Term
1. OBSTRUCTION 2. PROBLEMS WITH OBSTUCTION CAUSE..... |
|
Definition
1. ANY ANATOMICAL OR FUNCTIONAL CONDITION THAT BLOCKS OR OBSTRUCTS THE FLOW OF URINE. 2. URINE BACKUP CREATES ENLARGEMENT OF THE KIDNEYS & INFECTION |
|
|
Term
(3) CAUSES OF INTRINSIC OBSTRUCTION ____ * __: presence of calculi in urinary tract. Stones are norm asymptomatic until they reach ____, causing excruciating pain. *___: term used for stones that form in kidney & ___ used for stones forming in the ureter. |
|
Definition
1.ANOMALIES (ENLARGED PROSTATE) 2. GROWTHS 3. TUMORS *UROLITHIASIS *NEPHROLITHIASIS -- URETEROLITHIASIS |
|
|
Term
FOUR EXTRINSIC CAUSES OF OBSTRUCTION: |
|
Definition
1. PROLAPSED UTERUS 2. ABDOMINAL TUMOR 3. ADHESIONS (fibrous bands that form b/t tissue & organ, often as a result of injury during surgery... internal scar tissue) 4. FUNCTIONAL: SPINAL CORD INJURY |
|
|
Term
SEVERITY OF URINARY OBSTRUCTION DEPENDS ON WHAT 4 THINGS? |
|
Definition
1. LOCATION 2. DURATION 3.AMOUNT OF PRESSURE 4. PRESENCE OF URINARY STASIS |
|
|
Term
1. _____: THE STOPPAGE OF DIMINISHED FLOW OF URINE THAT MAY BE CAUSED BY ABNORMALITIES IN STRUCTURE OR INNERVATION OF THE URINARY OUTFLOW THAT RESULTS IN INCOMPLETE EMPTYING OF BLADDER. B/C URINE SIT IN BLADDER, BACTERIAL GROWTH OCCURS LEADING TO UTI'S. |
|
Definition
|
|
Term
*OBSTRUCTION CREATES WHAT 4 COMPLICATIONS FROM BAD --->WORSE? |
|
Definition
1. HYDROURETER 2. HYDRONEPHROSIS 3. PYELONEPHRITIS & RENAL ATROPHY 4. KIDNEY FAILURE |
|
|
Term
WHEN A CALCULUS BLOCKS URETER & BLOCKS THE FLOW OF URINE, THE URETER DILATES & ENLARGES. THIS IS __1__. THE PAIN ASSOCIATED W/ URETERAL SPASM SO BAD, PT. MAY GO INTO __2__. ALSO, __3__ (BLOODY URINE) MAY OCCUR FROM DAMAGE OF URTHELIAL WALL. IF OBSTUCTION IS NOT REMOVED URINARY STASIS RESULTS IN INFECTION & IMPAIR THE KIDNEY ON THE SIDE OF OBSTRUCTION. AS THE BLOCKAGE PERSIST __4__(ENLARGEMENT OF KIDNEY CAUSED BY BLOCK OF URINE IN LOWER TRACT & FILLING OF KIDNEY W/ URINE) & IRREVERSIBLE KIDNEY DAMAGE MAY OCCUR. |
|
Definition
1. HYDROURETER 2. SHOCK 3. HEMATURIA 4. HYRONEPHROSIS |
|
|
Term
*Occurs in 2-3% of population, men are more effected then women. Recurrance is 50% with in ten years after perveious episode. Occurs more in warm, humid climate and w/ family hx. |
|
Definition
*Nephrolithiasis (Kidney stones) |
|
|
Term
Types of stones: (Calculi) 1.__: may be drug induced, increased circulating calcium. 2.__: most common type. Thought that high levels of calcium intake cause this. 3.__: Seen in gout, hereditary. A diet low in animal proteins are reccomended. 4.__: a genetic disorder of the transport of a amino acid causes excess in urine. 5.__:caused by bacteria-mostly in females. |
|
Definition
1. Calcium Phosphate 2. Calcium oxalate 3. Uric Acid 4. Cystine 5. Struvite |
|
|
Term
The 3 Marjor parts of assessment of pt. with posible stones: |
|
Definition
