Lower Urinary System Male/female Urinary And Reproductive Disorders Flashcards
How much urine does the bladder hold
600-1000ml
Is the males urethra much longer than the females
Yes
What is the muscle that keeps urine flowing
Detrusor muscle
How does urine flow in the body
It flows downward
Is urine sterile
Yes
How often should we go to the bathroom
Every 2-4 hours
Why should we do pelvic floor exercises
To keep things tight and in place
What fluids should we limit
Caffeine and carbonated drinks
What are the three types of urinary incontinence
Stress
Urge (overactive bladder)
functional,
What can CAUSE stress incontinence
Laughing
Sneezing
Coughing
What CAN cause urge incontinence
Having the sudden urge to go
What can cause functional incontinence
Illness
Disability
Cognitive problems
What muscles are weakened and can cause stress incontinence
Pelvic floor muscles and urinary sphincter weaken
What can cause the pelvic floor muscles and urinary sphincter to weaken
Childbirth or prostate surgery
What is the big name to know for urge incontinence
Overactive bladder
What is enuresis
Bed wetting
How can we help those with functional incontinence get to the restroom
Keep things out of the way
Have good lighting
Easy to remove clothes
What are anticholinergics used to treat
Treat urinary incontinence
What do anticholinergics du to the body
Dry YOU up
What does oxybutynin(ditropan) decrease
Decreases urgency
Frequency
Nucturia in the overactive bladder
What pt should we not give anticholinergics
A pt with BPH
What drug should we not give along with anticholinergics
Decongestants
What do anticholinergic cause
Urinary retention
What are treatments for incontinence issues
Pelvic floor exercise
Scheduled toileting times
Botox injections
Nerve stimulates
What is urinary detention
Inability to empty the bladder all the way
What is the #1 cause of urinary retention
BPH
What are other causes of urinary retention
Obstruction- kidney stone
Narrowing- urethral
Tumors
Certain meds - anticholinergics, opioids
Being dehydrated
Constipation
What is acute urinary retention
Sudden and often painful inability to urinate at all despite bladder fullness
Does acute urinary retention require intervention
Yes
What is chronic urinary retention
Gradual inability to empty the bladder; painless retention associated with increased volume of residual urine
If a pt has chronic urinary retention can the bladder still feel full after passing urine
Yes
What is overflow incontinence
Leaking urine without being able to control it
What is the nursing management steps of acute bladder retention
Bladder scan
Palpate ht
Ask about voiding history
Need indwelling cath
Drink small amounts of fluids
Avoid alcohol, caffeine, acidic fruit
Sitting in warm water or warm shower
What are nursing management things seconds for chronic urinary retention
Intermittent or indwelling urinary cath
Schedule toileting
What is the most important risk factor for bladder cancer
Smoking
What is painless hemateria a sign of
Bladder cancer
Cancer can cause
Bladder inability
Dysuria
Frequency and urgency
What is the treatment for bladder cancer
Removing the bladder
What is a urostomy
Urine comes through an opening in the abdomen into a bag
What should the nurse do when one of the pts is getting a urinary diversion device
Teach family and pt about the device
Address psychosocial aspect of stoma, stoma care and pouch application
Encourage pt to talk about feelings related to stoma creation
Enterostomal therapist consult to visit with pt
What is a neurogenic bladder
Nerves b/w spinal cord and brain don’t work
What diseases can cause a pt to have neurogenic bladders
Parkinson’s
Multiple sclerosis
Stroke
Diabetes
What can the nurse do to help the neurogenic bladder pt
Provide routine voiding measures
Avoid caffeine and alcohol
Pelvic floor exercise
Cath care when en indicated
Meds-tamsulosin (flow max ) improves bladder storage and emptying
What diagnostic studies can we do for urine
Urinalysis
Urine studies
Serum creatinine
Bun
Creatinine clearance
When a serum creatinine is greater than 1.2 is what for women
Abnormal
When a serum creatinine is 1.4 for both men and women it means what
Abnormal
For a creatinine clearance what should the pt do with the first urine
Discard it
How long do we collect a creatinine clearance
24 hours
Where should they store the container for the 24 hour urine collection
On ice
Once the 24 hour collection is over what should we have the pt to beforefinishing the collection
Have them pee and add it to the collection
What is interstitial cystitis
Painful bladder syndrome
What are clinical manifestations of interstitial cystitis
Pain in perineum
Persistent urgent need to void
Painful intercourse
Frequent urination
Rain while bladder fills und relief after urinating
May have autoimmune component
What can cause UTIs
Hormones
Antibiotics
Renal stones
Diabetes
Toiletries
Obstructive prostate
Vesicoureter reflux
Over extended bladder
Indwelling urinary catheter
Decreased immune system
What is the number 1 cause of UTIs
Indwelling catheters
What should we teach our pts about UTIs
