Urological and GI Flashcards

1
Q

When is trimethoprim-sulfamethoxazole (Bactrim) given?

A

First line for UTIs

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2
Q

When is ciprafloxacin given?

A

For UTIs when there is a sulfa allergy

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3
Q

When is Nitrofurantoin (Macrodanti/Macrobid) given?

A

For recurring lower UTIs

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4
Q

UTI antibiotics teaching

A

Need to finish course of antibiotics even if your symptoms disappear sooner

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5
Q

Phenaxopyridine (Pyridium)

A

Urinary tract analgesic; for relief of pain due to UTI

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6
Q

Phenazopyridine (Pyridium) MOA and SE

A

Dye used in paint; local analgesic action; SE—reddish, orange urine, will stain

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7
Q

Mirabegron (Myrbetriq) MOA

A

Antispasmodic that targets the bladder; electively stims beta-3 adrenergic receptors, relaxes bladder smooth muscle

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8
Q

Mirabegron SE

A

HTN, urinary retention, UTI, headache

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9
Q

Mirabegron NC

A

Monitor BP and not good for ppl with already high BP, can cause UTIs from urinary retention

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10
Q

Oxybutynin (Oxytrol) Class and indications

A

Anticholinergic med; overactive bladder, incontinence

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11
Q

Anticholinergic med MOA

A

Blocks action of Ach (prevents action of smooth muscle contractions)

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12
Q

Anti-cholinergic SE and NC

A

dry mouth, constipation; can be in EC form; try non-pharm intx first—pelvic floor training

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13
Q

constipation

A

small, infrequent, or difficult BM (<3 BM/wk)

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14
Q

Causes of constipation

A

diet low in fiber, lack exercise, dec peristalsis, obstruction or diverticulitis–pathologic

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15
Q

impaction

A

unrelieved constipation–firm stool obstructs lower GI tract and liquid squeezes around

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16
Q

impaction sx

A

N/V, lose appetite, cramps and pain, distention

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17
Q

diarrhea

A

inc freq/fluidity of BM

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18
Q

Acute diarrhea causes

A

infection, emotional stress, some meds, liquid stool

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19
Q

chronic diarrhea

A

> 4 weeks; chronic GI infection, altered motility, malabsorption, endocrine dx

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20
Q

Episodic diarrhea

A

food allergy/irritants, caffeine, enteral feeding

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21
Q

Main concerns with diarrhea

A

skin b/d, fluid imbalance, nutritional concerns

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22
Q

Osmotic diarrhea

A

inc osmotically active solutes like mag sulfate and epsom salts; Na and water rush in, causing diarrhea (common with tube feed)

23
Q

secretory diarrhea

A

bacteria/toxin like Vibriocholerae and Staph

24
Q

exudative diarrhea

A

active inflammation in bowel lumen resulting in exudate of blood, mucus and protein–open wounds; pull water into intestines, Crohn’s and UC

25
Q

motility disturbance of diarrhea

A

dec abs of small intestine; dumping sx and IBS

26
Q

UTI and most common type

A

infection of lower tract and bladder; E. coli is most common

27
Q

Bacteriuria

A

bacteria in urine; not always causing infection

28
Q

Urethritis

A

infection in urethra

29
Q

cystitis

A

infection in the bladder causing frequency, urgency, suprapubic discomfort, dysuria

30
Q

Risk factors for UTI

A

being female (shorter urethra), incomplete emptying, protein in urine, foleys, peri irritation, incontinence, inc age, preg, sexually active female, spermicide use before sex, urinary obstruction or reflex, immobility, dec cognition, poor hygiene

31
Q

Why are men more likely to have recurring UTIs?

A

bacteria can hide by prostate and retention occurs with BPH

32
Q

UTI diagnosis

A

H&P, Urinalysis, urine culture, CBC

33
Q

UTI sx

A

asymptomatic, urgency, problems urinating, hematuria, dysuria, cloudy urine, fever, chills, fatigue

34
Q

UTI tx

A

antibiotics, inc fluids, avoid irritants, wear loose cotton clothes, frequent peeing, probiotics, don’t try to hold your pee

35
Q

Atypical UTI manifestations in kids

A

fever, irritability, vomit, poor eating, diarrhea, look ill, old enough to verbalize

36
Q

Atypical UTI manifestation in older adults

A

anxiety, confusion, lethargy, anorexia, hx of falls; not as likely to have urgency

37
Q

Protective fx for UTIs

A

acidic urine, presence of urea in the urine, prostatic secretions in men, urethral gland secretions in women, unidirectional urine flow (one way valve at urethral attachment to bladder); strong immune system

38
Q

Bladder structure

A

Made of smooth muscle

39
Q

How much can the bladder hold before saying it needs to pee

A

300-500

40
Q

Overactive bladder

A

Bladder muscles contract involuntarily even when the bladder amount is low; results in increased urge and frequency (8+/24h), nocturia

41
Q

Nocturia

A

Waking up more than 2x/night to pee

42
Q

Causes of overactive bladder

A

Neuro disorder, DM, UTI, hormone change, tumors/stones, obstructions

43
Q

Incontinence

A

Involves leakage of urine immediately after a sudden need to urinate

44
Q

Is incontinence a normal part of aging?

A

Not normal but can be age related

45
Q

Cause of incontinence

A

Overactive detrusor muscle that suddenly contracts (inc w/ age), bladder infection that irritates the bladder lining, bladder outlet obstruction such as large prostate, CNS condition like MS or Park’s, drug like diuretics

46
Q

Stress incontinence

A

When urine is involuntarily lost with an inc in intraabdominal pressure; precipitated by effort or exertion; angle of abdominal/pelvic muscle is changes do muscle does not close all the way—leakage

47
Q

Causes of stress incontinence

A

Lose pelvic floor muscle or loss of fascial support of bladder and urethra

48
Q

Risk factors of stress incontinence

A

Age, obesity, childbirth trauma, pelvic surgery

49
Q

Mixed incontinence

A

Combination of stress and urge

50
Q

Overflow incontinence

A

Bladder is so full it leaks (BPH)

51
Q

Functional incontinence

A

Physical/environmental limits that prevent getting to the toilet like cognitive and physical factors

52
Q

Transient incontinence

A

Sudden onset of incontinence; reversible

53
Q

Problems associated with incontinence

A

Psychosocial, skin b/d—pain, swelling, itching, susceptible to bacterial infections; high risk in butt, genitals, inner thighs