GUT Disorders Nursing Exam Prep PDF

21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Let’s begin your journey to...

21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Let’s begin your journey to Functional Concepts on THE MOST COMMON GUT DISORDERS on the PNLE/HAAD RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN TERMS TO KNOW THE GENITO- URINARY SYSTEM Dysuria- Pain while urinating Nocturia- Excessive urination at night Hematuria- Bloody urine Kidneys Incontinence- Involuntary voiding Proteinuria- Abnormal amounts of protein in the blood Ureters Oliguria- Urine output of less than 400mL/day Bladder Anuria- Urine output of less than 50mL/day Urethra Genital organs The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN KIDNEYS NEPHRON: Right kidney is slightly lower than the THE FUNCTIONAL UNIT OF THE KIDNEYS left About a million URINE FORMATION Filtering units Excretion of waste products Each unit has a filtering Regulation of electrolytes structure- glomerulus and Regulations of acid base balance the tubule Control of water balance Control of blood pressure The glomerulus filters the Regulation of red blood cell blood production (ERYTHROPOETIN) The bowman’s capsule Synthesis of vitamin D collect the filtrate Regulates calcium and phosphorus The tubule returns needed substances to the blood and removes wastes 1  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN NEPHRON: THE FUNCTIONS URINE FORMATION Filtration-blood Reabsorption- water, chloride, Transfer of water and Necessary contents such waste from blood to the Excess substances and as ions and water are glomerulus wastes are transferred to glucose, (FILTRATION)- GLOMELUAR FILTRATION transferred back to blood (REABSORPTION) urine for EXCRETION Excretion- potassium, urea, creatinine The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Renin-Angiotensin- Aldosterone-System THE GENITO-URINARY SYSTEM STIMULUS: Renin is released Decrease bp by the specialized Renin converts Decrease blood cells in the angiotensinogen Kidneys- regulation of acid-base balance, blood kidneys called volume juxtaglomerular to angiotensin I pressure, electrolytes, RBC production, Decrease sodium levels in the kidney cells prostaglandins, waste products and urine formation ALDOSTERONE increase By angiotensin converting enzyme ANGIOTENSIN II the reabsorption of sodium and ions. Ureters- transport urine from kidneys to bladder -vasoconstriction (ACE) in the lungs Angiotensin I is -release of aldosterone -SODIUM AND WATER RETENTION Bladder-reservoir of urine and ADH converted into Angiotensin II -promotes thirst -INCREASED BLOOD VOLUME AND BLOD Urethra-passageway of urine PRESSURE Female and male genital organs The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN URINE URINE Color: light yellow Protein: no protein Clarity: Clear Glucose: no glucose Odor: mild aromatic Ketones: no ketones pH: 4.6 and 8.0. Bilirubin: no bilirubin. Specific Gravity: The normal specific Urobilinogen: Normal urobilinogen levels in gravity of urine is 1.010 to 1.030. urine range from 0.2 to 1.0 mg/dL. 2  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN NORMAL VALUES TO REMEMBER Ray A. Gapuz’s NORMAL VALUES ❑CREATININE CLEARANCE ❑SERUM CREATININE TO ❑BUN ❑GFR REMEMBER ❑URINE SPECIFIC GRAVITY copyright 2012 by R.A. Gapuz. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® The normal GFR is The normal URINE 125mL/min SPECIFIC GRAVITY is 1.010-1.030 FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® SERUM CREATININE & CREATININE CLEARANCE The normal BUN levels is PURPOSE: 10-20 mg/dl. -assess kidney function NURSING ALERT: -alert for significant changes -medication adjustments FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 3  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Serum Creatinine ALBUMIN/CREATININE RATIO Creatinine Clearance - Reflects the filtering and - Reflects how well the kidneys filter PURPOSE: To detect albumin in relation excretion capacity of the kidneys creatinine to the amount of creatinine in the urine. N: 0.5 to 1.5 mg/dL N: 77 to 160 mL/min/BSA SPECIMEN: Blood SPECIMEN: 24-hour urine NURSING ALERT: - Fast overnight - There should be little or no albumin found in the urine - N: Men: less than 17 mg/g - Avoid eating meat before the test and avoid creatinine supplements - Women: less than 25 mg/g copyright 2012 by R.A. Gapuz. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concepts on THE MOST COMMON DIAGNOSTIC 24 h Urine Specimen for PROCEDURES FOR RENAL/ Creatinine Clearance GUT DISORDERS on the PNLE/HAAD RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® The nurse is giving instructions to a client for 24 hour urine collection for creatinine clearance test. Please arrange the following steps in order: The normal range of A. Urinate at the stop time creatinine clearance is: B. Use the plastic cup for each urine collected 77-160 mL/min/BSA C. Pour the urine into the collection container D. Keep the urine refrigerated Answer : B, C, D,A. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM © The Ray A. Gapuz Test Prep System for PNLE RN 4  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN URINALYSIS DATA NURSING DIAGNOSIS PURPOSE: screen medical URINE OUTPUT OF Decreased LESS THAN 30 condition ML/HR urinary output URINE SP. GR. OF Fluid Volume NURSING ALERT: LESS THAN 1.010 Excess URINE SPECIFIC -proper collection & delivery GRAVITY OF MORE Fluid Volume Deficit THAN 1.030 -infection control copyright 2012 by R.A. Gapuz. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN URINE CULTURE AND NURSING DATA DIAGNOSIS SENSITIVITY DISTENDED NECK Impaired PURPOSE: identify presence of VEIN Cardiac Output pathogenic microorganism & GENERALIZED Fluid Volume determine most effective medication EDEMA Excess URINE SPECIFIC Fluid Volume NURSING ALERT: GRAVITY OF MORE Deficit -proper collection THAN 1.030 -infection control copyright 2012 by R.A. Gapuz. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN KUB and IVP KUB IVP X-RAY WITH CONTRAST PLAIN X-RAY MEDIUM PURPOSE: assess urinary tract PREPARATIONS & surrounding structures NO CONSENT CONSENT REQUIRED IS REQUIRED NURSING ALERT: CLEANSING ENEMA BEFORE THE TEST -preparation ASSESS FOR ALLERGY copyright 2012 by R.A. Gapuz. 5  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN IVP BIOPSY The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® POSITIONING REMINDER Biopsy of an organ requires proper positioning and prevention of severe bleeding. Always put the CLIENT in the RIGHT POSITION before a procedure ! FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN KIDNEY BIOPSY PROSTATE BIOPSY lying on their stomach (prone) or on their side (lateral decubitus position). remain still and stay in this position for about 30 minutes. after the procedure: supine for 24 hours lying on their back. 6  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN CONE BIOPSY Functional Concept ® Slight spotting within a month after cervical cone biopsy is expected and is not reportable. normal to have bleeding for up to 4 weeks after a cone biopsy on a table and place the feet in stirrups to position the pelvis FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN CYSTOSCOPY Cysto Cysto Cystoscopy CYSTOURETHROGRAM Visualization urethrogram Infusion of fluids to determine metrogram Infusion of various amounts of saline CYSTOMETROGRAM of the urinary into the bladder to patency of the bladder determine bladder urethra capacity copyright 2012 by R.A. Gapuz. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concepts on THE MOST COMMON CATHETERIZATION THERAPEUTIC PROCEDURES FOR RENAL/ GUT DISORDERS on the PNLE/HAAD RN 7  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® LET’S Catheterization process is a STERILE PROCESS. THE STEPS FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN CATHETERIZATION 1. Explain the process to the client before beginning. Most clients are not used to inserting any object, let alone a long tube, into their urethra. Though this isn't always described as "painful", it is often described as "uncomfortable", even intensely so. Out of respect for the client, explain the steps of the procedure to him or her before beginning. Explaining the steps and what to expect can also help the client relax and avoid anxiety. © The Ray A. Gapuz Test Prep System for PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN 2. Ask the client to lie on his or her back. CATHETERIZATION The client's legs should be spread and his or her feet should be together. Lying in a supine position relaxes the bladder and urethra, facilitating easier catheter insertion. A tense urethra compresses the catheter, which results in resistance during insertion, causing pain and sometimes even damage to the underlying tissue of the urethra. In severe cases, this may cause bleeding. Assist the client in getting into the supine position if necessary. © The Ray A. Gapuz Test Prep System for PNLE RN 8  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN 3. Wash hands and put on sterile gloves. CATHETERIZATION Gloves are an important part of the PPE (Personal Protective Equipment) health care workers use to protect themselves and the client during medical procedures. In the case of catheter insertion, sterile gloves help ensure that bacteria are not introduced into the urethra and that the client's bodily fluids do not come into contact with