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NUR 329 > Male GU > Flashcards

Male GU Flashcards

0
Q

Structures of the renal/urinary system

A

Kidney
Ureters
Bladder
Urethra

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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
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2
Q

What stimuli initiates the renin angiotensin system (2)

A

Decr in renal tissue perfusion

Decr in salt concentration delivered to tubules

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3
Q

Medical conditions that may cause the initiation of the renin angiotensin system

A

Hemorrhage
Heart failure
Cirrhosis
Loop diuretics

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4
Q

Where is angiotensin released from

A

Liver

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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
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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
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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
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8
Q

Def enuresis

A

Involuntary voiding during sleep

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9
Q

Def oliguria

A

<500 ml / day

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10
Q

Def anuria

A

<50 ml/ day

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11
Q

Common GI S+ S

A

NVD
Abdominal pain
Abdominal distention

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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

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13
Q

Common s/s of anemia

A

Fatigue
Sob
Exercise intolerance
Anemia from chronic disease

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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
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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
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16
Q

Specific gravity range

A

1.010- 1.025

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17
Q

Serum creatinine range

A

.6- 1.2

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18
Q

BUN for normal adult

A

7-18

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19
Q

BUN for > 60 y/o

A

8-20

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20
Q

BUN: Cr. Ratio

A

10:1

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21
Q

What medication might the pt be on after urinary procedure

A

Analgesics

Antispasmodics

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22
Q

Post op kidney surgery complications

A 
Hemorrhage
Shock
Abd distention
Paralytic ileus
Infection
Thromboembolism
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23
Q

Renal surgery incisional sites

A

Flank
Lumbar
Thoracoabdominal

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24
Q

How do you position the pt after renal surgery

A

Lay on opposite side with pillow between legs

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25
Q

What assessments should be done post op after renal surgery

A

Fluid and electrolytes
Patency of tubing of drains
Pain

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26
Q

Post op urinary interventions

A 
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
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27
Q

Def lithiasis

A

Stone

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28
Q

Causes of stones

A 
Hyperparathyroidism 
Renal tubular acidosis
Cancer
Granulomas (sarcoid, TB)
Incr vit d
Excessive milk and dairy
Myeloproliferative diseases
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29
Q

Clinical manif of stones

A

Depends on location
Pain
Hematuria

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30
Q

Dx tests of stones

A

X ray
Blood chemistries
Stone analysis

31
Q

Deficiencies of substances that can cause stones

A

Citrates
Magnesium
Nephrocalcin
Uropontin

32
Q

Possible reasons for stone development

A

Dehydration
Infection
Urinary stasis, Immobility
Incr calcium concentrations in the blood and urine

33
Q

Causes of hypercalcemia and hypercalciuria

A 
Hyperparathyroidism
Renal tubular acidosis
Cancers
Granulomas
Excessive vit d intake
Excessive milk/ dairy
34
Q

Medical mgmt of stones

A 
Allow stone to pass
Pain mgmt
Moist heat to flank
10 x 8 oz of water per day
Drain all urine
35
Q

Diet for uric stones

A

Low purine diet
No mushrooms
No shellfish

36
Q

Cystine stones diet

A

Low protein diet

37
Q

Oxalate stones diet

A 
No:
Spinach
Strawberries
Rhubarb
Chocolate
Tea
Peanuts
Wheat bran
38
Q

What is the leading risk factor for urinary cancers

A

Tobacco

39
Q

Risk factors for bladder cancer

A 
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
Q

S/s and dx of bladder ca

A 
Visible, painless Hematuria
Alteration in voiding pattern
Back and/or pelvic pain
Cystoscope
Ct
Biopsy
41
Q

Medical mgmt of bladder cancer

A 
TURP
Fulgeration
Cystectomy
Chemo
Radiation
Investigational
42
Q

Reasons for urinary diversions

A 
Bladder cancers
Pelvic malignancies
Defects
Trauma
Strictures
Neurogenic bladder
Chronic infection
Intractable cystitis
43
Q

