genital urinary system l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Genital-urinary System PowerPoint Presentation
Download Presentation
Genital-urinary System

Loading in 2 Seconds...

play fullscreen
1 / 78

Genital-urinary System - PowerPoint PPT Presentation


  • 585 Views
  • Uploaded on

Genital-urinary System. Renal System Part 2. Behavioral Objectives. Identify and describe the etiology, pathophysiology, clinical manifestations, nursing management and patient education for the following: Urinary retention Urinary incontinence Urinary suppression Residual urine

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

Genital-urinary System


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
    Presentation Transcript
    1. Genital-urinary System Renal System Part 2

    2. Behavioral Objectives • Identify and describe the etiology, pathophysiology, clinical manifestations, nursing management and patient education for the following: • Urinary retention • Urinary incontinence • Urinary suppression • Residual urine • Discuss common pharmacological interventions appropriate in treatment of patient with GU disorders • Describe general nursing consideration and intervention in pre and post-operative care of patients undergoing urological surgery • Describe etiology, pathophysiology, clinical manifestations, nursing management and patient education for the following GU disorders: • Pyelonephritis • Cystitis • Urinary tract infections (UTI) • Urethritis • Nephritic syndrome • Hydronephrosis • Renal calculi • Renal neoplasm’s

    3. Dysfunctional Voiding Patterns • Urinal Incontinence • Pathophysiology • Unplanned loss of urine that is sufficient to be considered a problem • Continence requires intact urinary, neurologic and muscular-skeletal systems • Any break in communication between these systems can lean to incontinence (or residual)

    4. Types of Incontinence • Stress Incontinence • Involuntary loss of urine through an intact urethra due to a sudden h in intra-abd. pressure • Treatment-mild: Biofeedback & bladder drills • Treatment-moderate to severe: surgery

    5. Pelvic Floor Training and the role of Biofeedback:  Health Care Professionals usually advise Pelvic Floor Training as a first line treatment or an adjunct therapy for urine leakage that occurs during coughing, laughing or on exertion. Pelvic floor exercises are effective, but only if carried out regularly and diligently. The lack of feedback on progress may lead to frustration and the discontinuation of an exercise routine, hence, it is prudent to choose devices/exercisers with biofeedback function, such as Peritron Perineometer and PFX range of pelvic floor exercisers with pressure biofeedback. The challenge is to motivate and encourage the workout and simultaneously ensure exercising of the correct muscles. Appropriate feedback will stimulate discipline and step-wise progress. PFX is available in 2 versions - vaginal for women only and anal that can used by both men and women. PFX and Peritron Perineometer products can help people, who wish to monitor the effectiveness of their exercising efforts, because of the valuable biofeedback that they generate. Pelvic floor exercises should become routine events in women's lives, but especially before and after childbirth, hysterectomy and the menopause.

    6. Types of Incontinence • Urge Incontinence • Involuntary loss of urine associated with a strong urge to void that cannot be suppressed. • Treatment- • Biofeedback • Pelvic floor nerve stimulation • Bladder drill • Anticholinergics

    7. anticholinergic • An anticholinergic agent blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. • An example dicyclomine. • Decreased the effects mediated by acetylcholine on acetylcholine receptors

    8. Types of Incontinence • Reflux incontinence • Involuntary loss of urine due to Hyperreflexia in the absence of normal sensation • Associated with spinal cord injuries

    9. Types of Incontinence • Overflow incontinence • Involuntary loss of urine due to over-distention of the bladder • Bladder is unable to empty normally • over distended • frequent urination (just over flow)  • Incontinence • Treatment: • Catheterization

    10. Behavior Therapy Management • Fluid Management • Increase fluid • Decrease fluid • WATER!!!! • Standardized voiding frequency • Timed voiding • Bladder retraining

    11. Behavior Therapy Management • Pelvic Muscle Exercises • Kegel exercises • Goal • strengthen voluntary muscles

    12. Behavior Therapy Management • Pharmacological Therapy • Anticholinergic agents • Oxybutynin/Ditropan • Action: Inhibits bladder contractions • Indications for use: urge incontinence

    13. Surgical management • Involve lifting and stabilizing the bladder or urethra

    14. Nursing Management • h fluids • No diuretics after 4PM • Avoid bladder irritants • Caffeine • Alcohol • Aspartame (nutrasweet) • High fiber meals • Void regularly • Enc pelvic floor exercises • Stop smoking

    15. Urinary Retention • Pathophysiology • Urinary Retention • The inability to empty the bladder completely • Residual urine • urine that remains in the bladder after voiding • Assoc. with • post-op d/t reflux spasm of sphincters • Diabetes • Prostatic enlargement • Urethral pathology • Trauma • Pregnancy • Neurologic disorders

    16. Urinary Retention • Assessment • Measure post void residual urine • Portable bladder scanner

    17. Urinary Retention • Complications • Chronic infections  • Pyelonephritis  • Sepsis  • Kidney failure • Deathmosis

    18. Urinary Retention • Nursing Management • Promoting normal urinary eliminations • Provide privacy • Commode • Male stand • Sitz bath • Hot tea • Water faucet on • Tapping pubic area • Dipping hand in warm water • Promoting urinary elimination • Catheterization

    19. Neurogenic Bladder • A dysfunction d/t a lesion of the nervous system • Two types of neurogenic bladder • Spastic bladder / reflex bladder • Empties on reflex • Flaccid bladder • Bladder becomes distended  • Overflow incontinence  • Bladder does not contract • Can not feel discomfort

