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Med Surg 1 > urinary problems > Flashcards

urinary problems Flashcards

1
Q

stress incontinence

A

urine leaks out at times when your bladder is under pressure

ex) coughing or laughing

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2
Q

stress incontinence causes

A
  • weakening of the bladder neck supports; associated with childbirth
  • intrinsic sphincter deficiency
  • acquired anatomic damage to the urethral sphincter
  • vaginal prolapse from vaginal birth or aging
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3
Q

stress incontinence symptoms

A
  • loss of small amount of urine during physical activity or intraabdominal pressure (coughing, sneezing jumping, lifting, exercises)
  • normal voiding habits
  • postvoid residual usually less than or equal to 50ml
  • pelvic exam= hypermobility or urethra or bladder neck with Valsalva maneuvers
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4
Q

urge incontinence

A

when urine leaks as you feel a sudden urge to pee, or soon afterwards

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5
Q

urge incontinence causes

A
  • idiopathic
  • neurological disorders
  • benign prostatic hypertrophy
  • bladder irritants (artiical sweetners, caffeine, alcohol, citric, drugs, nicotine)
  • bladder cancer
  • medications that cause increased bladder contractibility
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6
Q

urge incontinence symptoms

A
  • loss of urine preceded by a sudden and severe desire to pass urine
  • nocturia
  • may have loss of large amounts of urine with occurrence
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7
Q

mixed incontinence causes

A

associated with stress and urge incontinence

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8
Q

mixed incontinence symtoms

A
  • associated with stress and urge incontinence
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9
Q

overflow incontinence (reflex incontinence)

A

when your unable to fully empty your bladder which causes frequent leaking

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10
Q

overflow incontinence (reflex incontinence)causes

A
  • urethral obstruction
  • diabetic neuropahy
  • some neurologic disorders
  • medications side effects
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11
Q

overflow incontinence (reflex incontinence) symptoms

A
  • bladder distension, constant dribbling of urine
  • sense of incomplete emptying of the bladder
  • pelvic discomfort
  • palpable bladder
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12
Q

functional incontinence

A

leakage of urine caused by factors other then disease of the lower urinary tract

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13
Q

functional incontinence causes

A

decreased cognition such as with dementia

- impaired mobility

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14
Q

functional incontinence symptoms

A
  • quantity and timing or urine leakage vary

- patterns difficult to discern

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15
Q

urinary incontinence focused assessment

A
  • risk factors
  • symtoms of urinary incontinence
  • assessment of mobility, self care ability, cognitive ability, communication patterns
  • assess the environment for barriers to toileting such as a privacy, restrictive clothing and access to the toilet
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16
Q

urinary incontinence physical assessment/ s/s

A
  • assess abdomen- feeling for distention
  • inspect females for uterine prolapse- uterine muscles weakened
  • digital rectal exam- both men and women check nerve integrity
  • assess for prostate enlargement in men
  • lab assessment- urinalysis
  • imaging assessment
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17
Q

imaging assements

A
  • bladder scan
  • ct of kidneys and ureters
  • voiding cystourethrogram
  • urodynamic testing
  • electromyography or pelvic muscules
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18
Q

urinary incontinence nursing diagnoses

A
  • altered urinary elimination related to incontinence

- potential for altered tissue integrity related to incontinence

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19
Q

urinary incontinence planning and integrating (nonsurgical management )

A

nonsurgical management

  • nutrition therapy
  • devices
  • electrical stimulation
  • magnetic resonance therapy
  • pelvic muscle therapy
  • vaginal cone therapy
  • behavioral interventions
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20
Q

urinary incontinence planning and integrating (maintaining tissue integrity)

A
  • reduce the risk for skin breakdown
  • reduce the risk of pt. developing incontinece- associate dermatits
  • educate the pt. on the possibility of using an external device
  • discuss the possibility of absorbent pads and breifs with the pt.
  • options for functional incontinence include intermittent or long dwelling catheter
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21
Q

urinary incontinence care coordination and transit management

A

home care management- bedside comode, clear path

  • self-management education- keeping on schedule
  • health care resources- estrogen cream, anticholergenics, the importance of diet, drinking lots of fluids, different exercise, legal exercises
22
Q

urinary incontinence evaulating outcomes

A
  • maintain optimal urinary elmination through a reduction in the number of urinary incont. ep.
  • maintain tissue integtiry of the skin and mucous membranes in the perineal area
  • demonstrate knowledge of proper use of drugs and correct procedures for self catheterization, use of artificial sphincter or care of an indwelling urinary catheter
  • demonstrate effective use of the selected exercise or bladder training program
  • select and use incontinence interventions, devices, and products
23
Q

cystitis

A

inflammatory conditon of the bladder

- usually refers to inflammation from infection of bladder

24
Q

cystitis causes

A
  • irritants without infection
  • complication of other disorders (gynecologic cancers, pelvic inflammatory disorders, endometriosis, chrons disease, diverticulitis, lupus, tb)
  • infectious cystitis caused by pathogens from bowel or vagina, viruses, mycobacteria, parasites, yeast
25
Q

