Nursing 214 - Exam 2 Questions and Correct Answers
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Course
NUR 214
Institution
NUR 214
Genitourinary and Renal System Normal Changes of Aging •Decreased glomerular filtration rate, renal blood flow, max urinary concentration, response to sodium loss, thirst •Excretion of more fluid/electrolytes at night •Impaired excretion of drugs/metabolites •Change in ability to concentrat...
Nursing 214 - Exam 2 Questions and
Correct Answers
Genitourinary and Renal System Normal Changes of Aging ✅•Decreased glomerular
filtration rate, renal blood flow, max urinary concentration, response to sodium loss,
thirst
•Excretion of more fluid/electrolytes at night
•Impaired excretion of drugs/metabolites
•Change in ability to concentrate urine
•Bladder is more fibrous, less smooth pliable muscle
•Detrusor muscles become less contractile and somewhat unstable
•Variations in ADH
Variations in ADH ✅•Higher basal levels (Edema)
•Blunted response to hypotension and hypovolemia
•Kidney less responsive to circulating ADH, leads to poorly concentrated urine which is
rich in sodium
Men Normal Changes in Genitourinary & Renal System ✅•Up to age 90, 50% of men
still produce viable sperm
•Decreased hormone level
•Shouldn't affect the ability to reproduce
Women Normal Changes in Genitourinary & Renal System ✅•Cessation of
menstruation
•Breast tissue is less firm, tissue is replaced by fat
•Decreased estrogen, contributes to vaginal thinning, appearance of facial hair, and
diminished pubic and axillary hair
Renal Failure ✅•A failure of kidneys to remove nitrogenous waste from the body and to
regulate fluid/electrolytes and acid-base balance
•Can be either Acute or Chronic
Acute Renal Failure ✅•Pre-renal problem with blood flow to the kidney
•Renal problem with the glomeruli or tubules of the kidney
•Post-renal obstruction of the outflow of urine
Acute Renal Failure Signs/Symptoms ✅•Postural hypotension is the primary symptom;
may not have oliguria
•Increased BUN and Creatinine
•Dependent edema
•Fatigue and drowsiness
•Nausea and vomiting
,•Flank pain
Chronic Renal Failure Signs/Symptoms ✅•Irreversible damage to the kidneys; popular
in older adult population
•Hypertension
•Pruitis
•Anemia
•Increased serum phosphate, calcium, BUN, creatinine, potassium
•Metabolic acidosis
•Edema
•Fatigue/drowsiness
•Decreased urine volume
•Nausea/vomiting
•Decreased GFR
•Altered mental status
Chronic Renal Failure Diagnosis/Treatment ✅•Dx based on lab work and other
symptoms
•Modify treatment for older adult
•Moisturizers help for pruitis
•Nephrologist to consider renal transplants/dialysis
Types of Urinary Incontinence ✅•Stress
•Urge
•Overflow
•Functional
•Mixed
Stress Incontinence ✅•Involuntary loss of urine when intraabdominal pressure is
increased
, •Either the pelvic floor muscles or the internal urethral sphincter is not strong enough to
counter the pressure on the bladder and urine is released
•Sneezing, coughing, laughing
Urge Incontinence ✅•Detrusor muscle contracts forcefully and unexpectedly
•Internal sphincter is unable to retain urine
•Person feels the need to go to the BR urgently
•Overactive bladder
Overflow Incontinence ✅•A blockage of the urethra may be the cause of the bladder
overfilling and stretching the bladder muscles beyond the point of contractility
•Muscles may be unable to contract properly because of the lack of innervation
•Ex: enlarged prostate obstructing the urethra, and urine backing up into the bladder
Functional Incontinence ✅•Incontinence related to causes external to the urinary
apparatus
•Immobility
•Dementia
Mixed Incontinence ✅•More than one type of incontinence
•Ex: urge & functional
•Intervention is focus on figuring out types of incontinence and what can be done
Urinary Incontinence Treatments ✅•Bladder training
•Pelvic floor exercises/Kegel exercises
•Anti-incontinence devices (Pessary)
•Anti-cholinergic meds
•Avoid caffeine, carbonated beverages, alcohol, citrus juices, diet drinks, smoking
•Bladder sling surgery
•Retain quality of life
•Don't use indwelling catheters (increase UTI's)
•Address skin breakdown
•Absorbent products (don't call diapers)
Benign Prostate Hyperplasia (BPH) ✅•Enlargement of the prostate
•Microscopic: histological (small cell) changes
•Macroscopic: palpable enlargement of gland during digital rectal exam
•Clinical: observable symptoms related to BPH
•A nuisance; makes a profound effect on the individual's daily living, difficulty starting a
stream, weak stream (dribbling), straining to urinate, longer time needed, feeling
incomplete bladder emptying
BPH Treatments ✅•Medications: Saw Palmetto or Flomax may help shrink the
prostate
•Surgery is always an option
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