1) Define/explain the acute glomerulonephritis. (Define acute glomerulonephritis).
In acute glomerulo nephritis inflammation of the glomerular capillaries in the kidney is called glomerulonephritis.
Acute glomerulonephritis is mainly caused by streptococcal bacteria.
seen due to
The most common symptoms of acute glomerulonephritis include swelling, increased blood pressure, and changes in urine output.
{Inflammation of the glomerular and its capillaries its called as a glomerulonephritis.}
2) Explain the etiology/ cause
of the glomerulonephritis.
Due to streptococcal infection.
Due to taking heavy doses of nonsteroidal anti-inflammatory drugs.
Due to bacterial, viral and parasitic infections.
3) Explain the clinical manifestation of the patient with the acute glomerulonephritis.
=> Hematuria (blood in urine).
=> Edema
=> Proteinuria (increased level of protein in urine).
=> Getting a fever,
=> feeling cold,
=> feeling weak,
=> loss of appetite,
=> feeling tired,
=>Nausea,
=> vomiting,
=> Generalized Facial,
=> Periorbital swelling,
=> headache.
4) Explain the diagnostic evaluation of the patient with the acute glomerulonephritis.
=> history taking and physical examination.
=> Urine Analysis.
=> 24 hour urine for protein and creatinine clearance outline the degree of renal function.
=>Assess the blood urea nitrogen level.
=>Needle biopsy of the kidney.
=> Antistreptolycin o titers.
=> Erythrocyte Sedimentation Rate Test.
=> Complete blood count.
=>KUB abdominal x rays.
=> Kidney scan.
5) Explain the management of the patient with the acute glomerulonephritis.
Medical management
Provide antihypertensive medicine to the patient.
Providing antibiotic medicine to the patient.
Providing corticosteroid medicine to the patient.
Administer diuretic medicine to the patient.
Providing corticosteroid medicine to the patient.
Providing an immunosuppressive agent to the patient.
6) Explain the nursing management of patients with the acute glomerulonephritis.
Advise patient to take salt and fluid restriction diet.
Instruct the patient to avoid fluid intake in excessive amounts.
To monitor patient’s vital signs.
Monitoring the patient’s intake output chart.
Advise the patient to take proper rest.
Monitor patient’s blood urea nitrogen, creatinine and blood pressure.
Properly monitor the patient’s fluid balance.
Advise the patient to take antihypertensive and diuretic medicine properly.
Advise patient to avoid high protein diet.
Advise the patient to take adequate amount of carbohydrates.
Advise the patient to restrict potassium and sodium intake.
Fully monitor the patient’s fluid balance care.
Monitor the patient for any signs and symptoms of heart failure.
If the patient has any type of infection, treat it immediately.
Monitoring the patient’s weight daily.
Advise the patient to take regular follow up
1) Explain/Define chronic glomerulonephritis. (Define chronic glomerulonephritis.)
Chronic glomerulonephritis is such a condition.
of glomeruli (kidney filtering unit).
Long term inflammation is seen.
Due to this, the kidney is damaged and the function of the kidney is impaired over time.
Chronic glomerulonephritis occurs due to repeated episodes of acute glomerulitis.
In chronic glomerulitis, kidney size is reduced and this leads to end-stage renal disease (ESRD).
2) Explain the etiology of the patient with chronic glomerulonephritis. (State the cause of chronic glomerulonephritis.)
Due to immune system disorders.
Not due to an autoimmune disorder.
Due to infection.
Due to chronic viral infection.
Due to hyper tension.
Because of diabetes.
Due to genetic factors.
Due to exposure to toxins.
Due to staphtococcal infection.
Due to bacterial, viral and parasitic infections.
3) Explain the clinical manifestation of the patient with chronic glomerulonephritis. (State the symptoms and signs of chronic glomerulonephritis.)
Proteinuria.
Hematuria.
Hyper tension.
In AD.
get tired
Weakness.
Decreased urine output.
Electrolyte imbalance.
Renal insufficiency.
Nosebleed.
Loss of weight and strength.
Irritability.
Nocturia.
headache.
Dizziness.
Digestive problem.
Occur in peripheral AD.
Anemia.
Cardio megali.
Distended neckline.
Congestive heart failure.
Crackling sound heard from lungs.
Tendon reflexes become demineralized.
Neurosensory changes.
4) Explain the diagnostic evaluation of the cronic glomerulonephritis. Write the diagnostic evaluation of chronic glomerulonephritis.
history taking and physical examination.