cystitis physical assessment and s/s

A
  • frequency, dysuria, urgency
  • fever, chills, nausea= infection
  • assess catheter
  • have pt. void for urine examination
  • vital signs, lower abdomen, bladder palpation
26
Q

cystitis lab assessment

A
  • clean cach urine specimen (urinalysis, culture, and sensitivity)
  • serum wbc with differential
27
Q

cystitis other diagnostic assessment

A
  • pelvic ultrasound or ct
  • voiding
  • cystourethrography
  • cystoscopy
28
Q

cystitis nonsurgical managment

A
  • drug therapy
  • fluid intake
  • comfort measures such as pain relief
29
Q

cystitis surgical managemnt

A
  • treat conditions that increase risk for utis
  • removal of obstructions
  • removal of vesicoureteral reflux
  • removal of calculi
30
Q

cystitis health promotion and maintenance

A
  • sterile technique when inserting catheters
  • clean technique when using intermittent catheters at home
  • single-use catheter recommended for home settings
  • national pt. safety goal- CAUTI prevention: removal of catheter as soon as possible
  • liberal intake of water
31
Q

cystitis care coordination and transition management

A
  • assess level of clients understanding
  • teach to take prescribed drugs
  • address concerns associated with intimacy and recurrent utis
32
Q

urethritis

A
  • inflammation of urethra
  • highest incidence is adults aged 20-24
  • sit is the most common cause
  • symptoms include mucopurulent or purlent discharge, dysuria, discomfort
33
Q

interpofessional collaborative care

A
  • urinalysis may show pyuria (a urinary condition characterized by an elevated number of white blood cells in urine
  • test for sti
  • usually resolves spontaneously
34
Q

urolithiasis

A

presence of calculi in the urinary tract

35
Q

nephrolithiasis

A

formation of calculi in kidney

36
Q

ureterolithiasis

A

formation of the calculi in the ureter

37
Q

urolithiasis causes

A
  • metabolic probelms (hypercalcemia, hyperoxaluria, hyperuricemia, struvite, cystinuria)
  • DEHYDRATION IS THE MOST COMMON RISK FACTOR THAT INCREASES CHANCE
  • risk factors: family history, obesity, diabetes or gout, diet (high sodium)
38
Q

urolithiasis s/s

A
  • severe pain
  • flank pain
  • nausea, vomiting, pallor, diaphoresis
  • frequency and dysuria
  • oliguria and anuria
39
Q

urolithiasis assessment criteria

A
  • history of urologic stones
  • diet
  • past treatment
  • recognize urinary tract obstruction
  • assess for bladder distension
    urinalysis
40
Q

urolithiasis managing pain (nonsurgical)

A
  • drug therapy

- lithotripsy

41
Q

urolithiasis managing pain (surgical management)

A

minimally invasive surgical procedures

- open procedures

42
Q

urolithiasis preventing infection

A
  • drug therapy- antibiotics

- lab test (urine sample, C&S test, urine cultures)

43
Q

urolithiasis preventing obstruction

A
  • high fluid intake (3l/day or more)
  • accurate measurements of intake and output
  • drug therapy
  • nutrition therapy/ diet modification
44
Q

urothelial cancer patho

A

malignant tumors of urothelium linning of transitional cells in kidney, renal pelvis, ureters, urinary bladder, and urethra

45
Q

urothelial cancer cause

A

direct cause unknow
- GREATEST RISK FACTOR IS TABACCO

-exposure to toxins, family history, schistosoma haematobium infection, use of drugs

46
Q

urothelial cancer physical assessment and s/s

A
  • ask about active and passive exposure to cig smoke
  • ask about hobbies and occupation
  • ask change in urine habit
  • assess skin color, nutrition status abdomen
  • examine urine color and clarity
    BLOOD IN URINE IS FIRST INDICATION OF BLADDER CANCER
47
Q

urothelial cancer psychosocial assessment

A
  • assess pt. emotions, including response to possibly having bladder cancer
  • assess pt. coping mechanism
  • available support groups
48
Q

urothelial cancer diagnostic assessment

A
  • urinalysis showing gross or microscopic hematuria (blood in urine)
  • bladder wash specimens and bladder biopsies
  • cytoscopy, cystoureterography, ct scans, ultrasounds, MRI
49
Q

urothelial cancer intervention/management

A

prophylatic immunotherapy with BCG

- multiagent chemotherapy; radiation therapy

50
Q

urothelial cancer surgical managment

A
  • depends on type and stage of cancer
  • complete bladder removal
  • alternatives for urine elimination
51
Q

urothelial cancer health promotion maintenance

A
  • smoking cessation
  • use ppe around dry, liquid, gaseous chemicals
  • shower or bathe, change clothing
52
Q

urothelial cancer care coordination and trainsition management

A
  • self-management education
  • united ostomy assoication
  • wound, ostomy, continence nurses society

Med Surg 1 (25 decks)

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