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My Foundations 2 > Quiz 4 > Flashcards

Quiz 4 Flashcards

1
Q

Upper urinary tract includes

A

ureter and kidney

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2
Q

lower urinary tract includes

A

Bladder, prostate and urethra

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3
Q

Nerve injuries- usually performed in lithotomy position (5)

A
  • Common peroneal
  • Obturator
  • Femoral
  • Saphenous
  • Sciatic
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4
Q

common peroneal pressure

A

Compression of fibular head on leg brace

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5
Q

Saphenous nerve pressure

A

Compression of medial tibial condyle

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6
Q

Sciatic nerve pressure (2)

A
  • Excessive external rotation of legs

- Excessive extension of the knees

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7
Q

Obturator and femoral nerve

A

Excessive flexion of the groin

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8
Q

Obturator reflex and increased risk?

A

Bladder rupture/injury secondary to adductor muscle contraction from obturator nerve stimulation from electrocautery.

This risk is increased when resecting lateral wall tumors, as electrosurgical resection of these lesions is more likely to inadvertently stimulate the obturator nerve.

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9
Q

regional anesthesia location for cystoscopy (2)

A
  • T9-T10 sensory level is required

- T8 for ureters

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10
Q

general and regional considerations for TURBT

A

General anesthesia - no coughing or straining can cause bladder perforation

Regional anesthesia - the bladder becomes atonic and may become thinner when distended, increasing the risk of perforation (better for elderly)

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11
Q

Bladder perforation (5)

A
  • Awake patient will experience suprapubic fullness, abdominal spasm and pain
  • Htn and tachycardia are early signs followed by severe hypotension
  • Cool irrigation causes vasoconstriction-systemic cooling—warm fluids will decrease this risk
  • DIC triggered by release of prostatic thrombogenic substances-especially with cancer of prostate
  • Possibility of open procedure
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12
Q

characteristics of solution to distend bladder

A
  • optically clear
  • nonconductive
  • nonhemolytic
  • nontoxic
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13
Q

TURP-Spinal considerations (3)

A
  • The bladder will be atonic with a large capacity, thus glycine infusion pressure can be low, emptying less frequent, facilitating resection
  • Postoperative bladder spasm is prevented allowing for hemostasis
  • Awake patients may supply early detection of complications
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14
Q

venous absorption of fluid in TURP? Early signs? Causes what?

A

Early signs- hypertension and tachycardia

  • CVP may rise as cardiac decompensation occurs
  • Awake patient may complain of dyspnea or nausea
  • Hypoxia and /or hyponatremia

TURP SYNDROME

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15
Q

other names for TURP syndrome

A

WATER INTOXICATION

GLYCINE TOXICITY

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16
Q

TURP syndrome causes (4)

A
  • Apprehension
  • disorientation
  • convulsions
  • coma
17
Q

Irrigation solutions and their risks (3)

A

Glycine (1.5%) – blindness/visual impairment
Sorbitol (3.3%) – high blood sugars/lactic acidosis
Mannitol (5%) - hypervolemia

18
Q

Look at slide 30

A

.

19
Q

more blood loss in which open prostatectomy procedure and due to what?

A

Retropubic approach

control of dorsal venous complex

20
Q

radical prostate: dyes used and side effects (2) What happens to O2 sat?

A

Methylene blue 1% - CAN CAUSE HYPOTENSION
Indigo carmine dye - 0.8% has an alpha sympathomimetic effect increase BP

85% can go as low as 65% (more so methylene blue)

21
Q

risk during nephrectomy

A

Lateral-flex table and use kidney bar - May cause vena cava compression and hypotension

22
Q

renal transplant avoid which drugs?

A
  • succinylcholine
  • atracurium
  • LR
  • K+
23
Q

solution in kidney preservation contains

A
  • glucose
  • potassium
  • magnesium
  • antibiotics
  • sodium bicarb
  • heparin

(can trigger hypersensitivy reaction in recipient)

24
Q

renal perfusion vs cold storage time frames

A

perfusion - 72 hours

cold storage - 48 hours

25
Q

Anesthetic considerations for radical cystectomy

A
  • CVP (Fluid shifting can be extensive-unable to monitor urine)
  • Large IV (duh)
  • Arterial
  • Diuretics may be needed to stimulate output
26
Q

Orchidopexy, orchiectomy and urogenital plastic procedures - if doing spinal, which level?

A

T9

27
Q

look at slide 48

A

.

My Foundations 2 (10 decks)

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