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MCAI-FINALS--1

Urinary System

QuestionAnswer
what is the responsibility of the bladder to collect, hold, secret urine.
how many mLs cause moderate bladder distention? 200 to 250 ml
how many mLs cause uncomfortable sensation? 400 to 600
what is the capacity of the bladder 1 liter
what is another term for urination? micturition and voiding
what are the assessment data for urinary system? pain, urinary pattern, urine output, urine characteristics, peripheral edima (w/ kidney problem)
what is passing urin many times a day and only small amounts refers to? frequency
what is dribbling? passing of urine stream (strong or not steady), common in men with prostate problem. They pee a little bit at a time, not too steady.
what is retention? urine building up inside even after voiding
what do you call the pain when passing the urine? dysuria.
what are the dx tool apply to urinary system. labs ( electrolytes, BUN, Creatinine, UA, C/S, radiological procedures , cystoscopy
what scope use for urinary system? cystoscopy
what type of x-ray specifically use for urinary system? KUB xray.
why BUN not specific for kidney? if there is a bleeding or nitrogen issue
what are the causes of UTI? frequency, urgency, burning upon urination, foul-smelling urine
What are UTI prevention? "Younger, sexually active females more predisposed as well as people who hold urine and don’t
pee, females wiping back to front exposing urethra to E.coli, recommend that women pee after sexual intercourse."
what are s/s of UTI fevers, pain (back region or higher), hematuria
what are the UTI tx? antimicrobial therapy sensitive to organism, analgesic, completion of antibiotic rx, adequate fluid intake, nutrition, rest and comfort, ask how they got it, teach prevention, and recurrence counseling
what is urethritis? inflammation of urethra, caused by viral/bacteria, Sexually xmitted (gonorrhea in men)
s/s urethritis? dysuria and frequency.
what is interstitial cystitis? painful inflammation of the bladder, onset 40yo, more for women
s/s insterstitial cystitis? dysuria relieved by urination, frequency, urgency
how to tx for interstitial cystitis? no treatment med, treat sympomptoms (palliative), pee more frequently, don't hold
what are the problems of bladder control? bladder emptying and bladder storage (incontinence)
what are the causes of urinary retention? muscle can't stretch overdistended (hypertrophy/enlargmnt),stones, trauma to muscle, neurological/sensory prob(dementia, stroke pts), tumor obstruc, scar tissue due to sx (cystoscopies),sctricture( narrowing or tumor obstruction ), meds , lack of privacy
complications of urinary retention: getting a bacterial infx, overdistended bladder could cause perforation; elevate BP and HR due to distention of bladder causes sympathetic response
what to assess pt that had cystoscopy and their system works? ask the pt to urinate, take note of the urine color, consistency, stream(if unstable , scan bladder to check urine retention, if retention, call the doctor), ease, discomfort, burning? (1st few pees/days),
what are the s/s of blockage pelvic region pain or discomfort and dribbling of urine but not enough to relieve pressure.
what is male retention problem? large prostate (hugging the ureter).
what are the tx of urinary retention? h/o of s/s , if problem persist, install urinary catheter even when they go home. This will prevents the urine go back to the ureter and cause UTI., Teach pt how to discontinue at home.
How sx and dx procedure (cystoscope) affect urine elimination and the properties of urine? dysuria, hematuria (irritation, pink , cherry red, salmon color),
what are the s/s of enlarge protstate gland? dysuria from enlargement and obstruction
What are the tx of enlarge prostate? Digipan, Flomax(conservative meds for BPH), TURP (surgery to remove section of the prostate, TURBT (bladder tumor removal)
what is creatinine clearance normal values? 70 to 135
Nursing care for BPH if bleeding or clot suspicion in the ureter, the bladder needs to be irrigated continously with N. Saline and not sterile water (too many electrolytes shift), I/O, Pain control, Nutrition, rest, comfort, observe s/s UTI.
what is urinary incontinence disease uncontrolled / involuntary leakage of urine from the bladder.