Fluids
Food
Eat
Void
Exercise
What is a catheter-associated urinary tract infection (cauti)
Most common hospital acquired infection
What is the #1 cause of prolonged use of urinary catheter
Cauti
What are some of the common bacteria for the UTIs
E. coli
Pseudomonas
Proteus marabilis
Who is at risk for UTIs
Peds and females
Congenital defects
Urinary retention
Pregnant
Menopause
Multiple partners
What are s/s of UTIs
Hesitancy, frequency, urgency
Dysuria
Superpubic pain
How do we diagnose a UTI
UA/ urine culture
+RBC
Cloudy
WBC
Nitrites
What should we see in elders pts that have UTIs
Sudden change in loc
Falls
Tachypnea
Anorexia
Low grade fever or no fever
How should a nurse manage a UTI
Get a urinalysis
Gena urine culture
place pt on medications as ordered
Prevent cauti
Reverent urosipesis
How do we perform a clean catch urine sample
Wash hands
Clean urinary opening with towelette front to back
Void into toilet for a few seconds and stop
Place sterile container into path of stream
Restarturite and collect mid stream of urine
What are the CDC indications for indwelling urinary catheter
Acute urinary retention or bladder outlet obstruction
Need for accurate I&O (hourly monitoring)
Assist in healing of open sacral or perineal wounds
Prior to certain surgical procedures
Pt requires prolonged immobilization
To improve comfort for end-of-life care
What is urosepsis
An untreated UTI that spreads to the kidneys
What causes urosepsis
Caused by infection from UTI
What are risk factors for urosepsis
Urinary catheters
Advanced age
Compromised immune system
Diabetes
Female gender
Surgical procedures involving urinary tract
What are the initial symptoms of urosepsis
Initially UTI symptoms:
Abnormal WBC count
Urgency
Frequency
Foul smelling urine
Dysuria
Lower abdominal pain
What are some more severe s/s (pyelonephritis) associated with urosepsis
Nausea
Vomiting
Fever
Pain in lower spine (CVA tenderness) costovertebral angle tenderness
What are sepsis symptoms
Respiratory rate 22 or higher
Systolic pressure less than 100mmhg
WBC too high or too low (4500 - 10,000 per microliter)
What are symptoms of severe sepsis/septic shock
Organ failure, such as kidneys (decreased urine output)
Low platelet count
Change in mental status
High levels of lactic acid in blood (cells are not utilizing oxygen in the right way)
How to we manage sepsis
Early goal directed therapy
Broad spectrum antibiotics
Control pain
Iv fluids to maintain blood pressure support
O2 therapy
Stick hourly I&O
Removal of am catheters or devices that may be infected
Supportive cure- stabilizing lungs and flow of blood
Disorders in the male population.
Peyronies
Priapism
Phimosis
Hypospadius
Diphilia
PRE
Prostatitus
BPH/TURP
Prostate cancer
Testicular torsion
Erectile dysfunction (ED)
What is peyronies
Scar tissue forms under skin of penis; plague pulls on surrounding tissue and causes penis to curve or bend during an erection
What is a priapism
Prolonged painful erection without sexual desire
What can priapism lead to
Can lead to impaired circulation and inability to urinate
What can priapism cause
Neurological and vascular disorders
Meds
Injury
What is phimosis
Inability to retract foreskin covering the head of the penis
What is hypospadius
Birth defect in which opening of the urethra is located @ the tip of the penis, along the shaft, or where penis and scrotum meet
What is Diphilia
Genetic condition present at birth in which a person has 2 penises
What is penile ring entrapment (PRE)
Penile ring works by reducing outflow of blood, sustaining a longer erection
If left for extended period can lead to swelling of shaft, strangulation, gangrene, and even complete loss of distal penis
What is the prostate gland
Male organ that produces semen and transports sperm during ejaculation
What can an enlarged prostate put pressure on
Put pressure on urethra which can cause difficulty urinating
What is the medical term for enlarged prostate
Benign prostatic hypertrophy (bph)
What is acute prostatitis
A bacterial infection of the prostate usually with sudden, severe symptoms
What is chronic bacterial prostatitis
Ongoing or recurring bacterial infection usually with less severe symptoms
What is chronic prostatitis/ chronic pelvic pain syndrome
Ongoing or recurring pelvic pain and urianry tract symptoms with no evidence of infection
What symptoms are seen in chronic prostatitis/ chronic pelvic pain syndrome
Flu-like
Pain in abdomen, groin, or back
Dysuria
Pain with ejaculation
What is treatment for prostatitis
Acute bacterial- antibiotics- 4-6 wks
Chronic bacterial-antibiotics-8-12 wks
What should we teach our pts that have prostatitis about
Safe sex
Wt loss
Avoid spicy or acidic foods
Avoid alcohol and caffeine
Eat more fresh/ unprocessed foods and less sugar
Water
What is BPH
Benign prostatic hyperplasia/enlarged prostate
What enlarges when a pt has BPH
Prostrate gland enlarges which disrupts outflow of urine
What is the main cause of urinary retention in men
BPH
What are risk factors for BPH
Age
Obesity
High protein diet
Alcohol & smoking
Family history in first degree relative
