Urology Anatomy and Nursing Considerations

Questions and Answers

What is the primary reason females are at greater risk for urinary tract infections?

Proximity to anal and vaginal areas (correct)

Higher incidence of kidney stones

Longer urethra length

Increased fluid intake

Which structure is located at the base of the bladder neck and envelopes the urethra?

Epididymis

Cowper’s gland

Seminal vesicle

Prostate gland (correct)

Which position is NOT typically used for patients undergoing urologic surgeries?

Lateral

Supine with Trendelenburg tilt

Lithotomy

Standing (correct)

What is the length of the male urethra?

20-25 cm Signup and view all the answers

Which adrenal gland part is responsible for secreting adrenaline?

Adrenal medulla Signup and view all the answers

What must be confirmed pre-, intra-, and post-operatively for patients undergoing urologic surgery?

Availability of blood products Signup and view all the answers

Which of the following is NOT a paired structure in the male reproductive system?

Scrotum Signup and view all the answers

What type of agents should the RPN be prepared with in the scrub role during surgery?

Hemostatic agents Signup and view all the answers

What is the maximum degree to which a patient's hips should be flexed to prevent nerve injuries during surgery?

90 degrees Signup and view all the answers

Which of the following is NOT a type of scope used in minimally invasive surgeries for GU applications?

Arthroscope Signup and view all the answers

What is the first count performed during surgical procedures involving GU surgeries?

Initial Count Signup and view all the answers

What safety measure should be taken when using stirrups for patients in lithotomy position?

Support should be ensured while removing legs from stirrups Signup and view all the answers

Which equipment is essential for cystoscopy setup?

Single tubing for irrigation Signup and view all the answers

What is a key responsibility of the perioperative nurse regarding the safety strap?

To secure it during patient positioning Signup and view all the answers

What type of retractor is mentioned as important for necessary surgeries?

Bookwalter retractor Signup and view all the answers

Why is shielding of reproductive organs not feasible in GU surgeries?

The operative field does not allow for shielding Signup and view all the answers

What is a major concern during open prostate surgeries?

Bleeding Signup and view all the answers

Which approach allows for excellent exposure of the prostate bed while minimizing intraoperative bleeding?

Simple Retropubic Prostatectomy Signup and view all the answers

What is the primary goal of a Nerve Sparing Radical Retropubic Prostatectomy?

To prevent damage to erectile function nerves Signup and view all the answers

What is an advantage of the Robotic Laparoscopic Radical Prostatectomy over standard open procedures?

Shorter recovery time Signup and view all the answers

Which procedure incorporates the removal of pelvic lymph nodes to assess the progression of cancer?

Nerve Sparing Radical Retropubic Prostatectomy Signup and view all the answers

In which surgical approach is the prostate removed through a transvesicle method?

Suprapubic Prostatectomy Signup and view all the answers

Which approach uses small portal incisions to enhance the range of motion during surgery?

Laparoscopic Radical Prostatectomy Signup and view all the answers

What technique is achieved using a verres needle during Laparoscopic Radical Prostatectomy?

Abdominal insufflation Signup and view all the answers

What is the main purpose of a Supra Pubic Cystostomy?

To create a drainage opening into the urinary bladder Signup and view all the answers

When is a Radical Cystectomy with Pelvic Lymphadenectomy indicated?

When the tumor has invaded the muscular wall of the bladder Signup and view all the answers

What does an 'Ileal Conduit' refer to in bladder surgery?

A stoma created for urine diversion after cystectomy Signup and view all the answers

What is the function of a lithotripsy probe in the removal of stones?

To activate a laser to break down stones in the urinary system Signup and view all the answers

Which type of bladder surgery is specifically designed for tumor removal?

Transurethral resection (TUR) of bladder tumors Signup and view all the answers

What is a common indication for performing ureterostomy?

To manage urinary tract obstruction due to stones or tumors Signup and view all the answers

What is the purpose of self-catheterization in a continent ileostomy?

To manage urine flow from a created pouch Signup and view all the answers

Which surgical method would likely be used for non-invasive bladder tumors?

Transurethral resection of bladder tumors (TUR) Signup and view all the answers

What is ureterectomy primarily used for?

To remove the complete ureter Signup and view all the answers

What is the purpose of ureteroenterostomy?

