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