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N143 !!!! > Module 4: Genital urinary assessment > Flashcards

Module 4: Genital urinary assessment Flashcards

1
Q

What position should female be in for urinary catheter care

A

dorsal recumbant (knees bent)

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2
Q

what position should male be in for urinary catheter care

A

supine or fowlers

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3
Q

Factors that commonly influence urinary elimination

A
  • Psychological factors (anxiety, stress, lack of privacy or time)
  • sociocultural factors
  • fluid balance (alchohol and caffeine will make u pee more)
  • diagnositic examination (may cause trauma)
  • sugery
  • pathological condition
  • medications
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4
Q

What are some pathological conditions that could affect micturition

A

stoke, parkinson’s, MS, diabetes, spinal cord injury, advanced dementia, hindered mobility , dehydration, kidney disease, obstructed urine flow

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5
Q

what are some meds that could affect micturition

A

-diuretics, anticholinergics, sedatives, hypnotics, opioids

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6
Q

What is considered urinary retention

A

can hold up to 1 liter of urine

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7
Q

what is a normal bladder capacity

A

400-600 ml

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8
Q

measures to reduce urinary tract infection

A
  • hand hygiene
  • encourage fluid intake
  • closed drainage system
  • no obstructions, kinks or poooling
  • bag below bladder
  • provide pt. teaching
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9
Q

what are some methods to preserve and protect healthy elimination

A
  • Assist pt. to understand and participate in appropriate self care practices
  • pt. education on specific elimination problem
  • promote complete bladder emptying
  • prevent infection
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10
Q

what is regular micturition

A

every 3-4hr

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11
Q

what may happen if you void too frequently

A

small-capacity bladder

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12
Q

what may happen if you infrequently void (8hr)

A

may contribute to hypotonic bladder

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13
Q

3 best ways to prevent infection

A

1) Hygiene
2) cleaning after elimination
3) adequate fluid intake

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14
Q

developmental considerations for infants and children

A
  • reproductive organs developed but evolve with ae
  • cannot concentrate urine effectively (appears light yellow or clear)
  • large volumes of urine
  • may not gain full control until 4-5
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15
Q

developmental considerations for preadolescent and adolescent

A
  • Puberty
  • hair growth
  • enlargement of sexual organs
  • menarche
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16
Q

What is a normal amt to void a ay

A

1500ml

or 2200-2700ml

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17
Q

when does menopause begin around

A

48-51

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18
Q

when does sperm production decrease

A

around 40

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19
Q

what does decreased testosterone (around 40) do to males

A

decreased testosterone slower and less intense sexual response

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20
Q

developmental considerations for older adults

A
  • ability to concentrate urine decrease or reabsorb water or sodium
  • dysuria, incontineence, nocturia
  • alterations in sexual function
  • thin, grey body hair
  • sex organs smaller
  • prostate enlargement
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21
Q

what is dysuria

A

painful urination

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22
Q

what subjective data would you do for genitourinary assessment

A
  • urinary frequency, urgency, nocturia
  • dysuria
  • hesistancy & strianing
  • urine color
  • urinary and sexual health history
  • pain, lesions, discharge, swelling, lumps, change in appearance
  • current sexual health status
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23
Q

what to assess for in a pt. with urinary catheter

A
  • assess meatus for redness, swelling, discharge, discomfort
  • Cauti symtoms
  • no kinds in tubing
  • secured properly
  • collection bag below bladder level
  • assess urine
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24
Q

What are typical symptoms of CAUTI

A
  • Urgency
  • tenderness
  • pain
  • fever over 38
  • urine that’s bloody
  • foul smelling
  • cloudy or increased sediment
  • worsening mental or functional status
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25
Q

what are some risk factors for CAUTI

A
  • cathetarization over 6 days
  • female
  • diabetes
  • malnutrition
  • old age
  • impaired immunity
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26
Q