1. History: family hx, immobility, diet, medications, fluid intake. 2.Urinalysis: Common findins- Hematuria (urine may be smokey/rust color), RBC(trauma), WBC & Bacteria, increases in serum calcium, phosphate, or uric acid levels. 3. Imaging is needed to confirm/rule out diagnosis. |
|
|
Term
1. Name 3 Diagnostic Test used to locate & diagnose Stones without potential damage to kidneys. 2. What would be a more invasive way that should be avoided if possible to avoid damaging kidneys? 3. The only way to see cystine or uric acid stones? |
|
Definition
1. Abdominal Ultrasound 2. Abdominal X-Ray (KUB) 3. Non-contrast CT scan 2. Intravenous Pyelogram (IVP)- contrast injected could cause acute renal failure b/c of contrast dye. 3. CT or MRI- both of these cannot be seen on an x-ray |
|
|
Term
The most Important part of collaborative managment of kidney stones is.... and .... Followed by what 4 other things? |
|
Definition
*Finding cause of stones & pain management *Hydration *Strain Urine *Diet |
|
|
Term
* Flank pain suggest that the stones are in the __1__ or the __2__. Flank pain that radiates abdominally or into the scrotum & testes or vulva suggest the stones are in the __3__ or the __4__. *Pain is most intense when stone is __5__ or when the ureter is __6__. |
|
Definition
1. KIDNEY 2. UPPER URETER 3. URETERS 4. BLADDER 5. MOVING 6. OBSTRUCTED |
|
|
Term
1. Kidney stone pain is most severe in what time frame? 2. Drugs:oxybutyinin (Ditropan) & propantheline bromide (Pro-Banthine) are important for control of pain, they are classified as... and are used for... |
|
Definition
1. In the first 24-36 hrs. 2. Antispasmodics- used to relieve symptoms associated w/ bladder spasms. |
|
|
Term
1. Avoiding over/ under ___ in the acute phase help make spontaneous passage of a stone less painful. 2. How would one monitor for passage of the stone? 3. Why is it important to send the stone to the Lab? |
|
Definition
1. HYDRATION 2. STRAINING 3. KNOWING THE COMPOSITION OF THE STONE CAN HELP PREVENT OCCURANCE OF FUTRUE STONES. |
|
|
Term
1. __:TREATS STONES IN ALL LOCATIONS, OUT PT. PROCEDURE. SHOCK WAVES BREAK UP STONES BY DELIVERING 500-1500 SHOCKS MAKING STONES EASIER TO PASS. PT. IS NORM BURIED AFTERWARD IN PLACE WHERE THEY ARE SHOCKED. PT. IS MONITORED FOR _2_ W/ _3_. STONE IS LOCATED W/ A __4__. ANESTHESIA IS USED ALONG WITH AN ANESTHETIC CREAM ON SKIN. OCCATIONALLY _5_ IS PLACED IN URETER B4 TO EASE PASSAGE OF STONE. __6__ STONES ARE OFTEN RESISTANT |
|
Definition
1.EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) 2. DSYRHYTHMIAS 3. ECG 4. FLUOROSCOPE 5. STENT 6.CYSTINE STONES |
|
|
Term
1.___: A SMALL TUBE PLACED IN THE URETER THAT DILATES THE URETER & CREATES A PASSAGEWAY FOR THESTONE OR STONE FRAGMENTS. 2. ENDOSCOPE PROCEDURE CALLED ____ OR ____. 3. DURING______ , THE URETEROSCOPE IS PASSED THRU THE URETHRA & BLADDER. ONCE THE STONE IS SEEN, THEY CAN BE REMOVED W/ FORCEPTS. |
