Med-Surg Ch 27 Test
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| A. Duloxetine (Cymbalta), inhibits uptake of norephinephrine and serotonin, Drug of choice for treating Stress UI not relieved by kegals. Side effects: Nausea, Headache, Insomnia, ConstipationB. Sulfonamides: Bactrim, photosensitivity, take ALL. Quinolones: Cipro, Levaquin, must be 18+ effects growth, monitor for dysrhythmias, no milk or antacids. Penicillins: Amoxil or Augmentin, watery diarrhea. Cephalosporins: Duricef, severe diarrheaC. Ureteroscopy (Laser beams used, No soft tissue damage), Percutaneous nephrolithotomy (Small incision, stone fragmented by laser/transducer, Nephrostomy tube, Monitor bleeding , pneumothorax, and infection)D. tobacco use, Occupational (Hair dressing chemicals, Rubber, Paint, Electrical cable, Work in textile industries), Schistosoma heamatobium (Egypt/Sundan) rresh water snail than can invadeE. Excruciating pain-renal colic, Flank pain, Sudden and unbearable, Nausea, vomiting, Pallor & Diaphoresis, Frequency and dysuria, Oliguria or anuiaF. Treat reversible cause. For non reversible: Urinary habit training, Catherization, Pessaries and penile clamps, Containment, Major concern: SKIN BREAKDOWNG. Tissue inflammation=scar tissue (fibrosis), Tubular cell necrosis, AbscessH. Extracorporeal shock wave lithotripsy, Moderate sedation, Monitor cardiac rhythm, Monitor for bruising, Hemorrhage, UO, may have Foley catheter, Strain urineI. Bethanechol chloride (Urocholine): Stimulates detrusor muscle contraction promoting emptying in flaccid neurogenic bladder, Use in combination with bladder training, Post-op and Postpartum urinary retention, Atropine is antidote, Slow position changesJ. Drink 2-3 L water/day, avoid sugar-filled drinks, Cleanse perineal area daily, Wipe front to back, Avoid bubble baths, nylon underwear, sprays, douche, Wear loose fitting clothing, Empty bladder regularlyK. Penetrating or blunt injury, Stabbing, Gunshot, Fx of pelvis, Sexual assault, Seat belt injur, Requires surgical interventionL. Look at treating structural causes, Prostatectomy, Cystocele, Urethocele, Artifical sphincter, Augmentation of bladderM. Morphine, Tordal or Indomethacin (NSAIDs), tamsulosin (Flomax)N. Nitrofurantion (Macrodantin), 6-8 glass of water/day, brown urineO. Large flank and abdominal incision, May place tubes and drains (Penrose, Foley cath), Monitor effects of anesthesia, bleeding, Maintain hydration, prevention of infection, Strain all urine, Teach prevent of future stonesP. Oxybutynin (Ditropan) and Tolterodine (Detrol): Causes bladder muscle relaxation/suppress urge to void, Caution use with glaucoma, SE: Dry mouth, Constipation, Urinary retention, dysrhymiasQ. Incomplete emptying of the bladder, Mechanical obstruction or Functional problem, BPH (benign prostetic hyprofetophy)R. Cranberry juice, avoid caffeine, carbonated beverages, tomato products, increase fluid intake (if possible), Sitz bath, heating pads, I/O, Strict aseptic technique, Maintain closed urinary drainage system, Perineal careS. Fever, Chills, Flank pain (Tender costal vertebral angle), N/V, diarrhea, Malaise, fatigue, symptoms of cystitisT. Increased abdominal pressure; <leakage by Diary, Kegal exercises, Nutritional (avoid things irritating bladder), Vaginal cone therapy(weights), Surgical |
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