NUR 114 FINAL EXAM STUDY GUIDE RECENTLY UPDATED

NUR 114 FINAL EXAM STUDY GUIDE RECENTLY
UPDATED




- age
- gender
- diseases that cause urinary retention or incomplete bladder emptying (BPH,
renal calculi, neurogenic bladder)
- diabetes mellitus
- bubble baths

- wiping back to front
catheterization
- sexual activity - ANSWER UTI Risk Factors


- fluid/food intake (alcohol decreases ADH, sodium retains water)
- muscle tone (ability to empty/store urine)
- psychosocial factors (anxiety, stress, time pressures)
- pathological conditions/diseases (renal failure, CHF, HTN, BPH, kidney
stones)
surgical and diagnostic procedures - ANSWER Urinary Retention Risk
Factors



anticholinergics and antipasmodics
- antidepressants and antypsychotics
antihistamines
- antihypertensives
antiparkinsonism
- beta blockers
- opioids - ANSWER Medication Risk Factors for Urinary Retention


- monitor VS frequently
- monitor urine output (blood should diminish 48-72 hours)
- maintain patency and placement of catheter

- irrigate if ordered - ANSWER Lithotripsy post op teaching

- report urine leakage from incision for more than 4 days

,- symptoms of infection
- pain
- bright hematuria - ANSWER Patient teaching on catheter


the next step is surgery - ANSWER What is the next step if lithotripsy fails?


- empty q3-q4 hours
- avoid strapping on leg too tightly and place a towel in between
- hand hygiene pre/post care
- place the bag below the pt for gravity to work and prevent back flow (NOT
ON THE FLOOR)
- report changes in color, odor, consistency, or significant decrease in amount of
urine

- different daytime/night time bags - ANSWER Indwelling catheter care for
kidney stones

- family hx / genetic predisposition
- dehydration (increased urine concentration)
- immobility (loss of calcium from bones)
- excess calcium, oxelate, or proteins
- gout
- hyperparathyroidism
- urinary stasis
- repeated infection - ANSWER Risk Factors for Renal Calculi


- obstruction
- infection
- hydronephrosis - ANSWER Complications of Renal Calculi


- look, listen, palpate, percuss
- don't bluntly percuss older adults
- abnormal findings: asymmetry, pain, hematuria, diaphoresis, fever, poor skin
turgor, oligura, anuria, - ANSWER Physical assessment for renal calculi


limit calcium and oxalate intake, drink fluids that acidify urine - ANSWER
dietary considerations for calcium stones

, low purine diet, increase fluids - ANSWER dietary considerations for uric acid
stones



sodium restriction, increase fluids - ANSWER dietary considerations for
cystine stones



nonmalignant enlargement of the prostate gland commonly seen in the aging
male ANSWER BPH
-




- pregnant women should not handle crush 5-aplha reductase
(cause restriction of urine flow)
avoid decongestants
-avoid drugs with anticholinergic side effecs (antihistamines, TCAs,
phenothiazine)
- testosterone and other anabolic steroids can increase enlargement - ANSWER
Medication interactions for BPH


- Doxazosin (cardura)
- Prazosin (minipress)
- tamsulosin (flomax)
- terazosin (hytrin) ANSWER Alpha-adnergic blocker
-




orthostatic hypotension, headache, dizziness - ANSWER SE of doxazosin
(cardura)


first dose phenomenon (severe hypotension and syncope), tachycardia -




ANSWER SE of prazosin (minipress)


dutasteride (avodart)
- finasteride (proscar) - ANSWER 5-alpha reductase inhibitors


sexual dysfunction, decreased libido, decreased ejaculate volume - ANSWER
SE of dutasteride (avodart)

no serious adverse effects - ANSWER SE of finasteride (proscar)

- avoid alcohol and caffeine

- drink small amounts of fluid spread throughout the day