Unit 1 - Gentiurinary Flashcards
Assess GU
Meds: NSAIDS, opioids, antibiotics, diuretics
PMH: drugs, hx of UTIs, viruses, comorbitites, prev pregnancy
Assess:
-Urine: color, frequency (recent change), smell
-abd px, flank pain
-incontinence
-diet
-discomfort before, during, after urination
Define elimination
Elimination for waste from body.
Organs of the Gentiourinary System
-Kidneys
-Ureters
-Bladder
Nephron anatomy
Glomerulus –> Bowman’s capsule –> PCT –> DCT –> last thingy –> ureter
Meds for Gentiurinary
-Antibiotics
Sulfamethoxazole
Cipro, levoflaxin
Cephalexin
Ceftraxione
-Opioid agonist: for BPH?
-Diuretics:
loop: furosemide/Lasix, bumtemide
k sparing: spirolactone/Aldactone
thiazide:
-Anticholinergics/antispasmotics
tolterodine (tx of urge incont., overactive bladder, UTI)
-Analgesics
aspirin, ibuprofen, acetaminophen, etc
Meds CONTRAINDICATED for GU
-Antibiotics
-NSAIDs
-Narotics: urinary retention
-Ibuprofen
Types of incontinence
Stress: physical stress
Urge: neurological issues
Functional: physically cannot make it to bathroom Ex. Elderly
Reflex: not sure
Transient: underlying cause
Overactive
Mixed: combo of urge and stress incontinence
Diseases of Gentiurinary
-CA
-BPH
-UTI
Diseases of Bladder
-CA
-UTI
-Urolithiasis
-BPH
Diseases of Kidney
-Pyelonephritis
-Hydronephritis
-Diabetic nephrotoxity
-Trauma
-Renal CA
At risk population
-Pregnancy
-Age: elderly, children
-Trauma
-Gender ~Female UTI
-Older men ~BPH
Urinary rtention
L -
A - if external or internal sphincter
T -
T -
E -
Pyelonephritis
Etiology: infection backs up into kidneys.
Benign Prostate Hyperplasia
L- Older male, DM
A - pain, discomfort, meds
T - bladder scan
T - urinary antispasmodics ex. Tamsulin
E
Acute Kidney Injuurt
L- ALOC
A -
trauma ~ blood loss, burns
medications ~furosemide, antibiotics, nsaids, chemo.
T -
-BUN and Cr: rapid drop
-MAP goal of 65-70
T - encourage fluids, stop nephrotoxic meds
E
Chronic Kidney Failure
L- jaundice, making them itchy. Yellow sclera. Ascites. ALOC.
A - BP r/t HTN.
T -
Labs:
-eGFR <60. Stages 2. <50 3. idk
-BUN: 10-20
-Cr: 0.6-1.2
ammonia
-albumin
-H&H r/t deceased RBC production
T - kidney transplant. Dialysis: peritoneal or through machine?
E - avoid high protein. Encourage fluids.
Urolithaisis
Etiology:
^Ca
^Hyperoxaluria
^Hyperureemia: gout
^ammnoia: struvite is stone of ammonia
^amino acid causes cystinuria
L: severe px, hematuria
A: r/t hydronephrosis
T
T
E
UTI
L - female. Tight clothes. Stressed. Could be radiation pt - CA.
A- flank pain, burning with urination, Cloudy urine, nocturia. Hx of UTIs, kidney stones, CA.
T- UA
T- antibiotics. Phenylphenidate: helps w burning.
E- wear cotton underwear, proper protection, finish meds***
CA
Bladder
A: hematuria, pain w peeing. Low wt & appetite
Renal
Diabetic neuropathy
r/t hyperglycemia. Similar to hydronephrosis: outflow obstruction. Buildup of urine.
Labs
BUN: 10-20
eGRF: > 60
Cr: 0.6-1.2
Cr Clearance: 90-120???
Specific Gravity: 1.001 - 1.035
Uric acid
Tests
-I/O
-Urinalysis
-Urine culture
-Cystoscopy, uroscopy
LABS
-Metabolic panel
-UA, or urinalysis: Glucose, protein, ketones, blood?
-Urine culture & sensitivty
-Biopsy
Radiology
-CT, MRI, US (ultrasound)
-Angiography
-XRAY or KUB
Screening Prevention
-Colonoscopy
-Occult blood
