Increased frequency of urination, Nausea and vomiting
Pain during urination (stinging, burning), Tenderness in the abdomen and kidney region
Urinary tract infection (fever, chills, loss of appetite). Pain most common symptom
Renal colic : Sudden onset unilateral flank pain, severe enough to cause the patient to go to the ED. Pain fluctuates in intensity, nausea present.
renal calculi complications
infection, blockage, hydronephrosis
Use of shock waves generated outside the body. Repeated shock waves pulverise the stones into fragments
lithotripsy (ESWL)
post care of lithotripsy
Observe for signs of bleeding
Monitor vital signs every hour
Monitor urine output for amount, color, clarity first 48 hours
Observe for increased bruising at side treated
Note any leakage (catheter), s/s of infection
common causes of neurogenic bladder
vaginal birth, cerebral disorders, diabetes, brain or spinal cord infections, MS, Parkinsons disease
accurate predictor of UTI
urinalysis with positive nitrate and pyuria and/or bacteria
antibiotic treatment for UTI sulfonamide (main one)
Trimethoprim/sulfamethoxazole (TMP-SMZ)
Bactrim/Septra
Bactrim DS should not be used if a patient has received it
For treatment of UTIs during the previous 3 months
two more antibiotics for UTI that are not sulfonamides
Fluroquinolones: e.g cipro Reserved for complicated cystitis Bactrim and Fluroquinolones-side effect of yeast infection Penicillins: Amoxicillin
urinary analgesic
pyridium (Phenazopyridine)
Can develop on the surface of the bladder wall or grow within the bladder wall and invade underlying muscles. Starts at base of bladder and involve the openings to the ureters and the bladder neck.
bladder cancer
More common in men over age 50
More common in populated industrial areas
Environmental carcinogens
bladder cancer
S/S: high BP and obesity, tobacco use, longer term dialysis, kidney stones, chronic hep C, exposure to chemicals, estrogen therapy, polycystic kidney disease
renal cancer
early manifestations of kidney cancer
asymptomatic initially, blood in urine, dull pain, lower back mass
late manifestations of kidney cancer
weight loss, weakness, fatigue, exhaustion, hight calcium levels in the blood, anemia, fever
non surgical treatment of kidney cancer
renal artery embolization, chemotherapy, biological response modifier, stem cell transplant, vaccination
most common invasive cancer in men and second most common cause of cancer death in men
prostate cancer
Risk factors: high fat diet, obesity, over 50, african and carribean background, elevated testosterone, STI increase risk
prostate cancer
Early S/S of prostate cancer
urinary complaints, urinary retention, urinary frequency, nocturia, reduction of urine stream, hematuria, back pain
Late S/S of prostate cancer
weight loss/no appetite, anemia, bone pain, spinal cord compression, neuro deficits from spinal cord compression, urethral obstruction caused by prostate growth
Diagnostic studies for prostate cancer
Prostate Specific Antigen (PSA. 3 consecutive measurements of specimens over at least 18-24 months), Digital rectal exam (needle biopsy), Transrectal ultrasound (TRUS)
painless lump or mass on testicle, heaviness in scrotum, backache, abdominal pain, weight loss, general weakness
testicular cancer (usually get at 15-35 years)
90% of testicular cancers are
germ cell germinal tumors