Creatinine test.
Blood urea nitrogen test (BUN).
Electrolyte test.
Complete blood count.
Urinalysis.
Ultrasound.
ct scan.
MRI.
Kidney biopsy.
Autoimmune infection test.
Renal function test.
24 hour urine test.
Blood pressure monitoring.
5) Explain the management of the patient with the chronic glomerulonephritis. (Write the management of a patient with chronic glomerulonephritis.)
Administer anti-hypertensive medication to the patient.
Provide immunosuppressive therapy to the patient.
Administer corticosteroid medication to the patient.
Administer diuretic medicine to the patient.
Monitor patient’s weight daily.
Advise the patient to avoid protein.
Advise the patient for adequate caloric intake.
Start dialysis to prevent any further complications.
Providing antibiotic medicine to the patient.
Anti-inflammation to the patient
Provide medicine.
Anticoagulant to the patient
Providing an agent.
Provide erythropoietin injection to the patient.
Regular monitoring of the patient’s condition.
Advise the patient to exercise regularly.
Advise the patient to have a balance diet, regular exercise, avoid smoking.
6) Explain the nursing management of patients with the cronic glomerulonephritis.
Provide comprehensive care and support to patients.
To monitor patient’s vital signs regularly.
Monitor the patient’s fluid intake output.
To properly monitor the nutritional status of the patient.
Advise patient to avoid sodium rich food.
Advise the patient for proper caloric intake.
Providing oral care to the patient.
Advise the patient to take proper rest.
Changing the position of the patient every two hours.
Properly administer medication to the patient.
Advising patients to take medication properly as per schedule.
To provide the patient with complete information about his disease condition, its causes, and its symptoms.
Properly managing the patient’s pain.
To reduce the patient’s pain
Provide analgesic medicine.
Advise the patient to maintain proper aseptic technique to prevent infection.
Monitor the patient’s blood urea nitrogen (BUN) regularly.
Properly monitor electrolyte levels of the patient.
Providing proper psychological support to the patient.
Advising the patient to do proper physical exercise.
Advise the patient to maintain proper good hygienic technique.
Administer proper immunosuppressive medicine to the patient.
Providing the patient with a properly implantable device.
Providing proper psychological support to the patient.
To provide a calm and comfortable environment to the patient.
Advising the patient to follow up properly.
1) Define/Explain urolithiasis. (Define urolithiasis.)
Urolithiasis involves the formation of urinary calculi (stones) and they are mainly located anywhere in the urinary system.
This stone is mainly a substance in urine
As the concentration of calcium and uric acid increases
Due to the formation of urolithiasis.
Stone formation in the urinary track occurs when
Urinary concentrations such as calcium oxalate,
Calcium phosphate, and uric acid levels
increases.
If stone formation occurs in the kidney, it (nephrolithiasis)
If stone formation occurs in the ureters, it is called (Ureterolithiasis).
And the formation of stones in the bladder
If it happens, it is (systolithiasis).
Urolithiasis varies in size from minute deposits called sand and gravel to large stones like orange stones.
Urolithiasis has a nucleus surrounded by a concentric layer of urinary salt deposits.
2) Explain the Etiology/cause of the urolithiasis.
Due to dehydration.
Due to hyperparathyroidism.
Due to obstructed urine flow.
Due to infection in the urinary track.
Due to renal tubular acidosis.
Because of cancer.
Due to granulomatous disease.
Due to intake of excessive amount of vitamin D.
Due to intake of excessive amount of milk.
Due to a genetic defect of cysteine metabolism.
Due to the use of certain types of medicine in excessive amounts.
Ex:=
~diuretic,
~Some chemotherapy medicine for cancer.
~Some medication used to treat HIV.
Due to chronic illness.
Due to cystic fibrosis.
due to renal tubular acidosis.
Due to inflammatory bowel disease.
Due to dietary factor.
Due to intake of salt and animal protein diet.
Due to excessive intake of certain minerals like calcium oxalate, uric acid etc.
Due to metabolic factors.
Due to genetic condition.
Due to some kind of medical condition.
Due to anatomical abnormalities.
Due to urinary stasis.
Because of obesity.
Due to inadequate fluid intake.
Having a family history of getting Idli Stone.
high protein,
Due to high sodium and high sugar diet.
Due to neurogenic bladder.
Due to pregnancy related changes.
Due to high amount of calcium in urine.
Obesity, diabetes, etc
Due to high blood pressure.
Due to inflammatory bowel disease.