your hands. © The Ray A. Gapuz Test Prep System for PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN 4. Open the catheter assembly. Some catheters also have specialized tips that allow them to serve different functions. For instance, a type of catheter called a Foley catheter Single-use catheters come in sealed, sterile kits. Before opening the is usually used for draining urine because it includes a balloon kit, ensure you have the correct catheter for your purposes. You will attachment which can be inflated to secure the catheter behind the need a catheter that is the correct size for your client. Catheters are bladder neck. rated for size in units called French (1 French = 1/3 mm) and are available in sizes from 12 (small) to 48 (large) French. Smaller Also gather medical-grade disinfectant, cotton swabs, surgical drapes, catheters are usually better for the client's comfort, but larger lubricant, water, tubing, drainage bag and tape. All should be properly catheters may be necessary to drain thick urine or to ensure the cleaned and/or sterilized. catheter stays in place. © The Ray A. Gapuz Test Prep System for PNLE RN © The Ray A. Gapuz Test Prep System for PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN CATHETERIZATION 5. Sterilize and prepare the client's genital area. Scrub the client's genital area with disinfectant-soaked cotton swabs. Rinse or scrub the area with sterile water or alcohol to remove any debris. Repeat as needed. When finished, lay down surgical drapes around the genitals, leaving a space for access to the penis or vagina. © The Ray A. Gapuz Test Prep System for PNLE RN 9  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN INSERTING THE CATHETER For female clients, be sure to clean the labia and urethral meatus (the outside of the opening of the urethra located above the vagina). For men, clean the urethral opening on the penis. Cleaning should be done from inside to outside so as not to contaminate the urethra. In other words, start at the urethral opening and gently work your way outward in a circular fashion. © The Ray A. Gapuz Test Prep System for PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN 6. Apply lubricant to the tip of the catheter. CATHETERIZATION Coat the distal portion of the catheter (the 2-5 cm portion at the tip) with a generous amount of lubricant. This is the end you will insert into the urethral opening. If using a balloon catheter, be sure to lubricate the balloon portion at the tip as well. © The Ray A. Gapuz Test Prep System for PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN 7. If the client is female, hold the labia 7. If the client is male, hold the penis and insert the catheter into the open and insert the catheter into the urethral opening. urethral meatus. Hold the penis in your non-dominant hand and gently pull upward, Hold the catheter in your dominant perpendicular to the client's body. Insert the tip of the catheter into hand and use your non-dominant the client's urethra with your dominant hand. hand to spread the client's labia so that you are able to see the urethral opening. Gently insert the tip of the catheter into the urethra. © The Ray A. Gapuz Test Prep System for PNLE RN © The Ray A. Gapuz Test Prep System for PNLE RN 10  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN CATHETERIZATION 8. Continue pushing until the catheter sits in the bladder. The length of the catheter should be gently fed through the urethra and into the bladder until urine is observed. After urine begins to flow, continue to push the catheter into the bladder another 2 inches to make sure the catheter is against the neck of the bladder. © The Ray A. Gapuz Test Prep System for PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN 9. If using a balloon catheter, inflate the balloon with sterile water. The amount of sterile water you use to inflate the balloon depends on the size of the balloon on the catheter. Use a water-filled syringe to inflate the balloon via sterile tubing connected to the catheter. The inflated balloon serves as an anchor Usually, about 10 cc of water is required, but check the size of your so as not to displace the catheter when moving. Once inflated, pull balloon to be sure. gently on the catheter to ensure the balloon is seated snugly against the neck of the bladder. © The Ray A. Gapuz Test Prep System for PNLE RN © The Ray A. Gapuz Test Prep System for PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN MALE CATHETERIZATION 10. Connect the catheter to the drainage bag. Use sterile medical tubing to allow urine to drain into a drainage bag. Secure the catheter to the client's thigh or abdomen with tape. Make sure you place the drainage bag lower than the client's bladder. Catheters work via gravity - urine can't drain "uphill". © The Ray A. Gapuz Test Prep System for PNLE RN 11  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® In a medical environment, For males, secure the catheter catheters can be left in for as long on the lower abdomen. as 12 weeks before being changed, though they are often removed For females, secure the much earlier. Some catheters, for catheter on the inner thigh. instance, are removed immediately after urine stops flowing. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Specimens for Culturing Should NOT be Cultured from Urine bags! Specimens should NOT be collected from the tap from the main collecting chamber of the catheter bag as colonization and multiplication of bacteria within the stagnant urine or around the drainage tap may have occurred. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Collecting a Sterile Urine Specimen DIAGNOSTIC TESTS Urine from a newly-inserted Urine for culture and sensitivity catheter – placed directly into - Clean catch specimen container provided in urinary catheter insertion kit. - Suprapubic aspiration - Catheterization Urine from catheter that is in place: Catheter tubing is clamped below A Positive Test the aspiration port so that urine - Bacteria colony count is more than collects in the tubing. 100,000/mL A sterile syringe is inserted into the aspiration port and used to - Proteinuria may also be present withdraw the urine specimen. indicating presence of bacteria 12  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN TYPES OF URINE COLLECTION: TYPES OF URINE COLLECTION: Suprapubic Aspiration Specimen Catheter Collection Specimen Suprapubic Aspiration Catheter Collection Specimen Specimen – This method – This assisted procedure is is used when a bedridden conducted when a patient is patient cannot be bedridden or cannot urinate catheterized or a sterile independently. The specimen is required. The healthcare provider inserts a urine specimen is Foley catheter into the collected by needle bladder through the urethra aspiration through the to collect the urine specimen. abdominal wall into the bladder. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN COLLECTION OF URINE SPECIMENS Functional Concept ® Improper collection – may invalidate the results. Potassium is primarily Containers for collection or excreted by the kidneys so urine should be wide hyperkalemia indicates poor renal excretion and is mouthed, clean, and dry. an indication for dialysis. Analyzed within 2 hours of collection, or else requires refrigeration. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN PERITONEAL DIALYSIS PERITONEAL DIALYSIS 13  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN PERITONEAL DIALYSIS CATHETERS for PERITONEAL DIALYSIS The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® HEMODIALYSIS Peritonitis, manifested by abdominal rigidity is a complication of peritoneal dialysis. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® An AV shunt is needed for a client undergoing hemodialysis until the AV fistula matures. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 14  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® A client with renal failure should be on a low protein diet Disequilibrium syndrome, to minimize metabolic waste products while a client on manifested by headache and hemodialysis should be on a vomiting is a complication of high protein diet to replace hemodialysis. protein loss during the procedure. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN LET’S COMPLICATIONS OF DIALYSIS Disequilibrium Dialysis Syndrome encephalopathy Cerebral edema resulting Syndrome observed in from urea removal from the chronic renal insufficiency blood clients on dialysis Restlessness Dementia Nausea & vomiting Asterixis Headache Hypertension Myoclonias Slurred speech Speech alterations PLEASE COPY Seizure Coma Convulsions 15  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Ray A. Gapuz’s FUNCTIONAL CONCEPTS Glucose in the urine of a on pregnant client is normal. DEVELOPMENTAL CONSIDERATIONS FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Frequent urination in Poor bladder control is expected on an elderly client. pediatric clients is normal. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Assessment Finding Could Indicate Ecchymoses in the flank Retroperitoneal area bleeding ASSESSMENT FINDINGS Severe colicky pain - flank Renal calculi - abdominal FOR GUT DISORDERS - groin Hematuria AGN Hypertension Periorbital edema copyright 2012 by R.A. Gapuz. 