What should you assess about the urine

A
  • Amount (1500ml+ a day is good)
  • color (pale to amber)
  • odor
  • unusual characteristics
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27
Q

where should you secure a catheter for a male

A

abdomen or upper thigh

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28
Q

where should you secure a catheter for a female

A

inner thigh

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29
Q

will antiseptic cleaners help prevent CAUTI

A

no

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30
Q

when could symptoms of a CAUTI show up after removal of catheter

A

2-3 days after

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31
Q

how much should pt. first void be after removal of cath

A

150ml, should occur 6-8 era & encourage pt to keep bladder diary 24-48 hr

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32
Q

how often should u change condom catheter

A

everyday

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33
Q

what is appropriate amount for specimen collection of urine

A

30-60ml

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34
Q

what is urinalysis for

A

commonly used to evaluate a variety of renal and non renal problems

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35
Q

What is normal ph range for urine

A

4.6-8

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36
Q

what is normal protein for urine

A

none or up to 8mg / 100 ml

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37
Q

What is a normal glucose amount for urine

A

none

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38
Q

what is a normal ketones about for urine

A

none

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39
Q

what is a normal blood amount for urine

A

up to 2 blood cells

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40
Q

what is a normal specific gravity for urine

A

1.010-1.025

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41
Q

what is a normal amount of WBC in blood

A

0-4

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42
Q

what is normal amount of bacteria in urine

A

none

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43
Q

what is a normal amount of casts in urine

A

none

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44
Q

when does the urinalysis need to be sent to the lab by

A

2 hrs

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45
Q

what is a specific gravity

A

the ratio of the weight of a given fluid to the weight of an equal volume of distilled water
*helps determine fluid balance

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46
Q

what is a urine culture

A

in the lab a variety of methods are used to determine the findings of bacterial growth over time (24-48hr)

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47
Q

how much fluid should a regular person drink per day

A

1500-2000ml

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48
Q

how much should someone with a cath drink a day

A

2000-2500

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49
Q

what kind of output would need to be reported and investigated

A

less than 30ml an hour

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50
Q

what to include in intake for fluid balance

A
  • Gelatin, ice cream, soup, water ect.
  • blood
  • any IV’s
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51
Q

What to include in fluid output

A

urine, diarrhea, vomit, gastric suction, drainage from wounds or other tubes

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52
Q

what is a daily weight

A

a daily weight is the most accurate measurement in evaluation of fluid balance. Patient should be weight at the same time each day, wearing the same clothes, after they void

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53
Q

what will a normal fluid balance look like?

A

Intake should equal outtake plus 500ml to account for evaporative water loss, skin, respiratory

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54
Q

what do FVD eyes look like

A

sunken, dry, conjustivae (red), absence of tears

55
Q

what do FVE eyes look like

A

periorbital edema, blurred vision, papillledema

56
Q

what does a FVD mouth look like

A

sticky, dry mucous membrane, cracked lips, less saliva, viscous saliva, shrunken tongue

57
Q

what does FVE mouth look like

A

excessive saliva

58
Q

what does FDV skin look like

A

increased temp, dry, scaly, poor turgor

59
Q

what does FVE skin look like

A

edema

60
Q

what does FVD cardiovascular do

A

increased pulse rate, weak pulse, hypotension, decreased pulse volume, decreased capillary filling, increased hematocrit, flat neck veins

61
Q

what does FVE cardiovascular show

A

bounding pulse, blood pressure normal without orthostatic changes, third heart sound, distended neck veins

62
Q

what does FVD show in the gastrointenstinal system

A

sunken abdomen

63
Q

what does FVE show in GI system

A

vomit, diarrhea, cramps

64
Q

what does FVD show in renal system

A

oliguria or anuria, increased urine gravity

65
Q

what is oliguria

A

small amounts of urine

66
Q

what is anuria

A

failure of kidneys to produce urine

67
Q

how much urine stays in bladder after voiding normally

A

50 ml

68
Q

who may require intermittent cath?

