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20 Cards in this Set
- Front
- Back
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causes of obstructive uropathies
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anomalies
growths/tumors bladder neck contracture BPH urethral stricture urethral meatus stenosis prolapsed uterus neurogenic bladder & sphincter dyssynergia |
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problems caused by obstructive uropathies
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mucosal scarring
outlet resistance detrusor muscle fiber hypertrophy bladder outlet obstruction |
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types of obstructive uropathies
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calculi/nephrolithiasis - kidney stones
urinary tract tumors |
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risk factors for calculi
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metabolic (incr urine levels of ca, oxaluricacid, uric acid, citric acid)
warm climate diet-protein, tea or fruit juices, calcium, low fluid intake history of gout sedentary lifestyle |
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types of stones
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calcium oxalate - 35-40%
calcium phosphate 8-10% struvite 10-15% uric acid 5-8% cystine 1-2% |
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s/s of calculi
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abdominal pain
severe flank pain hematuria renal colic n/v |
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diagnosis for calculi
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UA, UA C&S
IVP retrograde pyelogram ultrasound cystoscopy BUN creatinine levels |
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nsg mgmt for calculi
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past history
prolonged cath check for: guarding, fever, abdominal distention, absence of bowel sounds, oliguria, hematuria, flank pain |
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prevention of calculi
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fluid intake 3L to output 2L/day
alleviate metabolic risk factors cranberry juice of vitamin C |
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dietary considerations for calculi
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purine, calcium, oxalate (spinach, rhubarb, asparagus, cabbage, tea)
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meds for calculi
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pH agents
thiazide diuretics for calcium oxalate stones allopurinol for uric acid stones alpha penicillamine for cystine crystals antibiotics |
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methods for removal of calculi
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endourologic procedures-scope
percutaneous Nephrolithotomy - scope inserted ti kidney pelvis via skin, stone crushed & removed via scope, nephrostomy tube in place to ensure unobstructed ureter (invasive) lithotripsy-bathtub crush stones via ultrasound (non-invasive) under general or spinal anesthesia |
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why are stones removed
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too large to pass
assoc w/bacteriuria or infection causing impaired renal function causing pain, nausea, ileus |
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nsg mgmt for calculi
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pain relief
relieve obstruction (foley check) prevent further stones teach fluid 3L/day ambulate to move stone |
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general symptoms of kidney cancer
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weight loss, weakness, anemia
adv disease-gross hematuria, flank pain, palpable mass metastases to lungs, liver, long bones, vena cava |
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tx for kidney cancer
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no early signs
radial nephrectomy radiation for palliative care if inoperable or with metastasis chemo incl 5-FU if metastasis |
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bladder cancer info
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more men 60-70 yr old
risk factors-smoking, expsoure to dyes in rubber & cable industry chronic, recurrent stones LT indwelling caths women post radiation for cervical ca |
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bladder cancer s/s
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gross painless hematuria, dysuria, frequency, urgency, check cytology for neoplastic cells
cysto/bx are diagnostic |
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bladder cancer tx
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surgical-transurethral resection w/fulguration (cauderize) for superficial lesions to control bleeding
laser photocoagulation for superficial tumors open loop resection with fulguration |
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post op care bladder ca
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fluids, avoid alcohol, analgesics, sitzs baths bid, monitor urine color
radiation for inoperable or refused surgery systemic chemo (methotrexate, platinol, vinblastin) intravesical therapy-local instillation of chemo or immune stimulating drugs into bladder via cath @ wkly intervals |
