renal and urologic problems part 2

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bpayton
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250257
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renal and urologic problems part 2
Updated:
2013-12-03 01:38:42
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theory
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theory test
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  1. What is the definition of benign prostatic hyperplasia?
    enlargement of prostate gland resulting from increase in number of epithelia cells and stromal tissue
  2. Which type of individual is most likely to develop BPH?
    males between age of 50-80
  3. True/False. Having Benign Prostate Hyperplasia does not predispose a person to develop prostate cancer.
    True
  4. What are possible causes to developing BPH?
    • excessive accumulation of dihydroxytesterone
    • stimulation of estrogen
    • local growth hormone action
  5. What are risk factors of a patient developing BPH?
    • family history
    • environment
    • obesity
    • increased waist circumference
    • diet
    • polyunsaturated fatty acids
  6. Which types of symptoms are due to urinary retention?
    obstructive symptoms
  7. which types of symptoms are associated with inflammation or infection?
    Irritative symptoms
  8. Decrease in caliber of force of urinary system, difficulty in initiating urination, intermittency, dribbling at end of voiding are all symptoms of what category?
    obstructive symptoms
  9. Urinary frequency and urgency, dysuria, bladder pain, nocturia, and incontinence are all symptoms of what type of category?
    Irritative symptoms
  10. What is the main problem with complications from BPH?
    urinary obstruction
  11. What are some complications with BPH?
    • Acute urinary retention
    • UTI
    • Sepsis
    • incomplete bladder emptying
    • calculi in bladder
    • hydronephrosis cause renal failure
    • Pyelonephritis
    • bladder damage
  12. What are ways to diagnose BPH?
    • history and PE
    • DRE
    • UA
    • PSA level
    • CREAT
    • TRUS scan
    • Uroflometry
    • Cystourethroscopy
  13. What are the major goals of the nurse in treating a patient with BPH?
    • 1. restore bladder drainage
    • 2. relieve symptoms
    • 3. prevent/treat complications
    • 4. watchful waiting
    • 5. diet change
    • 6. timed voiding schedule
  14. Which medication is used to decrease the size of the prostate gland. Takes 3-6 months for improvement.
    • 5-a Reductase inhibitors
    • Finasteride (Proscar)
    • Dutasteride (Avodart)
  15. Which medication is used to promote smooth muscle relaxation in prostate; facilitates urinary flow and takes 2-3 weeks to improve.
    • a-Adrenergic receptor blockers
    • Tamsulosin (Flomax)
    • doxazosin (Cardura)
  16. What are side effects to 5 a-Reductase inhibitors medications? Proscar, Avodart
    • decreased libido
    • decreased volume of ejaculation
    • erectile dysfunctions
  17. What are side effects of a-Adrenergic receptor blockers? (Flomax, Cardura)
    • orthostatic hypotension and dizziness
    • retrograde ejaculation
    • nasal congestion
  18. What types of situations will cause the need for invasive therapy for BPH?
    • decreased in urine flow that cause discomfort
    • persistent residual urine
    • acute urinary retention
    • intermittent catheterization can reduce symptoms and bypass obstruction
  19. Is it okay for a patient with BPH to have a long-term catheterization?
    no it is contraindicated because it increases the risk of infections
  20. What types of things are based on what type of treatment will be done for a patient with BPH?
    • size and location of prostate
    • age
    • surgical risk
  21. What treatment has the best outcome with low risk involved for BPH?
    Transurethral resection (TURP)
  22. Which treatment involves removal of obstructing prostate tissue using resectoscope inserted through urethra. Performed under general or spinal anesthesia and requires hospital stay?
    Transurethral resection (TURP)
  23. After a patient comes on the floor after a TURP procedure what is the importance of the nurse to do?
    Bladder irrigate for first 24 hours to prevent mucus and blood clots
  24. What are complications that may arise after having a TURP?
    • bleeding
    • clot retention
    • dilutional hyponatremia
    • retrograde ejaculation
  25. Which type of treatment delivers microwaves directly to prostate through a transurethral probe and the heat cause tissue death and relieves obstruction?
    Transurethral microwave therapy (TUMT)
  26. Which type of treatment for BPH uses low wave frequency that increase temperature of prostate tissue for localized necrosis and only the tissue in contact with needle is affected?
