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PAR3012 - Extended Care > Week 6 > Flashcards

Week 6 Flashcards

1
Q

what is in the upper urinary system?

A
  • kidneys

- ureters

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2
Q

what is in the lower urinary system

A
  • urinary bladder
  • urethra
  • urethral meatus
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3
Q

which kidney sits lower and why?

A

Right lower than left because the right one sits under liver

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4
Q

What vertebrae are the kidneys located at?

A

Approx T12-L3

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5
Q

What is a visual landmark for T12

A

approx level of of umbillicus

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6
Q

Where are the adrenal glands what what do they secrete?

A 
Sit on top of kidneys
secrete:
- Catecholamines
- Androgens
- Corticosteroids
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7
Q

What is the urinary bladder?

A

Hollow organ to hold urine before excretion

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8
Q

What is commonly injured from the lower seat-belt in MVA?

A

Urinary bladder

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9
Q

What is the difference between the male and female urethra?

A

Urethra is longer in male
18-23 cm

Urethra is considerably shorter in females (3-8cm)

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10
Q

What causes an increase in the size of prostate?

A

Puberty

- @40 it begins to grow again called Benign Prostatic Hyperplasia

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11
Q

What is Benign Prostatic Hyperplasia?

A

Growth of prostate after the age of 40

  • Causes problems with urinary retention/infection
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12
Q

What is Hypospadias?

A

Abnormality of the penis and urethral meatus.

Opening of urethra is abnormally positioned on the ventral surface affecting urine stream/erections

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13
Q

What is one of the main reasons for increased UTI’s in females?

A
  • Smaller urethra

- proximity of meatus to vagina and anus

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14
Q

What happens with a vaginal prolapse?

A

Common problem where th ebladder, uterus or bowel protrudes in to the vagina

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15
Q

What is the largest cause of vaginal prolapse?

A

pregnancy

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16
Q

What are some indications for a colostomy or ileostomy?

A
  • bowel obstruction
  • Trauma
  • Ischaemic bowel
  • Perforated bowel
  • Infection
  • IBS
  • Diverticulitis
  • Colorectal/anal cancer
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17
Q

What are some indications for an ileal conduit?

A
  • bladder cancer and cystectomy
  • traumatic bladder injurt
  • severe urinary incontinence
  • neurogenic bladder
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18
Q

What are some indications for a faecal diversion system

A
  • burns
  • sacral pressure injuries
  • infective diarrhoea
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19
Q

What is inflammatory bowel disease/crohns disease?

A

subacute and chronic transmural inflammation of the bowel

  • commonly develops in adolescents
  • occurs more commonly in women
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20
Q

What is ulcerative collitis?

A

recurrant ulcerative and inflamatory disease of the mucosal and submucosal layers

  • begins in rectum and then spreads proximally
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21
Q

What are some key differences found in Chrohns disease compared to ulcerative colitis?

A 
Location: Ileum, ascending colon
Bleeding: Unusual
Fistulas: Common
Rectal involvements: 20%
Diarrhoea: Mild (2-5 motions)
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22
Q

What are some key differences found in Ulcerative collitis disease compared to Chron’s disease?

A 
Location: Rectum, decending colon
Bleeding: Common and severe
Fistulas: Rare and mild
Rectal involvements: 100%
Diarrhoea: Severe (10-20 motions)
23
Q

what are the three types of bladder cancer?

A
  • urothelial carcinoma
  • squamous cell carcinoma
  • adenocarcenoma
24
Q

what is the most common symptom of bladder cancer?

A

Haematuria

blood in urine

25
Q

What is the most common injury to the bladder? What symptoms would be seen?

A

Blunt trauma
Pt presents with:
- gross haematuria
- suprapubic pain

26
Q

What is diarrhoea?

A

Increased fluidity or frequency of bowel motions

27
Q

What is a gastrointestinal stoma?

A

opening into the abdominal wall to allow evacuation of doo doo following bowel surgery

28
Q

What type of gastrointestinal stomas can be used?

A
  • Colostomy

- Ileostomy

29
Q

What happens with a renal stoma?

