Other Urinary Tract Disorders
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| What is the medical name for the most common form of kidney cancer? | Renal cell carcinoma
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| Why are renal tumors often large when detected? | due to vague symptoms that are often ignored early on (clinically silent)
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| What do renal tumors arise from? | cells of the proximal convoluted tubules
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| What are the most common sites of renal carcinoma metastasis? | *Lungs *Adrenal glands *Liver *Bones
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| What is the subjective data for Renal Tumors? | *Hematuria which “comes and goes” with no associated pain *Weight loss *Fatigue *Dull Flank pain
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| What is the objective data of renal tumors (Advanced stages)? | *Palpable mass in flank *Hematuria *Signs of metastasis
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| What is important for a nurse to check prior to the PT receiving an Intravenous Pyelogram (IVP) | Allergy to iodine
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| Why is the medical management for renal tumors a radical nephrectomy? | Radiation and chemotheraphy provide minimal benefit
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| What is the most common site of cancer in the urinary tract? | The bladder
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| What is the medical management of bladder tumors? | *Fulguration: burning with an electric spark *Laser ablation *Chemotherapy instillation into bladder *Radiation therapy
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| What is polycystic kidney disease? | Genetic disorder with growth of numerous fluid-filled cysts which can slowly replace function of kidney
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| True or False: A single renal cyst may occur without clinical significance | True. Multiple cysts interfere with kidney function.
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| Other than genetic, who else can develope polycystic kidney disease? | Person with long-standing renal insufficiency or on dialysis
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| What is the medical management of polycystic kidney disease? | No specific treatment, Aimed at relief of pain and symptoms of the disease, Heat and analgesics
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| Urinary stasis from polycystic kidney disease can lead to what? | UTIs
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| List 3 causes of renal function compromise in polycystic kidney disease | *Pressure on the cysts on kidney structures *Secondary infections *Scarring from ruptured cysts
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| Who is Benign Prostatic Hypertrophy (BPH) common in? | Men over the age of 50
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| Symptoms of BPH are associated with what? | Symptoms of urinary retention
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| What symptom do Renal Tumors, Bladder Tumors, Polycystic Kidney Disease, and Benign Prostatic Hypertrophy have in common? | Hematuria
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| What are objective signs of BPH? | *Hematuria, pyuria *Distended bladder *Enlarge prostate on rectal exam
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| What is the initial goal of the medical management of BPH? | Relieve obstruction
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| Upon relief of obstruction from BPH, what is the drainage stopped at, and why? | Drainage should usually be stopped at 1000ml initially to prevent rapid decompression of bladder to avoid rupturing mucosal blood vessels.
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| What is the most common surgical procedure for BPH? | TransUrethral Resection of the Prostate (TURP)
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| What is ruled out before a Transurethral Ultrasound-guided Laser-Induced Prostatectomy (TULIP) is performed? | The possibility of cancer since the procedure destroys the obstructing tissue.
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| What is used to provide continuous irrigation and continuous drainage of the bladder? | Three way foley catheter.
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| What may cause bladder spasms in a PT with a 3-way foley catheter? | Clots
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| Why is the 3-way catheter taped to the PTs abdomen? | To maintain upward pressure on the prostate
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| When do you remove the tape from a 3-way catheter? | Not until ordered by physician
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| Why is prolongued sitting discouraged in a PT who just had a TURP/TULIP? | It may cause the operative site to bleed
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| How will the urine of a PT who just recieved a TURP/TULIP appear for the first few days after surgery? | Bloody
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| PTs on their first dose of Terazosin Hydrochloride may experience what? | Orthostatic hypotension
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| When should Terazosin Hydrochloride be administered? | At bedtime
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| What anti-HTN drug is given to the PT with BPH to help relax the prostate? | Terazosin
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| What are the adverse effects of Finasteride? | *Decreased libido *Decreased volume of ejaculate *Impotence
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| What should be performed before and periodically during therapy for BPH? | Digital rectal examinations
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| What alpha1-adrenergic receptor antagonist is given to a PT with BPH to relax smooth muscle in the bladder neck and prostate? | Antispasmodics such as alfuzosin (Uroxatral)
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| What are the frequent metastasis sites for cancer of the prostate? | Pelvic lymph nodes and bone
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| What is the normal range for the Prostate-specific antigen (PSA) | 0-4ng/mL
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| What interventions should NOT be implemented in the PT with cancer of the prostate? | Rectal temperatures, enemas, rectal tubes.
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| Which prostatectomy procedure provides access to the pelvic lymph nodes? | Retropubic prostatectomy
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