    Transurethral needle ablation (TUNA)
  27. Which type of cancer is the most common cancer in men and second leading cause of cancer death in men?
    Prostate cancer
  28. Where are majority of the tumors in prostate cancer located?
    in outer aspect of the prostate gland and is usually slow growing
  29. What are the three ways prostate cancer can spread throughout the body?
    • 1. direct extension
    • 2. through lymph system
    • 3. through blood stream
  30. What are non-modifiable risk factors for developing prostate cancer?
    • over 65 years old
    • males
    • African americans
    • first degree relative
  31. What are some modifiable risk factors for developing prostate cancer?
    • high fat diet
    • exposure to certain chemicals
  32. True/False. Having BPH is a major risk factor to developing prostate cancer.
    False. BPH is NOT a risk factor
  33. What type of symptoms will a patient develop if prostate cancer has metastasize?
    pain in lumbosacral area that radiates to hips or legs and urinary symptoms
  34. What is the major priority of the nurse when the diagnose of prostate cancer has metastasize?
    Pain managment
  35. What are the three primary ways of screening for prostate cancer?
    • 1. PSA (prostate specific antigen) blood levels
    • 2. DRE (digital rectal exam)
    • 3. PAP (prostatic acid phosphatase) increased levels
  36. What is the purpose of the PSA (prostate specific antigen) test?
    • Monitor success of treatment
    • elevated levels indicate prostate malfunction
  37. When doing an digital rectal exam and the doctor feels a hard, nodular, and asymmetric phosphate what does this suggest?
    diagnose of prostate cancer
  38. What is the only way to confirm diagnosis of prostate cancer?
    biopsy of prostate
  39. When a patient is diagnosed with prostate cancer and has a life expectancy of less than 10 years, has comorbid disease, and has a low-grade, low stage tumor what is the best treatment for this patient?
    watchful waiting
  40. If a patient with prostate cancer that has not metastasize and is < 70 years of age what treatment is best for this patient?
    Radical prostatectomy
  41. Which treatment for prostate cancer is considered the most effective for long-term survival?
    radical prostatectomy
  42. In doing a radical prostatectomy what should the nurse educate the patient on what is going to happen during and after the procedure?
    • entire gland, seminal vesicles, and part of bladder neck is removed
    • retroperineal lymph node dissection is done
    • after will have a catheter for 1-2 weeks
  43. what are some complications after having a radical prostatectomy?
    • erectile dysfunction
    • incontinence
    • hemorrhage
    • urinary retention
    • infection
  44. Which type of treatment to treat prostate cancer involves sparing nerves that are responsible for erection and done only for cancer confined to the prostate?
    nerve-sparing surgical procedure
  45. Which type of treatment to treat prostate cancer involves a surgical technique that destroys cancer cells by freezing the tissue. It is the initial and second line treatment after radiation fails?
    Cryosurgery
  46. What are some complications of cryosurgery treatment?
    • damage to urethra
    • urethrorectal fistula
    • urethrocutaneous fistula
    • tissue sloughing
    • erectile dysfunction
    • urinary incontinence
    • prostatitis
    • hemorrhage
  47. What is the purpose of using external beam radiation to treat prostate cancer?
    most widely method of radiation used to treat cancer confined to prostate and/or surrounding tissue
  48. Which type of treatment is best used for stage A or B prostate cancer?
    Brachytherapy
  49. What is the purpose of androgen receptor blockers as a drug therapy for treatment of prostate cancer?
    • to compete with circulating androgens at receptor sites
    • used in combination with luteinizing hormone-releasing hormone agonists
  50. What are side effect to androgen receptor blockers?
    • loss of libido
    • erectile dysfunction
    • hot flashes
    • breast pain
    • gynecomastia
  51. What are some side effects to orchiectomy?
    • loss of libido
    • erectile dysfunction
    • hot flashes
    • irritability
    • weight gain
    • loss of muscle mass
    • osteoporosis
  52. what is the purpose of having a orchiectomy?
    • surgically removal of testes for advanced stages of prostate cancer
    • may be done alone or with prostatectomy
  53. When is chemotherapy done to treat prostate cancer?
    in patients with hormone-resistant prostate cancer in late stages
  54. After all treatments for prostate cancer has responded poorly what is the main goal for the patient?
    Palliation
  55. What is the purpose of estrogen used in hormonal therapy?
    a form of androgen deprivation therapy
  56. What is the primary therapeutic approach for treatment of prostate cancer?
    Androgen deprivation
  57. What is the purpose of androgen deprivation therapy? When is it best used?
    • reduce levels of androgens to reduce tumor growth
    • Used before surgery or radiation to reduce tumor size
  58. After a few years tumors become resistant to hormone therapy and this is known as?
    Hormonal refractory
  59. What is the first sign that hormonal therapy is no longer effective?
    elevated PSA levels
  60. What are the three types of hormonal therapy?
    • 1. Luteinizing hormone
    • 2. Androgen receptor blockers
    • 3. Estrogen
  61. What are side effects to Luteinizing hormone drug therapy?
    • loss of libido
    • erectile dysfunction
    • hot flashes
    • gynecomastia
  62. Which type of hormonal therapy produces a chemical castration similar to orchiectomy?
    luteinizing hormone

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