what are the s/s of incontinence frequency, urgency, urge incontinence
what are the types of incontinence? stress(sneez, cough), urge(spasms in bladder), overflow(bladder fill up and overcome sphincter control), reflex(d/t spinal cord inj), trauma to spincter, functional(older can't go bathroom because they hold full bladder too long, or bathroom too far)
what are the dx test for urinary incontinence? h&p, PE, labs, bladder scan
How to measure residual urine? bladder scanner
What are altered urine production? polyuria, oliguria, anuria , need to monitor for 24 hours
what is polyuria? lots of urine, abnormal if other disease process , diabetes, neurological condition, )
what is oliguria? (too little urine) 100 to 400 ml per day (less than normal range) normal range is about 1500 ml per day
what is anuria? (almost no urine) < 100 ml per day (very dehydrated) r/t renal failure or kidney disease.
what is the normal urine output 60 ml/hour or 1500 ml/day, below 30ml (give 2 hours of information) per hour is acceptable
what is the most important nursing assessment for client with indwelling urinary cateter and why? check if the catheter is patent, palpate bladder, flush bladder if needed, check cat. Bag
what is ileal conduit? ileal loop /urinary diversion: cut a small piece of ileum (ex. 2 inches), take out bladder, connect ureter to small piece of ileum, connect small piece of ileum to abd wall. (suture the remaining ileum back GI tract)
what is ureterostomy? connect ureter directly to abd wall. Not used anymore due to more complications.
what is ureteroileosigmoidostomy? ureter connected to small piece of ileum, small piece of iluim connected to sigmoid colon.
what is nephrostomy surgically insert catheter through the back of the pelvis, and connect the catheter right after the kidney.
what is neobladder create bladder, no nerve, no sensation, scheduled pee use abd muscle to void.
what is acute pyelonephritis? inflammation of renal parenchyma, lower UTI, urosepsis, septic shock
s/s pyelonephritis? fatigue, chills, fever, vomiting , flank pain, dysuria, urgency, frquency, CVA pain.
what organism caused by pyelonephritis? gram negative bacteria
what is glomerulonephritis? inflammation of glomeruli., GFR < 125 per hour, autoimmune, streptococcus, acute vs chronic, 3rd leading cause of acute renal failure.
s/s glumerulonephritis? hematuria, WBC, proteinuria, inc. BUN/creatine.
what is goodpasture syndrome? cytotoxic autoimmune disease, affect kidney and lungs, yung male smoker.
what is nephrotic syndrome loss of plasma protein, fluid shift and fluid retention,
causes of nephrotic syndrome glomerular disease SLE, DM, Bcterial, viral, protozoal , leukemia, tumors, hodgkins, allergen, Drugs (NSAID, Captopril, heroin)
s/s nephrotic syndrome labs and pt s/s
what is nephrolithiasis kidney stones (renal calculi)
cause of nephrolithiasis metabolic, dietary, genetic, lifestyle, and occupational.
what are the calculi? ca phospate, ca oxalate, uric acid, cystine, struvite (mg ammonium phospate)
what is polycistic kidney disease genetic, cysts that damage (need transplant)
alport sysndrome gene mutation, altered synthesis of glomerular
foods to avoid with oxalate renal problem spinach rhubarb, asparagus, tomatoes, chocolate, nuts, celery, and parsley
kidney pain of infection flank pain
kidney pain of hydronephrosis acute colicky pain.
bladder & pelvis obstruction distentionn and pressure.
priority RN dx for pt with renal failure fluid excess management
when should RN infuse 1 pack of blood xfusion between 1 to 3 hours
sign of lower UTI burning sensation while voiding
sing of pyeloneprhonitis flank pain, costovertebral angle tenderness, chills
what tx for renal calculi pt Opiods (NSAID and salicylates are anti-inflammatory)
tx specific to bladder tylenol and pyridium (turn urine orange)
how much amount of water should pt with renal calculi drink per day 3 liters (12 cups ) per day
Why pt with renal disease's skin feels itchy? because of Calcium-phosphat deposits.
what to do if patient have muscle cramps after hemodialysis? infuse N. Saline. Muscle cramp occurs when Na and Water are removed too quickly.
organisam in glomurelonephrotitis what could be the symptoms streptococcus infection / sore throat problem.
what pt could be done to prevent recurrence of UTI? Urinate every 2 to 3 hours
after TURP, notify provider any signs of: infection such as fever, urinary frequency, or painful urination.
what nutrition diet of pt with renal problem? fluid intake. Eat food low in K, Phos, and protein 'coz kidney can't excrete them and will retain inside the body. Eat food high in Calcium
signs of hyperkalemia RR 28/min, nausea, dull headache, palpitation, general malaise.
Created by: rt-study