Due to prolonged immobilization.
3) Explain the sign and symptoms/clinical manifestation of the urolithiasis.
Renal colic (sudden and severe pain at abdomen which should be radiating towards the groin area).
Camping pain in the lower back.
Hemenchuria.
Urinary frequency
and emergency.
dysuria (pain or discomfort during urination).
Cloudy and foul smelling urine.
to come up with a fever.
Feeling cold.
Painful urination.
Burning sensation during urination.
oligouria and anuria.
Pyuria (pus in urin).
Post renal azotemia.
Abdominal distension.
nausea and vomiting.
incontinence of urine emptying.
4) Explain the diagnostic evaluation of the patient with the urolithiasis.
history taking and physical examination.
Blood test.
Urine test.
Analysis of passed stones.
imaging test
x-rays.
ct scan.
MRI.
ultrasonography examination.
Retro Grade Pylography.
24 hour urine test.
A blood chemistry study.
5) Explain the medical management of the patient with the urolithiasis.
Providing analgesic medicine to relieve the patient’s pain.
Provide hot bath to the patient.
Advise the patient to intake fluids in moderate amounts.
Provide nutritional therapy to the patient.
If there is calcium stone, provide calcibin to the patient to increase absorption of calcium.
If the patient has oxalate stone, advise to avoid chocolate, tea, spinach.
Advise patient to restrict protein rich diet.
Intervenor fluids to maintain patient’s hydration status.
If the patient is vomiting then provide antiemetic medicine.
If the patient has severe pain, provide opioids analgesic medicine.
If the patient has colic pain, provide an anti-spasmodic agent.
Provide anti-inflammatory drug to the patient.
Provide calcium channel blocker medicine to the patient.
Provide antacid medicine to the patient.
1) Calcium stones:= To prevent formation of calcium
For the patient
Thiazide diuretic
And provide phosphate containing preparation.
Provide cellulose sodium phosphate to prevent calcium stones.
2) Uric acid stone := To prevent the occurrence of uric acid stone, provide allopurinol medicine which is used to reduce the level of uric acid in the blood.
3) Struvite stone : =
To prevent struvite stones from occurring, providing the patient with antibiotic medicine will keep the urine free of bacteria and prevent infection.
4) cystin stone:= Stone is difficult to treat, so by providing some kind of medication, urine is alkalized, due to which stone formation can be prevented.
6) Explain the surgical management of patients with urolithiasis. (Write surgical management of patient with urolithiasis.)
1) ureteroscopy (Ureteroscopy)
Ureteroscopy is primarily used when stone formation has occurred in the lower urinary tract.
In ureteroscopy, the stone is first visualized and then the stone is destroyed.
2) Extracorporeal shock wave lithotripsy
Extracorporeal shockwave lithotripsy is a procedure used primarily to remove stones smaller than half an inch that are lodged near the calyx of the kidney.
In this procedure, ultrasonic wave or shock wave is used to break the stone.
The stone is then removed from the body through urine.
3) percutaneous stone dissolution/chemolysis
In percutaneous stone dissolution, alkalizing agents and acidifying agents are infused and stones are dieselized.
4) Percutaneous Nephrolithotomy
Percutaneous nephrolithotomy is mainly used to remove large stones near the kidney.
In this procedure, the stone is removed by inserting an endoscope.
5) Cystolithotomy
In cystolithotomy, bladder calculi are mainly removed through a suprapubic incision, but this procedure is used only when the stone is not crushed and can be removed transurethrally.
6) Partial Total Nephrecromy (Partial Total Nephrectomy)
A tangential total nephrectomy is mainly performed when there is kidney damage and overwhelming renal infection.
7) Explain the Nursing management of patients with the renal calculi.
Nursing assessment
Complete health history and physical examination of the patient.
Obtaining information about the patient’s family history of tonsillitis.
Assess whether the patient has a condition of dehydration or not.
Assessing whether the patient has a urinary tract infection or not.
Assessing the patient’s pain level.
Assess whether the patient has any other symptoms like nausea, vomiting, abdominal distention, diarrhea or not.
Assess whether the patient has signs and symptoms of urinary tract infection such as urinary urgency and frequency, pyuria, fever, chills or not.
Assess whether the patient has the condition of oligouria, anuria or not.
Nursing interventions
1) controlling pain
=> Assessing the patient’s pain level.
=> Using opioid analgesic to relieve the patient’s pain.
=> Provide nonsteroidal anti-inflammatory medicine to the patient.