A

someone who consistently has more than 100ml of urine

69
Q

bladder scanner protocol for women with hysterectomy

A

should be designated as a male

70
Q

What is the 1st sign of male puberty

A

larger testis, pubes, penis larger

71
Q

developmental considerations for male adults

A
  • no finale end to fertility
  • 55/60 slightly less testosterone
  • decreased pubes and grey
  • penis size decreased, testies sag
  • longer refractory period
  • may withdraw from sexual activity
72
Q

Pros and cons of circumcision

A

Pro: Hygiene, medical indications, fathers, religion, values, decreased STI’s
Cons: Not recommend or covered, some complications,

73
Q

Subjective data for male genitourinary

A

1) Frequency, urgency, nocturia
2) Dysuria
3) Hesitancy & Straining
4) urine colour
5) past genitourinary history
6) Penis
7) scrotum, self-care behaviour
8) Sexual activity & contraceptive use
9) STI contact

74
Q

how to make it more comfortable for adolescents

A
  • ask appropriate Q
  • Aware that norms may vary
  • clear up misconceptions
  • avoid judgement
  • start with a permission statement : Some boys your age feel.. “
  • ubiquity approach: When did u not do you
  • May not wanna talk - come back when they’re ready
75
Q

Additional history for adolescents

A 
1- puberty
2- nocturnal emission
3- erotic feelings
4- sexual activity 
5- self-exam
6- molestation
76
Q

Additional history for older adults

A

1) Prostate enlargement
2) Incontinence
3) Nocturia
4) Sexual function

77
Q

What are some fears males may have during the objective data phase

A
  • Modesty
  • Pain
  • Cold hands
  • Judgement
  • Memory of uncomfortable
  • Comparrison
  • Erection
78
Q

how does the nurses demeanour needs to be..

A
  • Confident
  • Relaxed
  • Unhurried
  • business like
  • Firm deliberate touch
  • dont stop if erection
79
Q

What is phimosis

A

Inability to retract foreskin

80
Q

What is paraphimosis

A

inability to pull forsaken forward again

81
Q

What could scrotal edema mean

A
  • heart failure

- local inflammation

82
Q

What does an abnormal lymph node feel like

A

enlarged, hard, matted, fixed

83
Q

Developmental considerations for female infants/adolescents

A
  • @ birth engorged bc of estrogen
  • puberty 8.5-13 (breasts first)
  • ovaries migrate from abdomen to pelvis
84
Q

developmental considerations for pregnant women

A
  • cervix softens
  • cyanotic cervix
  • uterus capacity inc.
  • mucus plug forms
85
Q

Developmental considerations for older women

A
  • hormones decrease rapidly
  • menopause (35-60)
  • vagina: shorter, wider, less elastic
  • dry, painful intercourse
86
Q

Dangers of female circumcision

A
  • Servere pain, hemorrhage, urinary retention, infection, sepsis, death
  • disfunction, painful menstration, sex and birth control difficulties, pregnancy/ birth complication, psychological drainage
87
Q

What subjective data should u collect

A

1) menstration history
2) obstetrical history
3) menopause
4) self-care
5) urinary symptoms
6) vaginal discharge
7) history of surgery
8) sexual activity
9) contraceptives
10) STI’s
11) STI risk reduction

88
Q

What position should women be in

A

Lithotomy position

89
Q

Inspect the external genetalia

A
  • skin color
  • hair distribution
  • labia majora (symetrical, plump, meet @ midline)
  • skin texture
90
Q

Developmental considerations for genitourinary exam for a infant or child

A
  • Infant on table
  • toddler/pre-school on lap of parent in frog position
  • school-age on exam table (EXTERNAL ONLY)
91
Q

Developmental considerations for adolescents

A
  • Examine pt. alone if they wanna be alone

- pelvic floor exam when contraception is desired or when sexual activity or 18

92
Q

Developmental considerations for pregnant women

A
  • tummy grows
  • increased vascularity
  • hemorohids
  • variocose veins
  • wall, violet or blue
93
Q

What do they kidneys do

A

Remove waste from blood

94
Q

what do the ureters do

A

transfer urine from kidney to bladder

95
Q

what does the urethra do

A

urine leaves

96
Q

what do the glomerular capillaries permit filtration of

A
  • water
  • glucose
  • amino acids
  • urea
  • creatinine
  • major electrolytes
97
Q