A

ureters are resected from the bladder and anastomosed to a resceted part of the ileum

  • known as urostomy
30
Q

what are the differing types of colostomies and ileostomy?

A

Single barrelled/double barrelled / loop

31
Q

How do you visually identify a urostomy?

A
  • Flatter appearance
  • round shape stoma
  • right hand side of umbilical
  • urine output
32
Q

How do you visually identify a colostomy?

A
  • shorter in length
  • round shaped
  • left hand side of umbilicus
  • has soft output
33
Q

How do you visually identify an ileostomy?

A
  • Longer in length
  • cone shaped
  • right side of lower abdomen
  • liquid output
34
Q

What is the actual name for a bag attached to a stoma?

A

Ostomy pouch or ostomy appliance

35
Q

What type of ostomy appliance is common for colostomy?

A

one piece

36
Q

what type of ostomy appliace is common for an ileostomy?

A

two piece

37
Q

What can cause stoma necrosis ? and when is it most common?

A

venous or arterial insufficiency

Most common: first 5 days post op

38
Q

What is stomal prolapse?

A

when the bowel is externally displaced.

39
Q

what are some considerations for the assessment and managment of a stoma as paramedics?

A

Call stoma support nurse

  • always ask about normal stoma appearance/function and output
  • has patient attempted to resolve problem
  • listen for bowel sounds with stethoscope to confirm peristalsis
  • assess stoma for colour, warmth, activity, mucous and odour
40
Q

what to consider when caring for a patient with a urinary catheter?

A
  • past medical history
  • reason why catheter was inserted
  • where abouts was it inserted
  • when
  • what type
  • what size?
41
Q

what are the different types of urinary catherterisaton techniques?

A

Intermittent - drains urine in bladder

Continuous - semi-permanent for output monitoring

Suprapubic - long-term inserted through abdomen

Condom - condom with draining tube basically

42
Q

What are the indications for intermittent urinary catheters?

A
  • drains urine remainign in bladder after voiding
  • prevents urinary incontinence
  • post-operatively
  • used in community to avoid continuous
  • specimen collection in elderly
  • enlarged prostate
43
Q

What are the indications for continuous urinary catheters?

A
  • measure hourly output
  • allows draining is meatus is swollen
  • used for patients with epidural /spine block
  • pts with neurogenic bladder problems
  • autonomic dysreflexia
44
Q

What are the indications for supra-pubic urinary catheters?

A
  • failed urethral catheter insertions
  • long term or permanent urinary catheterisation required
  • pt wants to maintain sexual relationship
  • sustained urethral trauma
45
Q

What are the indications for condom urinary catheters?

A
  • non-invasive
  • easily applied
  • wants sexual relationship
  • palliative care with urinary incontinence
  • pts with sacral pressure wounds
46
Q

What are the contraindications of urinary catheterisation?

A
  • recent urological trauma
  • recent urological surgery
  • has previously been know to be difficult to catheterise
  • known urethral stricture or narrowing
  • urethral meatus bleeding or current frank haematuria
  • male with phimosis that prevents meatus visualisation
47
Q

what is phimosis?

A

tight foreskin making visualisation of meatus difficult

48
Q

what size catheter do you use for males and females?

A

Male - 14 - 16 french gauge

Female - 12 - 14 french gauge

49
Q

What can cause difficult urinary catheter insertion?

A
  • Prostatic urethra

- Urethral spasm

50
Q

What is the most common complication of urinary catheterisation?

A

UTI

51
Q

What is paraphimosis?

A

foreskin retracted to insert catheter, then not returned… becomes a surgical emergency

52
Q

What are common causes of blocked urinary catheter?

A 
bladder neck spasm
sediment and encrustation
blood clots
low flow
granulation tissue
53
Q

What can a blocked catheter and distended bladder cause?

A

autonomic hyperreflexia in spinal cord lesions above T5

54
Q

What should you do to dislodge any sediment in a urinary catheter?

A

rotate 360 degrees

PAR3012 - Extended Care (12 decks)

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