    20. Neurogenic Bladder: Management • Catheterization • Obstruction • Post-op • Monitor output with critical • Neurogenic bladder or urinary retention • Stage III or IV decubitus ulcers • Indwelling devices • Drainage bag below the level of the bladder • Tubing not kinked and no too long • Increase fluids • Suprapubic catheterization

    21. Urological Surgery • Drainage tubes • Nephrostomy drainage • Tube inserted directly into the kidney

    22. Nephrostomy drainage • Nursing management • Assess for complications • Bleeding • Infection • Skin • Ensure unobstruction • Never clamp • Irrigate • Encourage fluids • Aseptic technique • Measure I&O

    23. Urethral Stent • A tubular device that maintains position & patency of the urethra

    24. Nursing Process: post-op urinary surgery • Ineffective airway clearance r/t the surgical incision • Ineffective breathing pattern r/t to surgical incision & general anesthesia • Assess resp status • Auscultation • Admin analgesics • Splint • Change position frequently • Incentive spirometer • Amb.

    25. Test Question! • Which of the following is appropriate nursing interventions for a patient with a nursing diagnosis of ineffective breathing patterns following renal surgery? • Have the patient lay on affected side most of the time • Encourage short breaths so not to strain incision site • Bed rest • Administer analgesics • None of the above

    26. Nursing Process: post-op urinary surgery • Acute pain • Assess pain level • Assess abd. distention • Admin analgesics • Moist heat • Massage • Splint • Exercise

    27. Nursing Process: post-op urinary surgery • Urine retention r/t pain, immobility and anesthesia • Asses I&0 • Assess drainage & drainage system • Aseptic technique • Maintain closed system • Irrigate? • Enc pt to move – assist to move • Anchor cath • Fluids

    28. Nursing Process: post-op urinary surgery • Potential complications • Bleeding • Pneumonia • Infection • Fluid disturbances • Deep vein thrombosis

    29. Urinary tract infections (UTI) • Describe etiology, Pathophysiology, clinical manifestations, nursing management and patient education for Urinary tract infections (UTI) • Pathophysiology • UTI’s are caused by pathogenic micro-organisms in the urinary tract • Bacteria in bladder  attach to the bladder  colonizes in the epithelium • E. Coli

    30. Urinary tract infections • Reflux • Backward flow of urine from the urethra to the bladder • Cough  • increase bladder pressure  • urine forced into urethra  • stop coughing  • decreased pressure  • urine flows back into bladder

    31. Urinary tract infections • Types of UTI’s • Cystitis – • Inflammation of the bladder • Prostatitis – • Inflamation of the prostate gland • Urethritis – • Inflammation of the urethra • Pyelonephritis – • Inflammation of the renal pelvis parenchyma • Interstitial nephritis – • Inflammation of the kidney

    32. Defense Mechanism • Physical barrier • Urine flow • Enzymes • Antibodies

    33. Defense Mechanism • Who is more likely to get a UTI • Male • Female • Why? • Shorter urethra

    34. Predisposing factors to UTI • Factors increasing urinary stasis • Foreign bodies • Anatomic factors • Factors compromising immune system • Functional disorders

    35. Clinical Manifestations: Lower UTI • Dysuria • Burning • Frequency • Urgency • Nocturia • Incontinence • Pelvic pain • Hematuria • Cloudy urine • Back pain

    36. Clinical Manifestations: Upper UTI • Fever & Chills • Back pain (flank) • N/V • H/A • Malaise • Dysuria

    37. Gerontologic considerations • Few S&S • Fatigue • Alt cognitive function • Slight drop in temp

    38. Assessment & Dx findings • UA • Culture

    39. Medical management/pharmacological therapy • Antibiotic • Cephalosporin • Bactrim/Septra • Urinary analgesic • Phenazopyridine (Pyridium) • Urine  orange

    40. Nursing Process: UTI • Assessment • S&S • Voiding patterns • Sexual intercourse • Urine

    41. Nursing Process: UTI • Diagnosis • Acute pain related to inflammation of the urinary tract • Assess pain • Admin. Analgesics • Tell pt  orange • Teach non-Rx • Heating pad • Warm showers • Admin antispasmodics

    42. Nursing Process: UTI • Diagnosis • Deficient knowledge detection, preventions and recurrence and meds • Hygiene • Fluid intake • Voiding habits

    43. Nursing Process: UTI • Nursing Interventions: Hygiene • Shower not bath • Front to back • Wash after BM w/soap & water • No harsh soaps

    44. Nursing Process: UTI • Nursing Interventions: Fluid Intake • Increased • Water • Avoid irritants • Coffee • Tea • Citrus • Spices • Cola • Alcohol

    45. Nursing Process: UTI • Nursing Interventions: Voiding habits • 2-3 hrs • Empty completely • Before & after intercourse

    46. Pyelonephritis • Bacterial infection of the renal pelvis, tubules and interstitial tissue of one or both kidneys. • Pathophysiology • Lower ascends up • Reflux • Obstruction •  enlarged kidney

    47. Pyelonephritis • Clinical manifestations • Acutely ill • Fever & Chills • Pyuria • Flank pain • Bacteriuria

    48. Pyelonephritis • Assessment & Dx: • Ultrasound • CT • UA • Pyuria • Bacteriuria • Hematuria • WBC

    49. Pyelonephritis • Medical Management • Outpatient • Dehydration

    50. Pyelonephritis • Rx • 2 week antibiotics • IV