MSP II Renal Quiz part 2

What is the Pathophysiology and Etiology of Urinary Retention?

acute retention
chronic retention
residual urine
Involuntary accumulation of urine in the bladder from loss of muscle tone, appears 6-8 hrs after surgery

What are the S/S of Urinary Retention?

inability to void
restlessness
distended bladder (on percussion the bladder sounds like a drum)
HTN
lower abdominal pain
diaphoresis

What are the diagnostic test used for Urinary Retention?

results of urinalysis
catheterization
ultrasound, bladder scan(BVI)

What are the medical and surgical interventions for urinary retention

Acute retention: immediate catheterization
Chronic retention: permanent drainage, surgery for men, Permanent indwelling catheter for women

What Nursing management considerations are important for a patient with urinary retention?

assess for distended bladder
monitor for voiding
HTN
encourage to ambulate as order
encourage fluids intake as order
assist for voiding
privacy
running water
straight cath after all noninvasive techniques have been attempted.

Is the following statement true or false?
The customary solution for urinary retention is developing a permanent drainage system.

True
The customary solution for urinary retention is developing a permanent drainage system. In men, surgery is indicated; in women, a permanent indwelling catheter is utilized.

What is the pathophysiology and etiology of Cystitis and UTI

inflammation of the urinary bladder;
bladder irritation; causes; Ecoli, pseudomonas, entrobacter,...women more than men
catheters, bladder stasis, calculus

What are the S/S of Cystitis and UTI

burning on urination
incomplete emptying
cloudy dark foul smelling urine
hematuria
bladder spasms
malaise
chills
fever
N/V

What diagnostic test are used for Cystitis and UTI

microscopic examination
C & S
IVP
cystoscopy for repeated episodes

What is the medical management of Cystitis and UTI

antimicrobial therapy
cranberry juice or vitamin C

Nursing Management for Cystitis and UTI

urine sample
fluid intake up to 3 L/d
maintain PH of urine acidic
acid ash diet
strict aseptic technique for catheterization
perineal care
AB treatment such as sulfonamide, antispasmodics and analgesics
less caffeine
avoid alcohol
sitz baths & heat to the

What is the pathophysiology and etiology for Interstitial Cystitis?

chronic inflammation of bladder mucosa

What are the assessment findings of interstitial cystitis?

painful urination and intercourse

What diagnostic test are used for Interstitial cystitis?

cystoscopy
urinalysis
biopsy
cystourethrogram

What are the medical and surgical management for interstitial cystitis?

bladder instillation of dimethyl sulfoxide (DMSO) or silver nitrate
laser therapy

Nursing Management for interstitial cystitis?

(Same as Cystitis)
urine sample
fluid intake up to 3 L/d
maintain PH of urine acidic
acid ash diet
strict aseptic technique for catheterization
perineal care
AB treatment such as sulfonamide, antispasmodics and analgesics
less caffeine
avoid alcohol
sitz

What is the pathophysiology/etiology for Urethritis

Microorganisms (including gonococci),in men
Chlamydia trachomatis infection, in men
In women: feminine hygiene sprays
perfumed toilet paper and sanitary napkins
spermicidal jellies
UTIs
changes in vaginal mucosal lining

S/S of Urethritis

Dysuria
nocturia
urgency
discharge from genital
painful urination

Medical Management for Urethritis?

antibiotic therapy
liberal fluid intake
analgesics
warm sitz baths

What nursing management is used for a patient with Urethritis

fluid intake
meds
sexual precautions and self hygiene

Is the following statement true or false?
To treat cystitis (bladder infection), ingestion of cranberry juice or vitamin C is recommended.

True
Rationale: To treat cystitis (bladder infection), ingestion of cranberry juice or vitamin C (ascorbic acid) is recommended. The acid creates an environment within the bladder that is hostile to the development of pathogenic microbial growth.

What is BPH (bladder prostatic hypertrophy)

A slow enlargement of the prostate gland with hypertrophy and hyperplasia of normal tissue,
The enlargement causes narrowing of the urethra and results in partial or complete obstruction,
The cause is unknown and the disorder usually occurs in men older t

What are the assessment findings for BPH?

urgency
frequency and hesitancy
changes in size and force of urinary stream
retention
dribbling
nocturia
hematuria, urinary stasis
UTIsPSA testing ( measuring a protein in the blood called prostate specific antigen)
in clients with prostate cancer PSA lev

What is a normal PSA reading in a 40 year old male?

2.5

What is a normal PSA reading in a 60 year old male?

4.5

What is a normal PSA reading in a 70 year old male?

6.5

What are the medical surgical implementations for BPH?

encourage fluids up to 2-3 L/day
prepare for bladder drainage via urinary cath.for distention
avoid administering medications that cause urinary retention such as anticholinergics, antihistamines and decongestants
admin Proscar per order to shrink the pro

What are the assessment findings for a patient with bladder stones?

frequent urination, especially during the night.
lower abdominal pain
men and women may experience a burning sensation or pain in the urethra when urinating
urine that contains blood or appears cloudy
inability to control urine

What diagnostic test are used to determine bladder stones

cystoscopy
KUB study
IVP,
ultrasound
24-hour urine collection

What is the medical/surgical management for a patient with bladder stones?

litholopaxy
surgical incision
low-purine diet
fluid intake

What are the assessment findings found in a patient with Bladder Malignancies?

blood in urine little rusty to bright red in color
frequency
dysuria
low back pain

What Diagnostic Test are used to determine Bladder malignancies?

microscopic biopsy
cystoscopic examination
retrograde pyelogram
CT, radiography
ultrasonography

What is the medical/surgical management for a patient with Bladder malignancies?

coagulation
antineoplastic drugs
photodynamic
radiation therapy; cystectomy
TUR

What nursing considerations are needed for a patient with Bladder malignancies?

post op care and radiation therapy and chemo.

A patient is suspected to have bladder stones. How many hours should a urine sample be collected for as part of the diagnostic workup?
A) 6
B) 12
C) 18
D) 24

D) 24
Rationale: A 24-hour urine collection is part of the diagnostic workup for suspected bladder stones.