|
Definition
1. STENT 2. URETEROSCOPY OR URETERORENOSCOPY 3. RETROGRADE URETEROSCOPY |
|
|
Term
WHEN A STONE IS REMOVED, PT. IS AT RISK FOR ___ B/C IF THE STONE IS SHARP, AS IT MOVES, OR IS PULLED THRU URETHRA IT CAN CAUSE MAJOR DAMAGE TO THE LINING. USING A ____ PREVENTS THE STONE FROM COMMING IN CONTACT WITH URETHRAL MUCOSA. |
|
Definition
|
|
Term
1._____: MOST DIFINITIVE TREATMENT- USED FOR LARGER STONES. PT. LAYS IN PRONE OR LATERALLY & RECEIVES GENERAL ANESTHESIA. THE MD PASSES A NEEDLE INTO THE COLLECTING SYSTEM OF THE KIDNEY AND A LASER CAN BE USED TO BREAK UP AND REMOVE THE STONE. OFTEN A _____ IS LEFT IN PLACE INITIALLY TO PREVENT THE SONE FRAGMENTS FROM PASSING THRU URINARY TRACT. 3 OF THE MAIN COMPLICATIONS WITH THIS PROCEDURE INCLUDE>>> |
|
Definition
1. PERCUTANEOUS NEPHROLITHOTOMY ~NEPHROSTOMY TUBE~ 1. BLEEDING @SITE OR THRU TUBE (MAJOR COMP) 2. PNEUMOTHORAX 3. INFECTION |
|
|
Term
NURSING CARE AFTER STONE REMOVAL: *PAIN RELIEF- WORKS BEST WITH.... *PREVENTION OF ____ W/ GENTAMICIN (GARAMYCINE) & CEPHALOSPORINS (KEFLEX) *ENCOURAGE ____ *PREVENT____ *OBSERVE FOR _____ *PT. EDUCATION ON...... |
|
Definition
*MEDS GIVEN AT A REGULAR SCHEDULE INTERVALS INSTEAD OF PRN, PRN MEDS CAN BE GIVEN FOR BREAK THRU PAIN MANAGMENT. *INFECTION *FLUIDS- CHECK HYDRATION STATUS (URINE COLOR) *OBSTRUCTION (FLUIDS, I&O, MEDS FOR DIF KINDS OF STONES *POST OP COMPLICATIONS *PREVENTING FUTURE STONES |
|
|
Term
1.PREVENTING CALCIUM PHOSPHATE STONES? |
|
Definition
1. LOWER CALCIUM INTAKE, LOW NA+ INTAKE, LOWER PROTEIN INTAKE (REDUCTION IN PROTEIN REDUCES ACIDIC URINE & PREVENTS CALCIUM PRECIPITATION) |
|
|
Term
DIET FOR MANAGEMENT OF STONES: 1. CALCIUM OXALATE STONES--PH? 2. URIC ACID--PH?-- DRUG USED? |
|
Definition
1. LOW OXALATE DIET- BEETS,SPINACH, COCOA, BLACK TEA. TREAT W/ VIT. C AND DIURETICS. URINARY PH IS NOT A FACTOR 2. LOW PURINE DIET- ORGAN MEATS, POULTRYM FISH, GRAVIES, RED WINES, & SARDINES. WANT TO MAKE URINE PT ALKALINE ALLPURINOL (INCREASES URINE PH) |
|
|
Term
MANAGEMENT OF STONES BASED ON TYPE: 1. CYSTINE: DIET? DRUG USED? 2. STRUVITE: DIET? PH? |
|
Definition
1. INCREASE VEGGIES (ALKALINE/ASH)-LIMIT ANIMAL PROTEIN, ENCOURAGE FLUIDS (500ML Q4H) -PENICILLLAMINE 2. ACID/ASH DIETS- LIMIT HIGH-PHOSPHATE FOOD (DAIRY PRODUCTS, RED/ORGAN MEETS, & WHOLE GRAINS). - WANT ACID PH |
|
|
Term
*___: PART OF NORM AGING PROCESS, AFFECTS 1/2 MEN OVER 50. AFRO AMERICANS DEVEL. AT YOUNGE AGE WHILE ASIAN AM. ARE LESS LIKEY TO HAVE IT. *NOTHING IS PROVEN TO REDUCE RISK!! |
|
Definition
BPH BENIGN PROATIC HYPERTROPHY |
|
|
Term
IN BPH, ADH IS SUPPRESSED AND WATER IS RETAINED. THIS CAUSES 8 URINARY SYMPTOMS>>>> |
|
Definition
1. DECREASED FORCE OF URINARY STREAM 2. NOCURIA 3.DIFFICULTY STARTING URINATION 4.URGENCY 5. FREQUANCY 6. INCOMPLETE BLADDER EMPYING 7.TERMINAL DIBBLING 8. URINARY RETENTION |
|
|
Term
