Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med emerg > Retention, Trauma , Catherization and Dialysis > Flashcards

Retention, Trauma , Catherization and Dialysis Flashcards

1
Q

Urinary Retention:

A

the inability to voluntarily void urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Categories of Urinary Retention:

A
  • Obstructive
  • Infectious & Inflammatory
  • Pharmacologic
  • Neurologic
  • Other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of Urinary Retention

Obstructive:

A
  • Benign prostatic hyperplasia
  • Strictures
  • Bladder calculi
  • Faecal Impaction
  • Phimosis
  • Benign/malignant pelvic masses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of urinary retention obstructive:

A

Organ prolapse eg: cystocele, rectocele, uterine prolapse
• Pelvic mass – gynaecological malignancy
• Uterine fibroid / ovarian cyst
• Retroverted impacted gravid uterus
• Foreign bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Infectious and Inflammatory

Causes:

A
  • Prostatitis
  • Prostatic abscess
  • Balanitis
  • Cystitis
  • Acute vulvovaginitis
  • Herpes simplex virus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pharmacologic causes

A 
• Drugs with anticholinergic properties 
eg: tricylic antidepressants (amitriptyline)
• Opioids
• Sympathomimetic drugs eg: oral decongestants with Ephedrine ( Sudafed)
• NSAIDs 
• Antiparkinsonian agents (levodopa)
• Antipsychotics (chlorpromazine)
• Muscle relaxants  (Baclofen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Neurologic cause

A

AUTONOMIC OR PERIPHERAL NERVE
• Diabetes mellitus, Guillain-Barre syndrome Pernicious anaemia, radical pelvic surgery

CNS
• CVA, MS, Tumour, Parkinson’s disease, concussion

SPINAL CORD
• Haematoma / abscess / tumour, Cauda equine, spina
bifida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Other causes

A
  • Post-op complications
  • Pregnancy- associated retention
  • Trauma eg: penile fracture or laceration
  • detrusor muscle failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Presentation of acute urinary retention:

A
  • Sudden inability to pass urine
  • Suprapubic pain which typically causes spasm
  • Patient is acutely distressed
  • Often longer history of bladder outflow symptoms
  • Bladder is visible, tender and palpable
  • Patient is typically male
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic Retention of Urine:

A
  • Completely different – maybe painless
  • Incomplete emptying
  • Large bladder, uraemic,anaemic, fluid overloaded ?
  • Large residual volume
  • Bladder drainage may cause haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management can include urethral

catheterisation

A

• Check for sepsis prior to catheterisation
• Ensure correct catheter selection
• Always use an aseptic procedure
• Never force catheter against resistance
• Never inflate balloon in urethra
• Always record details and residual
volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Renal trauma

A
  1. Renal Trauma
  2. Ureter Trauma
  3. Bladder Trauma
  4. Urethral Trauma
  5. External Genitalia Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Renal Trauma - mechanism:

- Blunt Trauma (90%)

A
  • MVA, falls
  • May cause contusion, laceration, avulsion
  • Usually conservative treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Renal Trauma - Mechanism:

- Penetrating Trauma (10%)

A
  • “Blast effect” - radiating current of energy
  • Adjacent tissue necrosis
  • Often are associated injuries
  • Selective observation vs operative treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Renal Trauma:

Clinical Clues, Signs and Symptoms

A
  • Hematuria **
  • Flank Pain**
  • Sudden deceleration/fall
  • Flank bruising•
  • Broken ribs (11th and 12th)
  • Lower chest/upper abdomen trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

American Association of Trauma

Surgery:

A
  • Grade I - Contusion (normal imaging); subcapsular hematoma
  • Grade II – Non -expanding perirenal hematoma; <1cm cortical laceration
  • Grade III - >1cm cortical laceration (no collecting system injury)
  • Grade IV - > 1cm laceration extending into medulla and collecting system; Artery or vein injury (controlled hemorrhage)
  • Grade V - Completely shattered kidney; Hilar avulsion (devascularized kidney)
17
Q

Renal Trauma - Summary

A

Found in ~ 10% of abdominal trauma
• Hematuria is the cardinal symptom
• 90% blunt
• Greatest determinant of mortality is severity of concurrent injuries
• Accurate staging (CT) is very important

18
Q

Urinary Catheters:

A 
CATHETER 
- A TUBE USED TO 
DRAIN OR INJECT FLUID 
THROUGH A BODY OPENING
• INSERTED THROUGH THE 
URETHRA, INTO THE BLADDER 
TO DRAIN THE URINE.
• CAN BE TEMPORARY OR LEFT IN 
PLACE
• A BALLON IS INFLATED TO 
HOLD THE CATHETER IN PLA
19
Q

patients who need a urinary catheter?

A
  • TOO WEAK
  • DISABLED
  • POST SURGICAL
  • PROTECT WOUNDS OR PRESSURE ULCERS
  • FREQUENT URINARY MEASUREMENTS
20
Q

Catheter Care:

A 
• THE CATHETER SITE WILL
NEED REGULAR CLEANING
TO PREVENT INFECTION
• WEAR GLOVES AND 
FOLLOW STANDARD
PRECAUTIONS
• CLEAN FROM THE MEATUS
DOWN THE CATHETER
• USE A DIFFERENT PART
OF THE WASHCLOTH OR
A CLEAN WIPE FOR EACH
STROKE
21
Q

Peritoneal dialysis (PD):

A
  • Instillation of dialysis fluids into the peritoneal space via a surgically-inserted catheter
  • Most catheters are silicone
  • Fluid is removed to take out toxins
  • Most common types include:
  • Chronic ambulatory
  • Continuous cyclical
  • Chronic intermittent
22
Q

Potential Adverse Events:

A
  • Peritonitis
  • Due to contamination at time of exchange or infection of the exit site
  • Loss of access site
  • Due to infection and fibrosis
  • Death
  • If sepsis develops
23
Q

Haemodialysis (HD)

A
  • Dialysis machine and a dialyser clean the blood
  • Blood and dialysis fluids do not mix
  • Can take up to 3- 6 hours
  • Usually 3 times per week
  • Either inpatient or outpatient by trained staff
24
Q

Central catheter?

A
  • For short term access use for HD

* Standard catheter care procedures must be followed

25
Q

Fistula?

A
  • A surgically-created connection between an artery and vein (usually in the arm)
  • Accessed via for needle for HD
26
Q

Vascular graft?

A
  • Intermediate risk of infection
  • A surgically placed artificial tube between a vein and artery (usually in the arm).
  • Accessed via needle for HD
27
Q

Dialysate:

A

A balanced electrolyte solution on one side of the semi-permeable membrane to exchange solutes with blood during HD

28
Q

• Dialysis water

A

• Purified water that is used to:
• mix dialysate
• to disinfect, rinse, or reprocess the
dialyser

29
Q

Dialyser:

A 
• Part of the HD machine 
• Two sections separated by a 
membrane
• Patient’s blood flows through 
one side and dialysate flows 
through the other

Med emerg (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions