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APA 2 > Week 2 urologic procedures > Flashcards

Week 2 urologic procedures Flashcards

1
Q

Why is it important to find out a babies gestational age?

A

Premises Have a higher risk for SIDS and anesthesia complications

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2
Q

What is included in upper urinary tract?

A

Ureter and kidney

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3
Q

What is included in the lower urinary tract?

A

Bladder, prostate, and urethra

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4
Q

What are 5 common nerve injuries with urologic procedures?

A
  1. Common peroneal; 2. Saphenous nerve; 3. Sciatic nerve; 4. Obturator nerve; 5. Femoral nerve
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5
Q

What position are urologic procedures usually performed in?

A

Lithotomy

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6
Q

How does common peroneal nerve get injured?

A

Compression of fibular head on leg brace

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7
Q

How does saphenous nerve get injured?

A

Compression of MEDIAL tibial condyle

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8
Q

How does sciatic nerve get injured?

A

Excessive external rotation of legs & excessive extension of the knees

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9
Q

How does obturator nerve get injured?

A

Excessive flexion of the groin

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10
Q

How does Femoral nerve get injured?

A

Excessive flexion of the groin

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11
Q

What is the average amount of blood in each leg?

A

500 mL

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12
Q

What is the obturator reflex and what can happen?

A

Obturator nerve stimulation by electrocautery leads to adductor muscle contraction which can lead to bladder rupture during urologic procedure

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13
Q

What procedure has an increased risk of obturator reflex occurring?

A

Resecting lateral wall tumors with electrosurgical resection

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14
Q

What happens during cystoscopy? What type of anesthesia is used?

A

Passage of rigid scope through the urethra — general or regional anesthesia

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15
Q

If using regional anesthesia for cystoscopy, what sensory level must be attained?

A

T9-T10 or T8 for ureters

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16
Q

Where are sympathetic and motor anesthesia levelsin relation to the sensory level?

A

Sympathetic is 2 levels up and motor is 2 levels down

17
Q

Why should TURBT patients be paralyzed?

A

Coughing or straining puts that at higher risk for bladder perforation

18
Q

What about regional anesthetisia puts TURBT patient at higher risk of bladder perforation?

A

Bladder becomes atonic and may be come thinner when distended

19
Q

If bladder perforation occurs what can awake patient experience (3)?

A
  1. Shoulder discomfort; 2. Nausea; 3. Vomiting
20
Q

What is pt at risk for if bladder perforation occurs with malignancy present?

A

seeding into the peritoneum

21
Q

What are the 3 main things pts are at risk for if bladder perforation occurs?

A
  1. Blood loss; 2. Hypothermia; 3. Bacteremia
22
Q

What are clinical indicators of bladder perforation?

A

HTN and tachycardia followed by severe hypotension; reduction of irrigation fluid return is early sign

23
Q

What is DIC triggered by during bladder irrigation?

A

Prostatic throbogenic substances - especially with cancer of prostate

24
Q

What is required with bladder perforation?

A

Emergent subrapubic cystostomy or possible exploratory lap

25
Q

What are 4 requirements of irrigation solution for TURP?

A
  1. Clear; 2. Nonconductive; 3. Non-hemolytic; 4. Nontoxic
26
Q

What spinal level is needed for TURP?

A

T10

27
Q

Why is spinal anesthesia preferred for TURP?

A
  1. Bladder will be atonic with large capacity; 2. Post op bladder spasm prevented (homeostasis); 3. Awake pts can supply early detection of complications
28
Q

What are 2 complications of TURP?

A
  1. Blood loss; 2. Venous absorption of irrigation fluid
29
Q

What are 2 early signs of TURP syndrome?

A

Hypertension and tachycardia

30
Q

How can blood loss be estimated during TURP case?

A

2-5 mL/min of resection time

31
Q

What may an awake pt complain of if experiencing TURP syndrome?

A

Dyspnea and nausea

32
Q

Where is irrigation fluid absorbed into body during TURP?

A

Open venous sinuses of prostate

APA 2 (2 decks)

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