During a assessment of BPH a ____ may be done to look for infection or hematuria *____ &____ : evidence of infection *___ &___ are checked to evaluate renal function. (Levels are ____ if renal disease is present) |
|
Definition
*URINALYSIS *WBC & RBC *BUN & SERUM CREATININE (ELEVATED) |
|
|
Term
ALL MEN OVER AGE 50 SHOULD HAVE THIS TEST DONE:___ -EXPLAIN THAT HE MAY FEEL THE URGE TO URINATE WHEN PALPATION OCCURS. -HELP PT TO BEND OVER THE EXAM TABLE OR INTO ____ POSTION. THE HEALTH CARE PROVIDER FEELS FOR ___ & ___. |
|
Definition
~DIGITAL RECTAL EXAM ~SIDE LYING FETAL POSITON. ~SIZE & CONSISTENCY. |
|
|
Term
1. BLOOD STUDY DONE TO DETECT PROSTATE CANCER? 2. ASSESSMENT FOR RECURRING INFECTIONS. A SERIS OF X-RAYS W/ CONTRAST DYE. PT. SHOULD BE NPO FOR 8HRS B4 TEST AND AFTERWARD DRINK ALOT OF FLUIDS TO FLUSH OUT CONTRAST DYE. |
|
Definition
1. PSA- PROSTATE-SPECIFIC ANTIGEN 2. IVP- IV PYELOGRAPHY |
|
|
Term
*OPERATIVE PROCEDURE THAT CAN BE USED FOR DIAGNOSIS OR TREATMENT OF BPH. IT CAN BE USED TO EXAMINE THE BLADDER & ID CAUSES OF OBSTRUCTION. CAN ALSO BE USED TO REMOVE TUMORS OR AN ENLARGED PROSTATE. GENERAL/ LOCAL W/ SEDATION MAY BE USED. PT. SOULD BE NPO AFTER MIDNIGHT & A BOWEL PREP (LAXATIVES/ENEMAS) IS DONE NIGHT BEFORE. |
|
Definition
|
|
Term
1. WHAT WOULD YOU INSTRUCT A PT. W/ BPH ABOUT OTC MEDS? 2. ALCOHOL INTAKE & CAFFINE? |
|
Definition
1. NOT TO TAKE OTC COLD & SINUMS MEDS W/ DECONGESTANTS AS THEY CAN MAKE CONDITION WORSE (URINARY RETENTION). 2. DECREASE INTAKE B/C IT MAKES YOU HAVE TO PEE. |
|
|
Term
BPH MEDICATION: 1.___: ANTI- ANDROGENS, BLOCK MAKING OF TESTOSTERONE. SHRINKS PROSTATE & IMPROVES URINARY FLOW. PREGNANT WOMEN SHOULD NOT HANDLE THESE PILLS!!! |
|
Definition
1. FINASTERIDE (PROSCRE, PROPECIA) |
|
|
Term
BPH MEDS: 1. ____, OR ____: ALPHA-ANDRENERGIC BLOCKER. RELAXES SMOOTH MUSCLE OF THE BLDDER & PROSTATE.(RISK OF HYPOTENSION). BEGIN DOSE AT NIGHT TO MINIMIZE SIED EFFECS |
|
Definition
~TERAZOSIN (HYTRIN) OR TAMSULOSIN (FLOMAX) |
|
|
Term
AN HERBAL REMEDIE- THERE IS NO ASSURANCE OF STRENGHT OR PURITY, BUT THERE IS SCIENTIFIC EVIDENCE THAT IT DECREASES SYMPTOMS OF BPH. |
|
Definition
~ SAW PALMETTO & PYGEUM AFRICANUM (HAS ANTI-INFLAMMATORY EFFECTS). |
|
|
Term
1. ___: A OUT PT. PROCEDURE, DOES NOT CURE BPH. A CATHETER IS INSERTED & HEATED TO BURN AWAY PROSTATE TISSUE. DOES NOT CURE! 2. __: THE GOLD STANDARD. REQUIRES ANETSHSIA. ACCOUNTS FOR 90% OF PROSTATE SURGERIES. PROSTATE IS RESECTIONED IN SMALL PIECES. (CLOSED PROCEDURE) |
|
Definition
1. MICROWAVE (THERMOTHEARAPY) 2. TURP- TRANSURETHRAL REMOVAL OF PROSTATE |
|
|
Term
1.___: PERFORMED WHEN PROSTATE IS LARGER TAN CAN BE REMOVED TNSURETHRLLY & PT.HAS ANY OTHER BLADDER PROBLEMS THAT CAN BE TREATED AT THE SAME TIME. 2. ___: WHEN PROSTATE IS TO LARE TO BE RESECTIONED BUT NO COEXISTING BLADDER PROBLESM IDENTIFIED. |
|
Definition
1. SUPRAPUBIC PROSTATECTOMY 2. RETROPUBIC PROSTATECTOMY |
|
|
Term