16  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN COMMON RISK CONDITION FACTOR ASSESSING FOR RISK WEARING SILK UNDERPANTS UTI FACTORS TO GUT HISTORY OF UTI HISTORY OF PID DISORDERS SORETHROAT AGN HISTORY OF AAA HYPERTENSION copyright 2012 by R.A. Gapuz. copyright 2012 by R.A. Gapuz. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN GUT DISORDERS VAGINITIS The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Specific cause of vaginitis (bacteria, candidiasis, trichomoniasis) No vaginal inflammation in bacterial vaginosis With vaginal inflammation in candidiasis and trichomoniasis Vaginitis is a general term used to describe inflammation or Thin, off-white discharge with fishy odor Thick cottage cheese discharge in candidiasis Thin yellow green malodorous frothy irritation of the vagina. discharge in trichomoniasis itching, irritation and discomfort FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 17  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Having uncontrolled diabetes Vaginitis can be related to and STI increase the risk of candidiasis, moniliasis, developing vaginitis. trichomoniasis and other irritants. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN VAGINITIS VAGINITIS Type Cause Clinical Type Diagnostic Test First-line Treatment Manifestation Bacterial Vaginosis Amsel Criteria Antibiotics: Metronidazole, Bacterial Vaginosis Gardnerella vaginalis Foul-smelling discharge Clindamycin Candidiasis Microscopic Examination Anti-fugal: Clotrimazole, Candidiasis Candida albicans Thick, white, cottage (Yeast Infection) using KOH Fluconazole (Yeast Infection) cheese-like discharge Trichomoniasis Wet Mount Microscopy, Metronidazole, Tinidazole Trichomoniasis Protozoan parasite Trichomonas Frothy, greenish-yellow Culture, NAAT vaginalis vaginal discharge Atrophic Vaginitis Thinning and inflammation of Vaginal dryness, burning, Atrophic Vaginitis Clinical Assessment Hormone Replacement vaginal walls due to hormonal itching Therapy (estrogen) changes (estrogren) Chemical Irritation Clinical Assessment Removal of irritant Chemical Irritation Irritants exposure (soaps, Inflammation, discomfort Symptomatic Relief (sitz detergent, perfume, spermicide) bath, cool compress) The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN VAGINITIS ENDOMETRIOSIS Malhotra, N. (2020). UNDERS TANDING VAGINITIS. Retrieved from https://www.facebook.com/2041713532798529/photos/a.2089394338030448/2315609225408957/?type= 3 18  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Related causes: Genetic factors, Dysfunction of immune system Hormonal factors, Inflammation and angiogenesis Tissue lining (endometrium) grows outside the uterus that will Endometriosis is the also shed blood. proliferation of uterine tissue The blood and tissue that have shed Formation of adhesion will stick organs outside the uterus are trapped within the body. and can close the fallopian tube The trapped endometrial flow will cause inflammation and pain. Other symptoms are irregular menstruation, blood in the urine and INFERTILITY FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® LET’S WATCH! Manifestations Pelvic pain before menstruation Infertility Diarrhea/Constipation Low back pain Irregular menstruation Blood in the urine FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® NURSING INTERVENTIONS The diagnostic examinations for Provide comfort by administering NSAIDS as endometriosis are ultrasound and prescribed, to relieve pain and cramps laparoscopy. The priority nursing Administer oral contraceptive pill (Progestine, Danazol) to relieve symptoms diagnosis is pain Prepare for possible surgery (laparotomy, hysterectomy) FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 19  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Prostatitis is the most PROSTATITIS common prostate problem in men under the age of 50. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Prostate Gland Inflammation Functional Concept ® -Acute Bacterial Prostatitis: Bacteria (E. coli) Diagnostic tests: Inflammatory Infiltration & Tissue Damage 1. Digital Rectal Examination (Inflammation as defense mechanism but can cause tissue damage within prostate) 2. Urinalysis Chronic Inflammation & Pelvic Pain (inflammation → neural pathway changes and sensitization of 3. Prostate-Specific Antigen Test pain receptors in pelvic area → chronic pain symptoms) 4. Transrectal Ultrasound Swollen, tender, painful prostate Pain in lower abdomen or pelvic region FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN DIGITAL RECTAL EXAM Functional Concept ® First-line treatment 1. Antibiotics 2. Alpha-blockers to relax prostate and bladder muscles 3. Pain medications No Author. (2008). Digital rectal exam. Retrieved from https://en.wikipedia.org/wiki/Rectal_examination#/media/File:Digital_rectal_exam_nci-vol-7136-300.jpg FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 20  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN LET’S WATCH! Functional Concept ® First-line treatment 1. Antibiotics 2. Alpha-blockers to relax prostate and bladder muscles 3. Pain medications FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® High fever + weak urine Acupuncture can be a stream indicates acute treatment for prostatitis. bacterial prostatitis. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Pain in the penis and scrotum of more than 3 Asymptomatic prostatitis = months indicate chronic inflammation of the prostate with no symptoms. prostatitis/chronic pelvic pain syndrome. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 21  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® FOCUS Prostatitis can lead to infertility, sepsis and death. BPH copyright 2012 by R.A. Gapuz. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® FOCUS Enlargement of the prostate gland resulting in the narrowing of the urethral opening copyright 2012 by R.A. Gapuz. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Specific causes: Testosterone converted to DHT Initial manifestation: Cellular change (overgrowth of glandular and stromal cells) Decreased urinary stream Nodular formation Inflammatory factors and immune response Other manifestations: Urethral compression (partial/complete blockage) Nocturia Incontinence nocturia, incontinence, dribbling, Dribbling urine retention, blood in the urine Urine retention Blood in the urine FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM 22  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® TURP Surgical management for BPH include: INSTRUMENT- RESECTOSCOPE- CAMERA WITH WIRE LOOP TO CUT AWAY AND REMOVE EXCESS PROSTATE Removed tissue will be flushed with special fluid TURP - transurethral resection of the prostate MONITOR SIGNS OF COMPLICATIONS TUIP - transurethral incision of the prostate Bleeding Urinary retention Infection or fluid overload TUMT - transurethral microwave thermotherapy- FOR PAIN: Acetaminophen/ NSAIDs microwave energy is applied through an electrode BLADDER IRRIGATION: CBI (HOURS TO DAYS) inserted in the urethra After TURP, blood clots can form in the bladder and urethra TUNA - transurethral needle ablation- needles are TRIPLE LUMEN CATHETER Inflation lumen: Used to inflate a balloon at the catheter's tip, securing it inside the inserted through a scope into the prostate. Radio bladder. waves pass through the needles heating and Irrigation lumen: Allows irrigation fluid (usually sterile saline) to flow into the bladder to destroying the prostrate. flush out clots or debris. Drainage lumen: Allows urine and irrigation fluid to drain out of the bladder. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM copyright 2012 by R.A. Gapuz. The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® LET’S WATCH! Post op management of TURP >Monitor signs and symptoms >Acetaminophen, NSAIDS >Bladder irrigation >Adequate hydration >Urinary catheter >Mobility >Dietary considerations A VIDEO ON BPH FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Prostatitis BPH Risk Factors UTI UTI BPH Prostatitis Rectal intercourse Urethral stricture Kidney stones Cancer of the prostate or bladder Dehydration Aging, Family history, DM, Pelvic trauma Obesity PNLE RN 23  21/01/2025 The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Prostatitis BPH Functional Concept ® TREATMENT 1. Alpha blockers – relax the 1. Warm sitz bath bladder tamsulosin (flomax), doxazosin High fever occurs in 2.Antibiotics 3. Anti inflammatory (Cardura) 2. 5- alpha reductase acute bacterial prostatitis agents 4. Alpha blockers inhibitors-shrink the and not in BPH. prostate: Finasteride 5. Avoid alcohol, (Proscar), Dutasteride caffeine, spicy foods (Avodart) and horse back riding 3. Tadalafil (Cialis) 4. Saw palmetto (no effect as per recent evidence) FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® FOCUS Weak urine stream occurs in both prostatitis and BPH. Cystitis Benjamin Michaels Limited. (2020). Retrieved from https://www.facebook.com/BM.Limited/photos/a.381785581954109/1917619898370662/?type=3 copyright 2012 by R.A. Gapuz. FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF THE RAY A. GAPUZ TEST PREP SYSTEM The Ray A. Gapuz Test Prep System for the PNLE RN The Ray A. Gapuz Test Prep System for the PNLE RN Functional Concept ® Functional Concept ® Inflammation in the urinary bladder Caused by ascending bacterial infection (E. coli) Diagnostic Test: Culture and Inflammatory Infiltration & Tissue Damage (Inflammation as defense mechanism but can cause tissue