Module 18 GU

Question 1

pregnant women contractions

Answer 1

onset, freq, duration, intensity
any back pain?
leakage for fluid
bleeding?

Question 2

older adults urinary s/s

Answer 2

nocturia
change in stream
incontinence

Question 3

older adults bowel patterns

Answer 3

constipation
diarrhea
fecal incontinence

Question 4

older adults dietary habits

Answer 4

fiber
food intolerances
change in appetite
daily fluid intake

Question 5

pregnant women physical exam

Answer 5

inc. estrogen and progesterone
-> inc. risk UTI
enlarged uterus
-> inc. urinary s/s
strengthened pelvic ligaments
-> pelvic pain
pelvic congestion and edema
thickened vaginal walls
inc. vaginal secretions

Question 6

older women physical exam

Answer 6

labia flatter and smaller
skin drier and shinier 
gray and sparse pubic hair
clitoris smaller
urinary meatus may appear as an irregular opening or slit 
Vagina narrower and shorter
diminished rectal tone

Question 7

renal abscess patho

Answer 7

localized infection in the medulla or cortex of the kidney
cortex: usually gram positive
Medulla: usually gram negative

Question 8

renal abscess subjective

Answer 8

s/s of pyelonephritis persisting beyond 72 hours of appropriate abx therapy

Question 9

renal abscess objective

Answer 9

ill appearing with fever and pain
CVA tenderness
UA: pyuria, bacteriuria

Question 10

Renal calculi patho

Answer 10

stones formed int eh pelvis of the kidney associated with obstruction and infections in the urinary tract
- calcium salts, uric acid, cystine, struvite

Question 11

renal calculi subjective

Answer 11

fever, dysuria, hematuria, flank pain
renal colic: sever cramping flank pain with N/V
As stone passes through the ureter the pain typically moves from the flank to the groin and then scrotal or labial area

Question 12

renal calculi objective

Answer 12

severe cramping pain
CVA tenderness and/or abd. tenderness with palpation
urinalysis may show microscopic hematuria, an elevated calcium to creatinine ratio

Question 13

hydronephrosis patho

Answer 13

dilation of the renal pelvis and calyces due to an obstruction of urine flow anywhere from the urethral meatus to the kidneys

Question 14

hydronephrosis subjective

Answer 14

acute obstruction
-> intermitent, severe pain, N/V
secondary infection
-> abd. pian, flank pain, hematuria, fever

Question 15

hydronephrosis objective

Answer 15

unremarkable physical examination
severe: kidney palpable, CVA tenderness
Lower obstruction: distended bladder
Most asymptomatic, found during imaging

Question 16

pyelonephritis patho

Answer 16

infection of the kidney and renal pelvis

Question 17

pyelonephritis subjective

Answer 17

fever, dysuria, flank pain

rigor, frequency, urgency, hematuria

Question 18

pyelonephritis objective

Answer 18

ill appearing with significant pain or discomfort
fever and CVA tenderness
UA: pyuria, bacteriuria confirm dx

Question 19

acute glomerulonephritis patho

Answer 19

inflammation of the capillary loops of the renal glomeruli

- immune complex deposition or formation

Question 20

acute glomerulonephritis subjective

Answer 20

nonspecific s/s

• nausea, malaise, flank pain, headache r/t HTN
• poss. tea colored urine or hematuria

Question 21

acute glomerulonephritis objective

Answer 21

possible nml exam
edema, HTN, oliguria
85% of affected children: peripheral and periorbital edema
microscopic hematuria

Question 22

recurrent cystitis

Answer 22

> 2 infections per year

Question 23

bladder cancer

Answer 23

usually presents with painless microhematuria

- familial component

Question 24

interstitial cystitis

Answer 24

chronic pelvic pain > 6 months

- frequency and urgency

Question 25

overactive bladder

Answer 25

urinating > 8 times in 24 hours
freq. and urgency
nocturia > 2x/night