NURSIN CARE AFTER A TURP: 1. THE CATHETER IS PULLED IN THE PROSTETIC FOSSA TO HELP PREVENT____. 2. ____: RATE ADJUSTED SO FLUID RETURN IS COLORLESS OR LIGHT-PINK.(PREVENT CLOT) 3. PLENTY OF __ ON CATH REMOVAL, MON. URINE OUTPUT FOR BLEEDING & H&H VALUES FOR BLOOD LOSS. 4.__- BLADDER SPASM MEDS |
|
Definition
1.BLEEDING 2.CONTINUOUS BLADDER IRRIGATION (CBI) 3. FLUIDS 4. DICYCLOMINE HYDROCHLORIDE |
|
|
Term
CBI MANAGMENT: *CHECK DRAINAGE BAG FOR ___, ___, ___, & _____. *ADJUST CLAMPS FOR CONTINUOUS FLOW RATE OF ____ IRRIGATION. *BLEEDING: CHECK __ OF DRAINAGE. __ RATE OF SALINE FLOW, NOTIFY MD. *CLOTS: ASSESS __ FREQUENTLY (SUBTRACT AMOUNT OF IRRIGATION FLUID), CHECK FOR IRRIGANT ___, ASCERTAIN __, CHECK DRAINAGE BAG FOR __, TURN OFF IRRIGANT, __ DRAINAGE TUBE, PALPATE THE ___. IF THERE IS A CLOT IRRIGATE W/ ___ ML OF SALINE |
|
Definition
*AMOUNT, COLOR, CONSISTENCY, & POSITION *SALINE *COLOR OF DRAINAGE. INCREASE RATE * I&O *RETENTION *PAIN *POSITION *MILK *BLADDER *30-50ML |
|
|
Term
NAME 4 NURSING DX R/T POST TURP? |
|
Definition
1. KNOWLEDGE DEFICIT R/T INDWELLING URINARY CATHETER 2. FLUID VOL. IMBALANCE R/T BLEEDIN AT OPERATIVE SITE OR ABSORPITON OF IRRIGATION FLUID 3. RISK FOR INFECTION 4. RISK FOR CONSTIPATION |
|
|
Term
1. ____: REMOVAL OF THE WHOLE BLADDER & SURROUNDING TISSUE. THREE MAIN RASONS FOR THIS PROCEDURE? 2. 3 OPTIONS W/ CYSTECTOMY? |
|
Definition
1. RADICAL CYSTECTOMY *BLADDER CANCER, NEUROGENIC BLADDER DYSFUNCTION, CHRONIC INFLAMMATORY DISEASE OF THE BLADDER. 2. DIVERSION, BLADDER RECONSTUCTION, REPLACEMENT OF THE BLADDER W/ VARIOUS INTESTINAL SEGMENTS. |
|
|
Term
NURSING CARE FOR URINARY DIVERSION *MAJOR SURG- BOWEL MANIPULATED -ASSESS ___ & ___ *URINARY OUTPUT MUST BE MAINTAINED -___ & ___ -__ IS PLACED TO ALLOW FOR HEALING |
|
Definition
-BOWEL SOUNDS & FLUIDS/ELECTROLYTE BALANCE -ASESS & MEASURE -STENTS |
|
|
Term
* W/ __: contrast dye is injected thru IV. As kidneys filter & excrete the dye, x-rays are taken @ specific times over 1hr. Kidneys, ureters, & bladder are visualized to evaluate function & see obstructions. Not the best idea, it puts kidney at risk b/c of the ___. Pre-test; pt should be NPO __. Ask pt. about __ allergy. Post-test: assess for Dye reactions such as ...(4 S&S). Encourge pt. to ..... post exam. |
|
Definition
*IVP *DYE *MIDNIGHT THE EVENING B4 *IODINE ALLERGIES *EDEMA, ITCHING, WHEEZING & DYSPNEA *DRINK ALOT OF FLUIDS TO WASH DYE FROM SYSTEM |
|
|
Term
___: most common operation for invasive bladder Sug. for collecting urine. A small piece of the bowel (intesine) is cut & rejoined at the ends. Tubes (ilemum) is rejoined @ ends. Tubes (ureters) that carry urine from kidney is sewn into 1 end of the part of bowel removed. A small hole is then cut into the abdomen, the open end of the peice of bowel is put into the hole creating a stoma (usually to the R. of umbilicus). The pt. must then wear a pouch (urostomy bag).
