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Perioperative Nursing Final Exam > UTI, BPH & Prostate Cancer > Flashcards

UTI, BPH & Prostate Cancer Flashcards

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0
Q

What is the effect of Renal Failure on Potassium levels?

A

Since the kidneys excrete Potassium, if the kidneys fail, then Potassium will not be excreted and instead level of Potasium in he body will increase causing Hyperkalemia.

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1
Q

What is Aldosterone’s effect on Sodium and Potassium?

A

As the adrenal glands secrete more Aldosterone, this causes the body to retain Sodium and excrete Potassium.

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2
Q

How does the kidney regulate oxygen?

A

The kidney stores Erythropoietin, which stimulates bone marrow to produce RBCs. RBCs carry hemoglobin which carries oxygen to cells.

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3
Q

What is the kidneys role in Vitamin D metabolism?

A

the kidneys Re responsible for the final conversion of inactive vitamin D to its active form. Vitamin D is used for the metabolism of calcium.

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4
Q

Urethrocele Vs. Cystocele Vs. Rectocele

A

1) Urethrocele - The bulging of the anterior vagina wall into the urethra.
2) Cystocele - Herniation of the bladder wall into the anterior vaginal vault.
3) Rectocele - Herniation of the terminal rectum into the posterior vagina.

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5
Q

Anti-Diuretic Hormone is also known by what other name?

A

Vasopressin

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6
Q

What is the link between the Glomerulus and the hormone Renin?

A

Renin is a hormone directly involved in the control of arterial BP; it is essential for the proper functioning of the Glomerulus.

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7
Q

Define Functional Capacity

A

A marked sense of fullness and discomfort with a strong desire to void usually occurring when the bladder contains 35 mL or more of urine.

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8
Q

What are the 4 age-related changes associated with the renal system?

A

1) Thickening of the renal arteries
2) ⬇ in the weight of the kidneys
3) Blood flow ⬇ by about 10% per decade
4) ⬇ bladder capacity

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9
Q

Approximately what percentage of blood passing through the glomeruli is filtered into the nephron?

A

Under normal conditions, about 20% of the blood passing through the glomeruli is filtered into the nephron, Mounting two about 180 L/day of filtrate.

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10
Q

Enlargement of the prostate causes which 4 renal problems?

A

1) Anuria
2) Oliguria
3) Frequency
4) Obstruction of urine flow

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11
Q

What is the normal ratio of BUN to creatinine?

A

10:1

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12
Q

What are the 3 primary signs of Glomerulonephritis?

A

1) Hematuria
2) Edema
3) Azotemia (excessive nitrogenous wastes in the blood)
4) Proteinuria ( > 3 to 5 g/day)

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13
Q

(T/F) Dietary protein is restricted when renal insufficiency and nitrogen retention (elevated BUN) develop?

A

True

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14
Q

What are the 3 types of Lower UTIs?

A

1) Cystitis - Bladder inflammation
2) Prostatitis
3) Urethritis

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15
Q

What are the 4 types of Upper UTIs?

A

1) Acute & Chronic Pyelonephritis - Infection of renal pelvis, tubules, and interstitial tissue of the kidneys.
2) Renal abscess
3) Interstitial nephritis
4) Perineal abscess

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16
Q

How does Ascorbic Acid (i.e., cranberry juice) help to prevent recurring urinary infections?

A

By making the urine more acidic

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17
Q

Which medication is a urinary analgesic administered for urinary discomfort associated with UTIs and what should you tech your patient about it?

A

Phenazopyridine (aka Pyridium) - Teach patients that this med will turn their urine dark orange.

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18
Q

Which types of fluids/drinks are discouraged in patients with UTIs and why?

A

Coffee, citrus, cola, alcohol, spices and tea because they irritate the urinary tract.

19
Q

What are the differences in the manifestations of Acute and Chronic Pyelonephritis?

A

1) Acute Pyelonephritis - Usually manifested by enlarged with interstitial infiltration e of inflammatory cells.
2) Chronic Pyelonephritis - Kidneys become scarred, contracted, and non-functional.

20
Q

In short, explain the following kinds of Incontinences:

1) Stress
2) Urge
3) Reflex
4) Overflow
5) Functional
6) Iatrogenic

A

1) Stress - Results from sneezing, coughing or changing positions because of pelvic floor dysfunction.
2) Urge - Strong urge to void but unable to hold it.
3) Reflex - When the patient doesn’t feel the urge to and as a result becomes incontinent.
4) Overflow - When the patient is unable to completely empty their bladder and as a result becomes incontinent because of the overflow.
5) Functional - When physical or mental impairment make it difficult for the patient to reach the bathroom in time.
6) Iatrogenic - Incontinence as a result of meds.

21
Q

Which class of meds are the first to choice for incontinence and what is the mechanism of action?

A

Anti-Cholinergics - Inhibits bladder contraction

22
Q

Which 2 surgeries, if recent, is a contraindication for urinary catheterization?