Types of urinary diversions

A

cutaneous

Continent

44
Q

cutaneous urinary diversions

A

Ileal conduit
Cutaneous ureterostomy
Vesicostomy
Nephrostomy

45
Q

Continent urinary diversions

A

Indiana pouch
Koch pouch
Uretherosigmoidostomy

46
Q

In the case of urinary diversions, what should be discouraged

A

Patients family. And/or significant other from doing the osteomyelitis care

47
Q

When a patient comes out of urinary diversion surgery, will the stoma be large or small

A

Very large

48
Q

What is DRE

A

Digital rectal exam

49
Q

Clinical manifestations of BPH

A

Urinary retention
Urinary obstruction
UTIs

50
Q

Meds for BPH

A

Alpha adrenergic blockers
Alpha adrenergic antagonists
Anti androgen agents

Flonase, hytrin, flomax, kondura

51
Q

Def hydronephrosis

A

Backup of urine from the bladder into the kidneys

52
Q

Flomax

A

Improves urinary flow and s/s of BPH

53
Q

Other treatments for BPH

A

Cath if unable to void

Prostate surgery

54
Q

Risk factors of BPH

A

Smoking, alcohol
Obesity, sedentary lifestyle
HTN, CVD, DM
incr fat, animal protein, refined carbs

55
Q

S/s of BPH

A

Freq, urgency, nocturia, hesitancy, decr force of stream, incomplete void, straining, dribbling, urinary retention, recurrent UTI
Fatigue, Norexia
NV
pelvic discomfort

56
Q

DRE results

A

Large, rubbery, non tender- benign

If tender- probably cancer

57
Q

BPH Dx

A 
DRE
PSA
Ua/ C&S
Ultrasound
S/s
Fam hx
58
Q

Meds for BPH

A

Alpha adrenergic blockers- alfuzosin, tezocin
5 alpha reductase inhibitors- finasteride
Saw palmento- vit / herb

59
Q

Procedures for BPH

A

TUMT- transurethral microwave heat treatment
TUNA- transurethral needle ablation
TURP- transurethral resection of the prostate

60
Q

Def traction

A

Tape cath to leg

61
Q

How much NS do you irrigate/ fill balloon for foley cath

A

30 ccs

62
Q

Risk factors for prostate cancer

A

Fam hx
Age
African American

63
Q

Clinical manifestations of prostate cancer

A

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
Q

Tx for prostate cancer

A

Prostatectomy
Radiation
Hormonal therapy
Chemotherapy

65
Q

Assessment and dx findings of prostate cancer

A 
DRE- hard, fixed, stony prostate
Elevated PSA
LUTS- lower urinary tracts s/s
Ultrasound
Needle biopsy
Bone scan
MRI for mets
66
Q

Medical mgmt of prostate cancer

A 
Depending on tumor size
Gleason score
PSA level
Watchful waiting
Radiation
Brachytherapy
Hormonal therapies
Chemo therapies
67
Q

Surgical mgmt of prostate cancer

A

Radical prostatectomy
TURP
Cyrosurgery.

68
Q

Types of surgical procedures for prostate cancer

A

Suprapubic prostatectomy
Perianal prostatectomy- worst as far as comfort
Retropubic prostatectomy
Transurethral incision of the prostate

69
Q

Potential complications of prostate surgery

A 
Hemorrhage and shock
Infection
Dvt 
Cath obstruction
Sexual dysfunction
70
Q

Discharge teaching regarding diet for prostate cancer

A

Avoid coffee, alcohol, and spicy foods

71
Q

Risk factors for testicular cancer

A

Age 15-40
Undescended testicles
Fam hx
Caucasian

72
Q

Clinical manif of testicular cancer

A

Painless lump or mass in the testes

73
Q

Early dx of testicular cancer

A

Monthly testicular self exams

Annual testicular exam

74
Q

Testicular cancer treatments

A

Orchidectomy
Retro peritoneal lymph node dissection ( open or laparoscopic)
Radiation therapy
Chemo therapy

NUR 329 (6 decks)

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