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Nurs 208 Urinary Pathophysiology Terms and Objectives Notes

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This is a comprehensive and detailed note on Urinary Pathophysiology it's Terms and Objectives.

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  • August 19, 2024
  • 19
  • 2019/2020
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Urinary Pathophysiology Terms and Objectives!



1. Kegel exercises: Repetitive isometric tightening and relaxing of the pubococcygeal

muscles which strengthens the pelvic fascia (pg. 814)."Kegel exercise, also known as

pelvic floor exercise, consists of repeatedly contracting and relaxing the muscles.!

2. Urethropexy: Surgical fixation to nearby tissue of a displaced"urethra"that is causing

incontinence by placing stress on the opening from the bladder."A"urethropexy"is a

surgical procedure where support is provided to the urethra."!

3. Post void cystometry: A cystometric test uses a catheter and manometer to

evaluate bladder urine volume and pressure in relation to involuntary bladder

contraction (the leak point pressure) and the urge to void (pg.751). Measure of bladder

pressure determined using a pressure-measuring catheter. Fluid volume and pressures

are measured as bladder is filled with fluid. Simultaneously pressures may be

measured in the rectum and sensations of bladder fullness is also recorded. Coughing

or straining can lead to involuntary bladder contractions. Male bladder holds 350-750

ml and female bladders hold 350-550 ml (pg. 744)."Although catheters are used, you

want to make sure the person really needs a catheter because they easier introduce

infection and you want to minimize the infection risk. If a person gets a cauti, hospital

acquired urinary tract infection, it is the nurses fault and the hospital has to pay.

Bladder scanners are used more often to check post void residual because they don’t

require and order and don’t have a risk of infection."!

4. Urge incontinence: Most common in older adults. It is the involuntary loss of urine

associated with abrupt and strong desire to void (urgency); often associated with

,involuntary contractions of detrusor. When associated with neurologic disorder, this is

called detrusor hyperreflexia. When no neurologic disorder exists, this is called

detrusor instability. Urge incontinence may be associated with decreased bladder wall

compliance (pg. 750). It is also incontinence in children with urgency (pg. 776)."!

5. Bladder overflow: Also overflow incontinence. Involuntary loss of urine with

distention of bladder. Associated with neurologic lesions below S1, polyneuropathies,

and urethral obstruction (i.e. enlarged prostate). If you find yourself leaking urine during

the day or even wetting the bed at night, you may be experiencing symptoms of

overflow incontinence. Overflow incontinence occurs when you are unable to

completely empty your bladder.!

6. Post void residual volume: Urine can be removed with catheter and measured or

ultrasound imagining can be used to measure urine. Postvoid residual of more than

200 ml is abnormal and requires further evaluation (pg.744). What is left when the

bladder does not fully empty (lecture notes).!

7. Underactive bladder (acute urinary retention): Underactive Bladder Syndrome"is a

chronic, complex and debilitating disease which affects the urinary bladder with

serious consequences. Patients with an underactive bladder can hold unusually large

amounts of urine but has a diminished sense of when the bladder is full and is not able

to contract the muscles sufficiently and as forcefully as it should, resulting in

incomplete bladder emptying."!

8. Overactive bladder (urge incontinence): Most common in older adults. It is the

involuntary loss of urine associated with abrupt and strong desire to void (urgency);

often associated with involuntary contractions of detrusor. When associated with

, neurologic disorder, this is called detrusor hyperreflexia. When no neurologic disorder

exists, this is called detrusor instability. Urge incontinence may be associated with

decreased bladder wall compliance (pg. 750).!

9. Acute cystitis: The inflammation of the bladder and is the most common site of UTI.

The morphologic appearance of the bladder through cystoscopy describes different

types of cystitis. With mild inflammation the mucosa is hyperemic (red). More advanced

cases may show diffuse hemorrhage termed hemorrhagic cystitis. Pus formation or

suppurative exudates on the epithelial surface of the bladder is termed suppurative

cystitis. Prolonged infection may lead to sloughing of the bladder mucosa with ulcer

formation termed ulcerative cystitis. The most severe infections may cause necrosis of

the bladder wall termed gangrenous cystitis (pg. 753). Necrosis of the bladder is when

the bladder wall is black or gray and is gone so the person can’t hold urine. This is

common in spinal cord patients. This may result in a urostomy to rid the bladder of

urine. Years of urinary tract infections can lead to bladder cancer. The most common

infecting microorganisms are uropathic strains of"Escherichia coli"and the second most

common is"Straphylococcus saprophyticus"(pg.753).!

10. Acute glomerulonephritis: Acute glomerulonephritis is inflammation of the

glomerulus caused by primary glomerular injury (ischemia, free radicals, drugs, toxins,

vascular disorders, and infection. Secondary glomerular injury is a consequence of

systemic diseases (DM, HTN, bacterial toxins, congestive heart failure).!

11. Anuria: Failure of the kidneys to produce urine (urine output less than 50 ml/day).

Anuria"is uncommon in acute tubular necrosis (ATN), involves both kidneys, and

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