GU HA Urinary

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GU HA Urinary
2015-10-26 12:59:42
Health Assessment FNP Seidel
Urinary Module 18, Ch 17 (Seidel), Ch 18, 34, 35 (Daines)
Show Answers:

  1. Intense flank pain extending to groin and genitals, could radiate to left shoulder, may be episodic; fever, dysuria, hematuria.
    Renal calculi
  2. Severe cramping pain, CVA tenderness and/or abdominal tenderness, fever, n/v, positive Kehr sign.
    renal calculi
  3. What is a positive Kehr sign?
    abdominal pain radiating to left shoulder
  4. Signs of fluid overload in ARF.
    • increased JVD & 
    • peripheral edema
  5. Signs of fluid deficit in ARF.
    • hypotension
    • orthostatic pulse & BP changes
    • dry mucous membranes
  6. In ______ ARF, with complete obstruction, may have abdominal distention and suprapubic tenderness to palpation.
  7. Fever, dysuria, flank pain; sometimes rigors, polyuria, urinary frequency, urgency, hematuria.
  8. Generally ill-appearing with significant pain or discomfort; fever and CVA tenderness; pyuria and bacteriuria.
  9. What distinguishes Pyelonephritis from uncomplicated UTIs?
    fever & CVA tenderness
  10. 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)
  11. An abrupt and strong desire to void with the inability to delay urination.
    Urge incontinence
  12. What causes urge incontinence?
    • hyperactivity or hypersensitivity of detrusor muscle
    • (h/o CNS DO)
  13. What causes detrusor muscle overactivity?
    pathological brain DO that interfere w/ central inhibitory centers (ex: stroke, MS, Parkinson)
  14. What is mixed incontinence?
    Features of both stress and urge incontinence
  15. Type of incontinence caused by an underactive or contractile detrusor muscle.
    Overflow incontinence
  16. Type of incontinence caused by sphincter-detrusor dyssynergia (loss of synergistic urinary sphincter relaxation that normally occurs with bladder detrusor muscle contraction)
    Overflow incontinence
  17. Type of incontinence caused from bladder outlet or urethral obstruction.
    Overflow incontinence
  18. What is primary nonorganic enuresis?
    bed wetting that has continued since infancy w/o an established pattern of dryness
  19. Pain with sex and vaginal dryness can be a sign of what?
    atrophic vaginitis
  20. What is functional incontinence? Examples?
    • Incontinence from reversible factors
    • -meds
    • -UTI, vaginitis, fecal impaction
    • -DI, DM, change in mental fxn or status
  21. How can fecal impaction cause incontinence?
    through mechanical obstruction of the urethra
  22. What is the primary symptom of detrusor overactivity?
    Urgency incontinence
  23. Voiding small-caliber or intermittent stream or difficulty in starting the stream indicates?
    • obstructive uropathy;
    • in males, secondary to enlarged prostate
    • (overflow incontinence)
  24. Chronic leakage of urine in females may indicate what?
    ectopic ureter that terminates in the vagina
  25. 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
  26. Lumbosacral DO affect bladder innervationand may cause _______.
  27. Head injury or brain tumor can cause _____ or _______.
    • polyuria
    • polydipsia
  28. What causes a neurogenic bladder and obstruction?
    Interference with nerve supply to bladder
  29. Functional neurogenic bladder & obstruction results from what?
    imbalance b/w detrusor muscle contraction and urethral sphincter relaxation
  30. Children with _________ may have a concentrating defect and excrete low USG in large volumes, causing them to wet the bed.
    sicke cell anemia
  31. In children, secondary enuresis can be caused by stress factors during what yrs?
    2-4 yoa
  32. Fever in infants without any other signs is likely caused by ______.
  33. When _________ is the result of inadequate amt of normally functioning renal tissue, the clinical presentation may be enuresis.
    chronic RF
  34. A lax sphincter suggests _______.
    spinal cord involvement
  35. Residual urine volume greater than 100mL suggests what?
    • bladder weakness (stress incontinence), OR
    • outlet obstruction (overflow incontinence)
  36. USG greater than ______ rules out DI as cause of incontinence.
  37. _________ produces incontinence as a result of local irritation.
  38. __________ indicates a loss of estrogen and a concomitant loss of the vesicourethral angle, which predisposes women to ______ incontinence.
    • Atrophic vaginitis
    • stress
  39. In ______ ARF: v/d, decreased fluid intake, diuretics = Dehydration & decreased kidney perfusion; SOB & peripheral edema w/ CHF = intravascular volume depletion.
  40. In ________ ARF, pts may have had symptoms from UTI.
  41. Pts with ________ ARF may present w/ symptoms r/t underlying cause of RF.
  42. Where do urinary stones occur?
    anywhere in the urinary tract
  43. Nausea and vomiting often accompany _____, _________, or ________.
    • pyelonephritis
    • lithiasis
  44. In newborns and infants, what symptoms may indicate UTI?
    • V/D, feeding difficulties
    • irritability, anorexia, wt loss
  45. Acute pain in back or abdomen suggests _______ and _______.
    • upper UTI
    • pyelonephritis
  46. UT stones may produce localized back pain or excruciating pain that often radiates to the ______.
  47. Dilation of the renal pelvis and calyces d/t an obstruction of urine flow anywhere from the urethral meatus to the kidneys.
  48. Cause of hydronephrosis.
    obstruction or kidney stone
  49. ______ is an infection of the kidney AND renal pelvis.
  50. With Pyelonephritis, the infection started in the _______ and traveled to the _______.
    • bladder
    • kidney
  51. Recurrent cystiis is how many infections per year?
  52. What is interstitial cystitis?
    Chronic pelvic pain >6 mos
  53. Fishy odor discharge and clue cells.
    bacterial vaginosis
  54. __________ are a common cause of dysuria, esp in college-age women.
    vaginal infections
  55. _________ suggests inflammation of the bladder neck or urethra, which is usually caused by bacterial infection or irritation.
  56. ________ is the cardinal symptom uf uncomplicated LOWER UTI (acute bacterial cystitis).
  57. Pt who appears ill or who is pacing in pain is likely to have what?
    • UPPER urinary tract problem such as
    • pyelonephritis or
    • urolithiasis
  58. Pts with _______ urinary tract problems usually do not present w/ signs of systemic involvement, are afebrile, and generally appear well.
    LOWER urinary tract problems
  59. Neonates with ______ may present with jaundice.
  60. Pain that is reproducible is indicative of renal capsule distention and characterizes _________ or _________.
    • acute pyelonephritis OR
    • acute ureteral obstruction
  61. Pt appears well, no fever; dysuria & vaginal discharge.
    • urethritis 
    • (new sex partner, freq sex, mult partners)