Male GU Flashcards
0
Q
Structures of the renal/urinary system
A
Kidney
Ureters
Bladder
Urethra
1
Q
Fx of the male renal and urinary system
A
Homeostasis Hormones for RBC production and bone metab Removing waste Fluid / electrolyte balance Regulate BP
2
Q
What stimuli initiates the renin angiotensin system (2)
A
Decr in renal tissue perfusion
Decr in salt concentration delivered to tubules
3
Q
Medical conditions that may cause the initiation of the renin angiotensin system
A
Hemorrhage
Heart failure
Cirrhosis
Loop diuretics
4
Q
Where is angiotensin released from
A
Liver
5
Q
Flow of the renin angiotensin system
A
Angio released from liver Renin released Renin--> angio 1 Ace from the lungs Angio 1-->angio 2 Renal auto regulation
6
Q
Effects of the renin angio system
A
Vasoconstriction Myocardial contractility Prostaglandin release Aldosterone release Na and h20 reabsorption Incr circulating volume K excretion Adh release
7
Q
What conditions put pts at an incr risk for renal disease
A
MS,Lupus DM, Gout, hyperparathyroidism, HTN Sickle cell, multiple myeloma BPH SC Injury
8
Q
Def enuresis
A
Involuntary voiding during sleep
9
Q
Def oliguria
A
<500 ml / day
10
Q
Def anuria
A
<50 ml/ day
11
Q
Common GI S+ S
A
NVD
Abdominal pain
Abdominal distention
12
Q
If a pt comes to the ER with SOB and the cardiac work up is negative, what is the most likely cause?
A
Anemia
13
Q
Common s/s of anemia
A
Fatigue
Sob
Exercise intolerance
Anemia from chronic disease
14
Q
Renal diagnostic tests
A
U/A , C&S Renal fx test Ultrasonography CT/MRI, Nuclear tests Intravenous urography, retrograde pyelography, cystography, renal angiography, endoscopic procedures Biopsies
15
Q
What values are part of the renal function test
A
Specific gravity Urine osmolarity 24 hr creat clearance Serum creatinine Creatinine : BUN Ratio
16
Q
Specific gravity range
A
1.010- 1.025
17
Q
Serum creatinine range
A
.6- 1.2
18
Q
BUN for normal adult
A
7-18
19
Q
BUN for > 60 y/o
A
8-20
20
Q
BUN: Cr. Ratio
A
10:1
21
Q
What medication might the pt be on after urinary procedure
A
Analgesics
Antispasmodics
22
Q
Post op kidney surgery complications
A
Hemorrhage Shock Abd distention Paralytic ileus Infection Thromboembolism
23
Q
Renal surgery incisional sites
A
Flank
Lumbar
Thoracoabdominal
24
How do you position the pt after renal surgery
Lay on opposite side with pillow between legs
25
What assessments should be done post op after renal surgery
Fluid and electrolytes
Patency of tubing of drains
Pain
26
Post op urinary interventions
```
Pain
Airway clearance, c & db, IS
Monitor UO, Patency of drains
Cath care
Monitor for s/s of bleeding
Leg exercises, early ambulation
Monitor and prevent DVTs
```
27
Def lithiasis
Stone
28
Causes of stones
```
Hyperparathyroidism
Renal tubular acidosis
Cancer
Granulomas (sarcoid, TB)
Incr vit d
Excessive milk and dairy
Myeloproliferative diseases
```
29
Clinical manif of stones
Depends on location
Pain
Hematuria
30
Dx tests of stones
X ray
Blood chemistries
Stone analysis
31
Deficiencies of substances that can cause stones
Citrates
Magnesium
Nephrocalcin
Uropontin
32
Possible reasons for stone development
Dehydration
Infection
Urinary stasis, Immobility
Incr calcium concentrations in the blood and urine
33
Causes of hypercalcemia and hypercalciuria
```
Hyperparathyroidism
Renal tubular acidosis
Cancers
Granulomas
Excessive vit d intake
Excessive milk/ dairy
```
34
Medical mgmt of stones
```
Allow stone to pass
Pain mgmt
Moist heat to flank
10 x 8 oz of water per day
Drain all urine
```
35
Diet for uric stones
Low purine diet
No mushrooms
No shellfish
36
Cystine stones diet
Low protein diet
37
Oxalate stones diet
```
No:
Spinach
Strawberries
Rhubarb
Chocolate
Tea
Peanuts
Wheat bran
```
38
What is the leading risk factor for urinary cancers
Tobacco
39
Risk factors for bladder cancer
```
Male > 55 y/o
Environmental carcinogens
Recurrent/chronic UTIs
