GU HA Urinary
Card Set Information
GU HA Urinary
Health Assessment FNP Seidel
Urinary Module 18, Ch 17 (Seidel), Ch 18, 34, 35 (Daines)
Intense flank pain extending to groin and genitals, could radiate to left shoulder, may be episodic; fever, dysuria, hematuria.
Severe cramping pain, CVA tenderness and/or abdominal tenderness, fever, n/v, positive Kehr sign.
What is a positive Kehr sign?
abdominal pain radiating to left shoulder
Signs of fluid overload in ARF.
increased JVD &
Signs of fluid deficit in ARF.
orthostatic pulse & BP changes
dry mucous membranes
In ______ ARF, with complete obstruction, may have abdominal distention and suprapubic tenderness to palpation.
Fever, dysuria, flank pain; sometimes rigors, polyuria, urinary frequency, urgency, hematuria.
Generally ill-appearing with significant pain or discomfort; fever and CVA tenderness; pyuria and bacteriuria.
What distinguishes Pyelonephritis from uncomplicated UTIs?
fever & CVA tenderness
Symptoms of renal abscess
Same as pyelonephritis but more than 72 hours
(generally ill-appearing, sig pain/discomfort, flank pain, fever, CVA tenderness, rigors, polyuria)
An abrupt and strong desire to void with the inability to delay urination.
What causes urge incontinence?
hyperactivity or hypersensitivity of detrusor muscle
(h/o CNS DO)
What causes detrusor muscle overactivity?
pathological brain DO that interfere w/ central inhibitory centers (ex: stroke, MS, Parkinson)
What is mixed incontinence?
Features of both stress and urge incontinence
Type of incontinence caused by an underactive or contractile detrusor muscle.
Type of incontinence caused by sphincter-detrusor dyssynergia (loss of synergistic urinary sphincter relaxation that normally occurs with bladder detrusor muscle contraction)
Type of incontinence caused from bladder outlet or urethral obstruction.
What is primary nonorganic enuresis?
bed wetting that has continued since infancy w/o an established pattern of dryness
Pain with sex and vaginal dryness can be a sign of what?
What is functional incontinence? Examples?
Incontinence from reversible factors
-UTI, vaginitis, fecal impaction
-DI, DM, change in mental fxn or status
How can fecal impaction cause incontinence?
through mechanical obstruction of the urethra
What is the primary symptom of detrusor
Voiding small-caliber or intermittent stream or difficulty in starting the stream indicates?
in males, secondary to enlarged prostate
of urine in females may indicate what?
that terminates in the vagina
How does polyuria result in people with DM?
from glucose-induced osmotic diuresis
renal tubules lose ability to concentrate urine = large volumes of
very dilute urine
DO affect bladder innervationand may cause _______.
Head injury or brain tumor can cause _____ or _______.
What causes a neurogenic bladder and obstruction?
Interference with nerve supply to bladder
Functional neurogenic bladder & obstruction results from what?
imbalance b/w detrusor muscle contraction and urethral sphincter relaxation
Children with _________ may have a concentrating defect and excrete
, causing them to
wet the bed
sicke cell anemia
In children, secondary enuresis can be caused by stress factors during what yrs?
Fever in infants without any other signs is likely caused by ______.
When _________ is the result of inadequate amt of normally functioning renal tissue, the clinical presentation may be enuresis.
A lax sphincter suggests _______.
spinal cord involvement
Residual urine volume
greater than 100mL
USG greater than ______ rules out DI as cause of incontinence.
_________ produces incontinence as a result of local irritation.
__________ indicates a loss of estrogen and a concomitant loss of the vesicourethral angle, which predisposes women to ______ incontinence.
: v/d, decreased fluid intake, diuretics = Dehydration & decreased kidney perfusion; SOB & peripheral edema w/ CHF = intravascular volume depletion.
In ________ ARF, pts may have had symptoms from UTI.
Pts with ________ ARF may present w/ symptoms r/t underlying cause of RF.
Where do urinary stones occur?
anywhere in the urinary tract
Nausea and vomiting often accompany _____, _________, or ________.
In newborns and infants, what symptoms may indicate UTI?
V/D, feeding difficulties
irritability, anorexia, wt loss
Acute pain in back or abdomen suggests _______ and _______.
UT stones may produce localized back pain or excruciating pain that often radiates to the ______.
Dilation of the renal pelvis and calyces d/t an obstruction of urine flow anywhere from the urethral meatus to the kidneys.
Cause of hydronephrosis.
obstruction or kidney stone
______ is an infection of the kidney AND renal pelvis.
With Pyelonephritis, the infection started in the _______ and traveled to the _______.
Recurrent cystiis is how many infections per year?
What is interstitial cystitis?
Chronic pelvic pain >6 mos
Fishy odor discharge and clue cells.
__________ are a common cause of dysuria, esp in college-age women.
_________ suggests inflammation of the bladder neck or urethra, which is usually caused by bacterial infection or irritation.
________ is the cardinal symptom uf uncomplicated LOWER UTI (acute bacterial cystitis).
Pt who appears ill or who is pacing in pain is likely to have what?
UPPER urinary tract problem such as
Pts with _______ urinary tract problems usually do not present w/ signs of systemic involvement, are afebrile, and generally appear well.
LOWER urinary tract problems
Neonates with ______ may present with jaundice.
Pain that is reproducible is indicative of renal capsule distention and characterizes _________ or _________.
acute pyelonephritis OR
acute ureteral obstruction
Pt appears well, no fever; dysuria & vaginal discharge.
(new sex partner, freq sex, mult partners)