|
|
Definition
|
|
Term
*A diet high in Ca+ alone is not believed to cause stones unless a ___ defect or ____ already exists. Even in pt. w/ a hx of nephrolithiasis, taking Ca+ supplements does not cause new stone formation. Urinary __, Urinary __, ___, & __ all contribute to calculus forming. Except for the use of ___ for treatment of calcium oxalate stones ___ causes vol. depletion & may promote stone formation |
|
Definition
1. Metabolic Defect 2. renal tubular defect 3. Urinary stasis 4. Urinary Retention 5. immobility 6. dehydration 7. Thiazides 8. Diuretics |
|
|
Term
*Pt. w/ urinary stones normally complain that the pain is wore when? *Pain is of ___ onset un- r/t precipitating event, unrealived by _______ or ______ medications. *B/C stone is blocking urine or damage to urter walls has happened, pain may be occupanied by what 3 urinary related symptoms? |
|
Definition
*MOVING *Sudden -- position changes -- non-narotic *Frequency -- Dysuria -- Hematuria |
|
|
Term
the ureters which carry urine from the kidneys, are diverted into the sigmoid colon. Problems: occasional bowel incontinence (in this case, a mixture of urine and feces similar to diarrhea) at night,procedure is an increased risk of kidney infections (nephritis) due to bacteria from faeces travelling back up the ureters (reflux) |
|
Definition
|
|
Term
*After surgical placement, a stoma should be assessed Q8h. What should it look like? *If it is pale or cyanotic, this indicates? |
|
Definition
*Rose to brick red in color w/ minimal swelling. *Altered blood supply. |
|
|
Term
*Broad spectrum antibiotic used to treat UTI *Prescibed to decrease ca+ levels thru the urine? These may cause ____, supplements to prevent this may be needed. *__ makes it difficult for body to make uric acid. This decreases the amount of uric acid in the urine, reducing the chance that a uric acid stone will form. |
|
Definition
*Graramycin (Keflex) *Thiazide Diuretics: Hydrochlorothiazide (Hydrodiuril) *Hypokalcemia *Allopurinol (Zyloprim) - B6- Antigout med |
|
|
Term
*__: surgeon makes a small incision in your back to remove kidney stones. He or she then puts a hollow tube into your kidney and a probe through the tube. In nephrolithotomy, the surgeon removes the stone through the tube. General anesthesia is used. Used in treatment of larger stones. Main Complication? Pt. education? |
|
Definition
Percutaneous nephrolithotamy Bleeding Preventing further stones |
|
|
Term
*Anti spasmatic drugs used in cotrol and pain relief of pain w/ stones *Used w/ struvite stones....prevents bacteria from splitting urea-- UTI *Drugs used for S&S of BPH- relaxes muscles and enables voiding. S.E: hypotension- begin dose at night to minimize side effects. |
|
Definition
*Oxybutynin (Ditropan) & propantheline (Pro-Banthine) *Acetohydroxamic Acid (Lithostat) or Hydroxurea (Hydrea) *Antiadrenergics- Flomax (tamsulosin) & Hytrin |
|
|