WWeek #8- Genitourinary/Renal/Reproductive Flashcards
common Genitourinary disorders to be called for?
UTI, Urologic stones disease, AKI, Chronic Kidneys disease(home dialysis disconnect), urinary retention/incotinence, Foley catheters (Type/care)
common disorders with the male reproductive tract?
Testicular torsion, Epididymitis, Orchitis, Prostate enlargement
common disorders with the female Gynecological system?
Dysmenorrhea/amenorrhea, PID<ovarian>, Endometriosis</ovarian>
What types of pain are common in GU disorders?
Visceral: hollow structures, ie:ureter/bladder
referred: achy, cramping, deepening, poorly localized pain.
what is a UTI?
Urinary tract infection characterized by bacteriuria in the presence of symptoms. Usually develops in the lower Urinary tract and can spread to higher structures when untreated—>pyelonephritits/urosepsis
Men UTI symtpms….
Bacterial colonization of the UT—> kidnyes, ureter, bladder
- dysuria, inflammation of urethra, epididmytitis ( inflmmation of epididymis), Prostatisis, orchitis ( infllmmation of the prostate), Pyelonephritits,
UTI in women…
occurs in abour 20% of every women in their lifetime, more frequent, usually involve cyctitis, inhibits perurethra vagaina, grwquent voiding reduces UTI
common UTI s/s…
Dysuria, clouds.foul smell, pain on palplation of lower abdo ( men usually), increased frequency/urgency to void
Pyelonephritis
kidney infection/infection of renal pelvis, cause by another infection which spreads
- dysuria, flank pain, increased frequency, nocturia, dark/cloudy urine, N?V, fever, chills, spepiss++
Urinalysis?
Hydronephrosis?
kidneys swell due to urine build up if untreated it can damage the kidneys, unilateral.
Urologic stone disease
Renal calculi: most common in men over 60(prostatic hypertrophy), gynecologic surgery, pregnancy & cancers of pelvic organs= important in women obstructions
s/s: flank/groin pain that increases when moving, dysuria, pain++
How often does trauma occur to the genitourinary system?
-3-10% of trauma pt→ GU
-10-15% of trauma pt w abnormal injuries→ GU involvement
-Renal injuries constitute 45% of all GU injuries
-Ureteral injuries → 5%
Testicular torsion?
spermatic crd which provides blood supply to the testicles is twisted
- congenital anomaly: Bell clapper deformity: undecended testicle, sexual arousal, trauma, exercise, cold etc.
- sudden onset/constant or intermittent,
Hx: 50% hve had it previously, needs surgery,6-12 hrs=++risk
Epididmymitis & Orchitis
- inflmmation of the epididmytis & convoluted duct that supples the testees w/ sperm ( both epididmysiz and orchitis)
Hx: scrotal pain, edemal. frequent urination, STI, dysuria, N/V/fever/chills, flank pain, bilateral involvement=10%
Tx: antibiotics
prostate enlargement
- beginign porstatic hyperplasia—> restricts the flow of urine
s/s: urinary frquency/urgency/hesitancy/incomplete void,
RX: erectile dysfunction meds are used for prostate
urinary retention emergency
commonly caused by: protstic hypertropphy, anticholinergic drugs, bladder stabalizers/tricycilic antidepressants, urethral calculus, bladder neck hypertrophy etc…
urinary incotinenece
- involuntary peeing, 15-30%
Hx: onset ( pregnancy/postpartum/surgery), duration of complains/patterns
tax: emesis bag for pee
Assessments:
ask if they are having flu like symptoms, feeling like their bladder is full, oligera, anurea, asses colour, frequency, heamturia,
Hx: of catheter, how much pee, etc
what are some risks of elderly men w hx of prostate enlargement?
septic shock: tachycardia, hypotension, tachypnea, fever
UTI: management…
supportive care, findings of; tahycardia, delayed cap refill—>shock/depletion and needs IV fluid resuscitation
- ketolarc for pain management, transport in position of comfort
common antibiotics for UTI in men…..
ciprofloxacin, Ertapenem, Cialis, Phenazopridine
(Female repro) Dysmenorrhea/amernorrhea
- > 3missed periods in a row or age 15 w/o any periods yet
Menorrhagia?
excessive mentstraul bleeding common in teens and perimenaopause, spontaneous abortions
Gynecological:
- PID: pelvic inflammatory disease
- infections of uterus, fallopian tubes, ovaries, peritoneum
- STI
- manage pain
endometriosis/endometritis:
itis- Infection of the uterine lining
Osis-endometrial tissue is found outside of the uterus due to hormonal chnages of the mentral cycle bleeding
Ovarian cysts:
- fluid filled pockets that develop in the ovaries that can rupture–>severe abdo pain
- whe the burst they can bleed into the abdo
interstitial cycitis
- chronic bladder condition, mild-severe pain, w/ s’s of uit or sti
manage s/s relife
AKI
toxic build up of waste that impairs kidney function and can take hours to days to occur
Risk factors/causes for AKI
- elderly, diabetic, chronic kidney disease, dehydration, chronic diease (CHF), women, cancer, anemia,
- exposures: sepsis, circulatory shock, burns, trauma, cardiac surgery etc
- patho: deceased renal perfusion, oxidative stress, ob, hypoxic injury etc
etiology of AKI
educed renal blood flow–> decreased GFR
- pre=-renal shock: due to decreased renal BF
- intra-renal: direct damage to the kidneys and their structures ex;NSAIDS
- post renal: Obstructions
(community acquired=25%)(hospital acquired=10-15%)
what would a patient in AKI look like?
- decreased urine out put, edema in extremities & face, fatigued, SOB, alt loa, N
chronic kidney disease:
- due to over 70% death to nephrons 80%–>endstage renal fialure
s/s of chronic kidney disease
lethargy, GI, alt mental status, utremia, jaundice, arrhythmias, edema, diaphoresis
cons of peritoneal dialysis
can give a falsely high BGL read & may need to Tx w/ s’s releif