A

1) Radical prostatectomy

2) Urethral reconstruction

23
Q

Urinary stones are formed in the urinary tract as a result of an increase in which 6 substances?

A

1) Calcium oxalate
2) Calcium phosphate
3) Uric acid
4) Cystine
5) Uric acid
6) Struvite (Magnesium, ammonium phosphate)

24
Q

How does cranberry juice help to manage the mucous in patients with urinary diversions?

A

Cranberry juice helps to acidifying the urine and manage mucous production.

25
Q

Which 2 metabolic defects are associated with renal stone formation?

A

1) Hyperparathyroidism

2) Hyperurecemia (Gout)

26
Q

Why is the course of antibiotic treatment for acute Prostatitis so long?

A

Because most antibiotics diffuse poorly from the plasma into the prostatic fluid.

27
Q

Which 4 conditions can cause an elevated Prostate-Specific Antigen (PSA) level in the absence of prostate cancer?

A

1) BPH
2) TURP
3) Acute urinary retention
4) Acute Prostatitis

28
Q

What are the 8 SxS of Cystitis?

A

1) Frequency, urgency hand burning
2) Voiding small amounts to none
3) Lower abd discomfort & back pain
4) Cloudy, dark, foul-smelling urine
5) Hematuria
6) Bladder spasms
7) Chills & fever
8) N & V

29
Q

What are the 9 SxS of Pyelonephritis?

A

1) Frequency, urgency hand burning
2) Voiding small amounts to none
3) Flank pain on the affected side
4) Cloudy, dark, foul-smelling urine
5) Hematuria
6) Bladder spasms
7) Chills & fever
8) Nausea
9) ⬆ WBC in urine

30
Q

What is a dipstick urinalysis used for and what does it test for?

A

Used for UTIs and tests for presence of nitrates, WBCs, and leukocyte esterase.

31
Q

What is Urised?

A

Urised is a urinary antiseptic, analgesic and anticholinergic combination used to treat UTIs. It is sometimes prepared with methylene blue which tints urine blue or green.

32
Q

Can immobilization cause the formation of urinary stones?

A

Yes

33
Q

What is the treatment in regards to pH when managing urinary stones of the following composition:

1) Calcium Oxalate
2) Cystine
3) Uric Acid
4) Struvite

A

1) Calcium Oxalate - ⬇ pH
2) Cystine - ⬆ pH
3) Uric Acid - ⬆ pH
4) Struvite - ⬇ pH

34
Q

Which type of urinary stone is the medication Allipurinol used to treat?

A

Uric Acid urinary stones

35
Q

Which type of urinary stone is caused by a urea-splitting bacteria?

A

Struvite urinary stones

36
Q

Besides a sharp, severe pain at the location of the stone, what are the 4 other signs of a urinary stone?

A

1) Lumbar pain
2) N & V
3) Hematuria
4) Diaphoresis

37
Q

What is Lithotripsy?

A

Shock wave used to break up urinary stones so that they can be passed

38
Q

Does BPH predispose men to the development of prostate cancer?

A

No

39
Q

What is the difference between BPH and prostate cancer in regard to the enlargement of the prostate?

A

BLH enlarges the prostate inward and closes off the urethral while prostate. Cancer enlarges the prostate outwards.

40
Q

What are the obstructive and irritation symptoms of BPH?

A

1) ⬆ urinary fx
2) Nocturia
3) Hesitancy
4) Abdoominal strain with urination
5) ⬇ in volume and force of stream
6) Incomplete emptying

41
Q

Which medication is used to treat BPH, how does it work, how long does it take to work and what are the 4 listed side effects?

A

1) 5-alpha reductive inhibitors (i.e., Finasteride) - works by ⬇ size of the prostate by suppressing androgen.
2) Takes 3-6 months for improvement
3) Side effects include ⬇ libido, ⬇ volume of ejaculation, ED, and hair growth.

42
Q

How do Alpha-Adrenergic drugs work to manage BPH, how long do they take to work and what are the 3 listed side effects?

A

1) Alpha-Adrenergic drugs promote smooth muscle relaxation in the prostate and facilitates urine flow.
2) Takes 2-3 weeks to work
3) Side effects include Orthostatic hypotension, retrograde ejaculation and nasal congestion.

43
Q

What are the 4 possible complications of TURP post-op?

A

1) Bleeding
2) Clot retention
3) Dilutional hyponatremia
4) Retrograde ejaculation

44
Q

Prostate cancer is usually Asymptomatic in the early stages, but patients may eventually experience which 4 symptoms that are also common in patients with BPH?

A

1) Dysuria
2) Hesitancy
3) Dribbling
4) Fx

45
Q

What is a Radical Prostatectomy, how long does the patient catheterized, and what are the 5 major post-op complications?

A

1) Radical Prostatectomy is the removal of the prostate, seminal vesicles, and part of the bladder neck in order to treat cancer.
2) Patients are catheterized for 1-2 weeks with a leg bag
3) Major complications include ED,incontinence, hemorrhage, retention and infection

Perioperative Nursing Final Exam (3 decks)

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