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GU system cheat sheet for final

GU system final

Upper—­renal parenc­hyma, pelvis and ureters (pyelo­nep­hritis)
Lower—­bladder (cystitis) and urethra (ureth­ritis)
System­ic—­uro­sepsis (life-­thr­eat­ening)
Compli­cat­ed—­str­uctural or functional problem in urinary tract
Uncomp­lic­ate­d—b­ladder only
Dx—H&P, UA, C&S, Imaging
UA— +leuko­est­erase, WBC >6.0, +nitrate
S/S—dy­suria, urgency, fever
Nursing Imp.—a­dequate fluid! [1.5-2L] , avoid irritating foods (spicy, acidic, alcohol, caffeine), heating pad/warm shower
Drug Therap­y—NEVER start drug therapy b4 culture is obtained

UTI Treatment — in depth

Increase Fluid Intake —
Look 4 New Symps—
avoid milk products
skin irritation
Avoid: chocolate, citrus juices, alcohol, caffeine, spicy foods
bladder distention
cranberry juice decreases risk of UTI
Drug therapy
Uncomp­licated cystit­is—­Sho­rt-term course (3 days)
Compli­cated UTIs—l­ong­-term treatment (7 to 14 days)
Trimet­hop­rim­/su­lfa­met­hox­azole (TMP-SMX)
Nitrof­ura­ntoin Cephalexin
Other: ampici­llin, amoxic­illin, or cephal­osp­orins
Compli­cated: fluoro­qui­nolones (can cause prolonged QT interval)
Fungal: flucon­azole
Urinary analgesic: phenaz­opy­ridine (azo dye)


s/s: difficulty starting urine stream, decrea­sed­/weaker flow of urine, urine freq.
Obstru­ctive: hesitancy, decreased in force of stream, difficult initiating stream, interm­ittent voiding pattern
risk factors: fam hx, enviro­nment, diet, obesity
Irrita­tive: urinary frequency, urgency, dysuria, bladder pain, nocturia, incont­inence
Dx: H&P, digital rectal exam, UA, C&S, prostate specific antigen, transr­ectal ultrasound in DRE, PSA positive
Dietary Changes: decrease caffeine, limit spicy and acidic food restrict night time fluid intake
- Drug therapy

o 5α reductase inhibitors Finast­eride (Proscar), Dutast­eride (Avodart): reducing the size of the prostate, suppresses androgen. Do not touch with outwearing gloves if you are a female, Takes 3-6 months to see improv­ement
o Erecto­genic drug: tadafil
o Alpha adrenergic receptor blockers: tamsulosin (Flomax)- smooth muscle relaxer facili­tates urine flow making it easier to void


Most common UTI among elderly men
Acute or Chronic
Acutie bacter­ial­—fever, chills, malaise
S/S for acute or chronic—
Frequency, nocturia, dysuria, varying degrees of bladder obstru­ction, low back, perineal pain, urinary retention
DRE: prostate swollen, tender and boggy

Prostate Cancer

s/s: similar symps to BPH, pain in lumbos­acral area radiating to legs/hips
Dx: o Digital rectal exam (DRE): prostate nodule is hard, asymme­tric, PSA: normal is 0-4
Other therap­ies­-Or­chi­ectomy: surgical removal of the testes, Chemot­herapy: only used when it is metast­asized
Radical prosta­tec­tomy: removal of entire prostate, seminal vesicles, and part of bladder neck
Cryosu­rgery: freezes tissue and destroy cancer cells
Brachy­the­rapy: placing radioa­ctive seed implants into prostate gland
Drug therapy
Hormone therapy to decrease androgen LH decreases levels of androgen that is feeding the area
LH-RL antagonist (Plena­xis): provides immediate testos­terone suppre­ssion
Androgen receptor blockers (Casodex): blocks action of testos­terone

BPH Surgeries

TURP: transu­rethral resection of prostate; Use of a resect­osope to enter through urethra to excise tissue Post op: Three way Foley Continuous bladder irrigation to prevent blood clots// must watch for: TUR or TURP syndrome: N/V, confusion, bradyc­ardia, HTN--R­esults from hypona­tremia due to longer operative times and prolonged intrao­per­ative bladder irrigation with iso-os­molar fluid;
TUNA: Transu­rethral Needle Ablation: ↑ temper­ature of prostate tissue for localized necrosis; compli­cat­ion­s-u­rinary retention, UTI, irritative voiding, hematuria up to a week
TUVP: transu­rethral vapori­zation of prostate; electr­osu­rgical modifi­cation of TURP
Discharge Planning Catheter care if left in place
Decreased or absent ejaculate volume
Retrograde ejacul­ation
Maintain fluids between 2000-3­000mL per day
Observe for S/S of bleeding, infection, increased intraa­bdo­minal pressure
Avoid prolonged sitting or walking and Valsalva maneuver
No lifting more than 10 pounds
Refrain from driving and interc­ourse until released by surgeon


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