To divert the ureter into the ileum Signup and view all the answers

During which procedure is an incision made into the kidney?

Nephrotomy Signup and view all the answers

Which surgical procedure involves the removal of a calculus through the renal pelvis?

Pyelolithotomy Signup and view all the answers

What does laparoscopy typically include during kidney removal?

Placement of several drainage catheters Signup and view all the answers

What is the goal of kidney transplantation?

To maintain renal function in end-stage renal disease Signup and view all the answers

In which situation is radical nephrectomy typically performed?

For cancer including the kidney and surrounding structures Signup and view all the answers

What is nephrostomy primarily used for?

Allowing drainage from the kidney Signup and view all the answers

Study Notes

Urethra

Male urethra measures 20-25 cm, while female urethra is about 4 cm.
Short female urethra and proximity to anal/vaginal areas increase UTI risk.
Cystoscopies, Transurethral Resection of Prostate (TURP), and Ureteric stents are performed via urethra.

Prostate Gland

Donut-shaped gland located at the bladder neck, surrounding the urethra.
Divided into four regions: right lateral, left lateral (intraurethral lobes), and posterior, median (extraurethral lobes).

Male Reproductive Organs

Paired organs include testes, epididymis, seminal ducts, seminal vesicles, and Cowper’s glands.
Singular structures consist of penis and scrotum.

Adrenal Glands

Located retroperitoneally with two main sections: Adrenal Cortex (secretes steroids/hormones) and Adrenal Medulla (secretes adrenaline).
Blood supply includes similar sources as kidneys plus branches from the inferior phrenic artery.

Perioperative Nursing Considerations

Urologic procedures may stress patients, requiring careful anatomical positioning.
Significant use of irrigation fluids necessitates lab/electrolyte monitoring.
Blood Replacement: Anticipate possible blood transfusions due to extensive vascular tissue dissection.
Patient positioning varies based on procedure; four common positions include supine, lithotomy, supine with Trendelenburg tilt, and lateral.
In lithotomy position, ensure stirrups are securely fastened, and avoid excessive hip flexion to prevent nerve injuries.
Coordinate leg removal post-surgery to facilitate hemodynamic adjustment.

Instrumentation and Counting

GU surgeries vary between open and minimally invasive.
Cystoscopy setups use a closed irrigation system, light cord, and different types of scopes with no count required.
Open surgeries (Nephrectomy, Prostatectomy, Cystectomy, Pyeloplasty) use basic and specialty instruments, with major and minor counts performed to prevent retained instruments.

Equipment

Use intra-operative fluoroscopy (C-arm) for imaging, ensuring patient protection from radiation.
Open Prostate Surgery is common in men over 50, involving prostate gland excision.
Suprapubic approach allows concurrent bladder condition treatment during prostate removal.

Minimally Invasive Radical Prostatectomies

Robotic Laparoscopic procedure enhances surgeon precision with fewer incisions and shorter recovery.
Laparoscopic approach includes abdominal insufflation and multiple ports for better visualization.

Bladder Surgery

Surgeries can be open or transurethral; diagnostic procedures typically use the latter.
Supra Pubic Cystostomy creates an opening into the bladder for drainage.
Radical Cystectomy entails removing the bladder and surrounding structures, requiring new urine receptacle creation (Ileal Conduit or Kock Pouch).

Ureteral Surgery

Common issues demanding surgical intervention include stones, infections, and tumors.
Ureterostomy/Ureterotomy allows for drainage; Ureterectomy involves complete ureter removal.
Ureterolithotomy opens the ureter to remove stones.

Kidney Surgery

Nephrostomy maintains urinary drainage; Pyelolithotomy removes kidney stones.
Open Nephrectomy is used for various renal conditions, often necessitating rib resection.
Radical nephrectomy targets cancerous conditions, removing extensive surrounding tissue.

Kidney Transplantation

Involves transplanting a living or cadaveric donor kidney to restore renal function in end-stage renal disease patients.
Involves simultaneous preparation in adjacent operating rooms for efficient vessel verification during the donor nephrectomy and recipient surgery.

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Description

This quiz covers key concepts related to the anatomy of the urethra, prostate gland, male reproductive organs, and adrenal glands. It also discusses perioperative nursing considerations relevant to urologic procedures. Test your knowledge on these critical topics in urology and improve your understanding of the associated nursing practices.