week 6 Flashcards
function of urinary system
Regulation of blood pressure (RAAS – kidneys secrete renin)
Production of hormones (calcitriol & erythropoietin)
Regulation of blood glucose levels
Excretion of wastes in the urine
Passing of urine from the kidneys to the bladder via the ureters
Storage of urine in the bladder
Emptying of urine from the bladder.
urinary incontinence stress incontinence
Stress incontinence occurs when abdominal pressure on the bladder increases due to coughing, sneezing, laughing or straining and the pelvic floor cannot provide enough counter pressure to stop urine from leaking.
what is urge incontinence or overactive bladder (OAB)
occurs when the detrusor muscle contracts instead of relaxing as the bladder fills.
what is functional incontinence
arises from factors outside the urinary tract.
urinary function and ageing process
bladder issues are common in older people it is not inevitable part of ageing, usually associated with other disease processes
-production of night-time ADH declines with age
- kidney function in elders may increase at night due to decreased demand of other organs
-elders are less able to concentrate urine in response to dehydration.
They have a reduced capacity to clear additional fluid overload by diuresis.
Drugs may accumulate in their body, leading to toxic effects.
- he contractility of the detrusor muscle can become impaired.
It becomes overactive and contract while the bladder is still filling, giving signals of urinary urgency. It may not contract fully during urination resulting in a failed voiding
what is Nocturia
frequent night time urination
affects 59% men and 62% women over the age of 70. very high risk of falls due to rushing to acess toilet, blood pressure is subject to postural drop and causes dizziness.
if there are existing deficits in mobility, the risk of falling will increase
prostate glas position
-Lies in front of anterior wall of rectum and 2 cm behind symphysis pubis.
-Two seminal vesicles project above prostate.
-Two bulbourethral Cowper’s glands located inferior to prostate on either side of urethra secrete a clear, viscid mucus.
-In the older male, the prostate may obstruct the flow of urine from the bladder, causing a condition termed bladder outlet obstruction.
prostate cancer known risks
most frequent diagnosed cancer in men
-Increasing age, family history, and inherited mutation of BRCA1 and BRCA2 genes
Ethnic/geographic variation is seen in terms of occurrence.
-Mortality rates are two times higher for men of African ethnicity.
-Diets heavy in red meat or high-fat dairy products may be factor
S-ome evidence suggests that prostate cancer may increase with obesity.
subjective data on urinary system
frequency or urgency.
burning or pain on micturition (urination).
nocturia.
presence of blood in the urine.
colour or odour.
problems with control (incontinence?)
loss of urine associated with activities—sneezing, laughing
objective data of urinary system
Inspection
Note the patient’s height to weight ratio, body shape and their ability to move around with ease. /level of hygiene/ Inspection of lower abdomen and genitalia – note any discharge or excoriation.
-vital signs
-bladder scan:usually post void
-examination of urine: ward urinalysis, report abnormities
-fluid balance: intake
what structure are you looking up during a reproductive assessment
Structures (female)
Vagina
Cervix
Squamocolumnar
junction
Anterior fornix
Posterior fornix
Rectouterine pouch, or cul-de-sac of Douglas
Uterus
Fallopian tubes
Labia majora
Labia minora
Perineum
Vestibule
Clitoris
Mons pubis
Rectum
Structures (male)
Testis
Scrotum
Glans penis
Urethra
Corona
Foreskin
Corpus spongiosum
Corpus cavernosum
Symphysis pubis
Ductus deferens
Seminal vesicle
Rectum
Prostate
Bulbourethral gland
changes in infants and adolescents reprodcutive
at birth external genitalia are engored because of the presence of maternal estrogen )female
-at puberty, estrogen and testosterone stimultes groth of cells in reprodcutive tract and develop sex characterestics eg breats and pubic hair 8-19 females 11-16 males.
changes in older adult reproductive system
Female: menopause, uterus shrinks, uterus drops, ovaries not palpable after menopause, vagina becomes shorter, narrower and less elastic, labia and clitoris decrease
Male: testicular tissue mass decrease, prostate gland enlarges, number of living sperm decreases
subjective data on reproductive system
Urinary symptoms
Past history
Sexual activity
Contraceptive use
Sexually transmitted infection (STI) contact
Immunisation history
Self-examination (breasts, testicular)Menstrual history
Obstetric history
Menopause
Vaginal discharge
Cervical screening (HPV)
Objective data on reproductive system
Inspection
Note any discolouration,
Sparsity of hair distribution,
Nodules or Lesions
Discharge
Excoriation
Lymphatic drainage – observe axillary and supraclavicular regions – note any bulging, decolouration or oedema.
Breasts – note symmetry, size, shape; obvious lumps, pain and any discharge, bleeding, excoriation, retraction, displacement, scaling or ulceration of the nipples.
Testicles – note if descended, of equal size,nternal inspection of genitalia
cervix and vagina - usually undertaken by nurse practitioners or medical officers who are competent with the use of a speculum.
Assessment of muscle strength (female)
Assessment of colour of cervical mucosa (female), cervix size and position.
what is human papillomavirus (HPV)
Appearance: Lesions are pink or flesh-coloured, soft, pointed and moist warty papules.
Symtoms: asymptomatic
treatment and prevention:
no cure symptom treatment, HPV vaccine, safe sex
what is cyctole
Appearance: With straining or standing there will be the presence of a soft, round, anterior bulge.
symptoms: pressure in the vagina or pelvis, vaginal bulge, lower back pain, urinary leakage, frequent uti, pain during intercourse.
treatmennt: pelvic floor exercise, avoiding heavy lifting, insertion of a support device, surgry
what is testicular torsion
appearance: red swollen scrotum, one testis will be highter than other
symptoms: severe pain in testicle sudden onset, abdominal pain, nausea and vomiting
treatment is surgry
spermatocele is?
appearance: round movable mass above and behind testes
asymptomatic
treatment is surgery