Bladder stones
High urinary pH
High cholesterol
Pelvic radiation
Cancers of prostate, pelvic, colon, and rectum
```
40
S/s and dx of bladder ca
```
Visible, painless Hematuria
Alteration in voiding pattern
Back and/or pelvic pain
Cystoscope
Ct
Biopsy
```
41
Medical mgmt of bladder cancer
```
TURP
Fulgeration
Cystectomy
Chemo
Radiation
Investigational
```
42
Reasons for urinary diversions
```
Bladder cancers
Pelvic malignancies
Defects
Trauma
Strictures
Neurogenic bladder
Chronic infection
Intractable cystitis
```
43
Types of urinary diversions
***cutaneous***
| Continent
44
cutaneous urinary diversions
Ileal conduit
Cutaneous ureterostomy
Vesicostomy
Nephrostomy
45
Continent urinary diversions
Indiana pouch
Koch pouch
Uretherosigmoidostomy
46
In the case of urinary diversions, what should be discouraged
Patients family. And/or significant other from doing the osteomyelitis care
47
When a patient comes out of urinary diversion surgery, will the stoma be large or small
Very large
48
What is DRE
Digital rectal exam
49
Clinical manifestations of BPH
Urinary retention
Urinary obstruction
UTIs
50
Meds for BPH
Alpha adrenergic blockers
Alpha adrenergic antagonists
Anti androgen agents
Flonase, hytrin, flomax, kondura
51
Def hydronephrosis
Backup of urine from the bladder into the kidneys
52
Flomax
Improves urinary flow and s/s of BPH
53
Other treatments for BPH
Cath if unable to void
| Prostate surgery
54
Risk factors of BPH
Smoking, alcohol
Obesity, sedentary lifestyle
HTN, CVD, DM
incr fat, animal protein, refined carbs
55
S/s of BPH
Freq, urgency, nocturia, hesitancy, decr force of stream, incomplete void, straining, dribbling, urinary retention, recurrent UTI
Fatigue, Norexia
NV
pelvic discomfort
56
DRE results
Large, rubbery, non tender- benign
| If tender- probably cancer
57
BPH Dx
```
DRE
PSA
Ua/ C&S
Ultrasound
S/s
Fam hx
```
58
Meds for BPH
Alpha adrenergic blockers- alfuzosin, tezocin
5 alpha reductase inhibitors- finasteride
Saw palmento- vit / herb
59
Procedures for BPH
TUMT- transurethral microwave heat treatment
TUNA- transurethral needle ablation
***TURP***- transurethral resection of the prostate
60
Def traction
Tape cath to leg
61
How much NS do you irrigate/ fill balloon for foley cath
30 ccs
62
Risk factors for prostate cancer
Fam hx
Age
African American
63
Clinical manifestations of prostate cancer
Early- few/ no symptoms
Urinary obstruction
Blood in urine and/or semen
Painful ejaculation
S/s of metas teases may be first signs oF illness
Hip/back pain, anemia, weight loss, spontaneous fracs
Hematuria if urethral or bladder cancer
64
Tx for prostate cancer
Prostatectomy
Radiation
Hormonal therapy
Chemotherapy
65
Assessment and dx findings of prostate cancer
```
DRE- hard, fixed, stony prostate
Elevated PSA
LUTS- lower urinary tracts s/s
Ultrasound
Needle biopsy
Bone scan
MRI for mets
```
66
Medical mgmt of prostate cancer
```
Depending on tumor size
Gleason score
PSA level
Watchful waiting
Radiation
Brachytherapy
Hormonal therapies
Chemo therapies
```
67
Surgical mgmt of prostate cancer
Radical prostatectomy
TURP
Cyrosurgery.
68
Types of surgical procedures for prostate cancer
Suprapubic prostatectomy
Perianal prostatectomy- worst as far as comfort
Retropubic prostatectomy
Transurethral incision of the prostate
69
Potential complications of prostate surgery
```
Hemorrhage and shock
Infection
Dvt
Cath obstruction
Sexual dysfunction
```
70
Discharge teaching regarding diet for prostate cancer
Avoid coffee, alcohol, and spicy foods
71
Risk factors for testicular cancer
Age 15-40
Undescended testicles
Fam hx
Caucasian
72
Clinical manif of testicular cancer
Painless lump or mass in the testes
73
Early dx of testicular cancer
Monthly testicular self exams
| Annual testicular exam
74
Testicular cancer treatments
Orchidectomy
Retro peritoneal lymph node dissection ( open or laparoscopic)
Radiation therapy
Chemo therapy