What are the factors influencing urination

A
  • Psychological stress
  • Sociocultural factors
  • Fluid balance
  • dignostic exam
  • surgical proceedures
  • pathological (ex. dementia)
  • medicines
  • pereferal edema ( increases nocturne)
  • sedatives/opioids (decreases alertness)
98
Q

what is pyelonephritis

A

long term kidney damage

99
Q

what are key women risk factors for UTI

A
  • sexual activity
  • pregnancy
  • diaphragm/spermacide use
  • low estorgen
  • obstruction of tract
  • incomplete emptying
  • abnormal anatomy
  • older
  • antibioitics
  • decreased immunity
100
Q

Symptoms of UTI

A
  • dysuria
  • fever, chills, nausea, vomiting
  • inflammed bladder (cystitis)
101
Q

what are the key signs of urinary retention

A
  • absense of urine output
  • bladder distension
  • restlessness
  • diaphoresis
  • abdominal discomfort
102
Q

What is transient incontinence

A

urine loss from causes outside of urinary system. resolves when underlying problem is treated. (depression, meds, delirium ect. )

103
Q

What is urgency incontinence

A

urinary loss proceeded by sudden need to void, overactive bladder. (nervous system disorder or outflow obstruction)

104
Q

What is stress incontinence

A

increased intra-abdominal pressure (women, obesity, hysterectomy) (from laughing, coughing)

105
Q

Urinary incontinence with chronic retention of urine

A

residual urine remains after void (prostate enlarge, pelvic prolapse, decreased contractility of bladder)

106
Q

Functional urinary incontinence

A

inability to reach toilet (decreased mobility)

107
Q

Muiltifactoral incontinence

A

(comorbid, age, meds, environment)

108
Q

to be able to be potty trained toddler must be able to…

A

-recognize bladder as full
-be able to hold for 1-2hr
-communicate
(may take till 4-5)

109
Q

Polyuria?

A

peeing large amounts

110
Q

what is a random urine test

A

urinalysis, electrolytes (collected anywhere & anytime in clean cup)

111
Q

What is a clean void/midstream urine test

A

culture and sensitivity (sterile cup)

112
Q

What is a catheter urine test

A

culture & sensitiivty, aseptic technique, sterile syringe

113
Q

ways to stimulate micturition

A
  • normal position
  • tap water sound
  • stroke inner thigh
  • pour warm water
114
Q

Ability to urinate depends on

A
  • Feeling urge
  • being able to control urethral sphincter
  • being able to relax
115
Q

conditions that require a catheter

A
  • monitor urine output
  • relif of urinary obstruction
  • post-op
  • bladder that emptiness inadaquetly
116
Q

what does testosterone do

A

secondary male sex male characteristics

117
Q

what does progesterone do

A

prevent breakdown of wall

118
Q

what does estrogen do

A

secondary sex characteristics triggers ovulation

119
Q

What is benign prostatic hypertrophy

A

the prostate gland is enlarged, nontender, firm, and smooth, with a palpable central groove.

120
Q

What is pruritis

A

an itching or burning sensation, which can be caused by hemorrhoids.

121
Q

When can child start potty training

A

Voluntary control of the external anal sphincter cannot occur until the nerves supplying the area have become fully myelinated, usually around age 1½ to 2 years.

122
Q

what is encopresis

A

persistent passing of stools into clothing in a child age 4 years or older, when continence would be expected.

123
Q

Dyschezia

A

is the painful passage of stools, resulting from a local condition (e.g., hemorrhoids, fissure) or constipation.

124
Q

Epispadias

A

is a meatus opening on the dorsal side of the glans or shaft.

125
Q

Orchitis

A

is an acute inflammation of the testes.

126
Q

A spermatocele

A

is a retention cyst in the epididymis filled with milky fluid containing sperm.

127
Q

Testicular torsion

A

is a sudden twisting of the spermatic cord; blood supply is cut off, and the testis can become gangrenous in a few hours. Emergency surgery is required.

128
Q

Cryptorchidism

A

Failure of testes to descend

129
Q

The rectouterine pouch

A

deep recess between rectum and cervix

130
Q

A caruncle

A

a small, deep red mass protruding from the urinary meatus.

131
Q

Amenorrhea

A

absence of mestraution

132
Q

what is hypertrophy

A

make new muscles

133
Q

what is hyperplasia

A

making new muscles

N143 !!!! (4 decks)

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