=> Advise to apply moist heat to relieve pain.
=> Provide allopurinol medicine to the patient to decrease the production of uric acid.
2) Maintaining urinary elimination.
=> Monitor the patient for any signs and symptoms of urinary obstruction.
=> Provide fluids orally and intravenously to the patient.
=> Monitoring intake output chart of patient.
3) control infection:=
=> Providing oral antibiotic medicine to the patient.
=> To monitor patient’s vital signs.
4) prevention of recurrent stone formation:=
=> Giving advice to avoid calcium and phosphorus in patient’s access account.
=> Advise patient to take low sodium diet.
=> Provide low protein diet to the patient.
=> Advising the patient to do urine pH testing.
=> Assess the patient for any signs and symptoms of urinary infection.
=> Advise the patient to avoid sugar and animal protein diet.
=> Provide adequate amount of fluid to the patient.
5) Improving knowledge:=
=> Advise patient to consume fluid in adequate amount.
=> Giving advice to avoid high purine rich food.
=> Advise the patient to avoid high oxalate foods.
=> Advising the patient to have limited intake of milk and dairy products.
=> Advising the patient to take modifying diet. Advise patients who have stone formation of calcium, oxalate, and uric acid to take late fasting diet.
1) Define/ Explain the renal calculi.
Renal calculi are also called kidney stones.
Kidney stones mainly form renal salts
Hard of salt and mineral
Deposits are made.
These stones are mainly different in size.
Renal stone, calculus, and lithiasis are the most common diseases of the urinary tract.
This is mainly seen in men more than women.
2) Explain the Etiology/cause of the renal calculi.
Due to dehydration.
Due to dietary factor.
Due to excessive amount of calcium, oxalate and uric acid.
Due to excessive intake of sodium and animal protein.
Due to genetic abnormality.
Due to metabolic disorder.
Due to urinary tract infection.
Due to certain types of medication.
Due to taking excessive amount of diuretic and antacid medicine.
Due to vitamin A deficiency.
Due to urinary infection.
Due to hyperparathyroidism.
low urine volume.
Due to less amount of fluid intake.
Due to high protein intake.
Due to high intake of sodium and low intake of calcium.
3) Explain the type of the renal calculus.
1) Primary stone
=> Primary stone is mainly found in healthy urinary tract even without any inflammation.
2) Secondary stone
=> Secondary stone is mainly seen due to inflammation in urinary tract.
4) Explain the clinical manifestation/ sign and symptoms of the Urinary calculi.
Severe pain.
Hemenchuria.
Increased urinary frequency and urgency.
Dysuria (pain and burning sensation during urination).
Nausea.
Vomiting.
Urine is coloudy and foul smelling.
Hydronephrosis.
Pyuria (pyuria).
Tenderness.
Muscle stiffness.
Abdominal distension.
Peristalsis moment to be deminized.
5) Explain the Diagnostic evaluation of the renal calculus.
history taking and physical examination.
Blood examination.
Urine Analysis.
Radiography
Straight X-ray
Excretory urogram
Ultrasonography.
Computed tomography.
Renal scan.
Cytoscopy.
Stone Analysis.
Blood urea nitrogen test.
Intravenous pyelogram.
Urography.
5) Explain the medical management of the renal calculi.
If the patient is in pain, provide nonsteroidal anti-inflammatory drug (NSAID) and analgesic medicine.
Advise on adequate fluid intake to maintain the patient’s hydration status.
Advising the patient to take the prescribed medicine in adequate amount.
Provide thiazide diuretic medicine to increase the patient’s urine flow.
Advise the patient for dietary modification.
Advise the patient to avoid oxalate rich food and purine rich food.
Advising the patient to make lifestyle modifications.
Treat patient with any other metabolic disorder immediately.
Advising the patient to avoid things like milk, cheese.
6) Explain the Nursing management of patients with the renal calculi.
Properly assess the patient.
To monitor patient’s vital sign properly.
Maintaining patient no intake output chart.
Assess the patient’s pain level.
If the patient is in pain, provide analgesic medicine.
Providing mind diversional therapy to the patient.
Provide a comfortable position to the patient.
Advise patient to intake adequate amount of fluid.
Monitoring the patient’s fluid balance.
Monitor the patient’s intake output chart.
Advise the patient for dietary modification.
Apply hot on the body part of the patient which is uncomfortable.
Provide emotional support and reassurance to the patient.
To provide medicine to the patient properly.
Collaborate with other health care personnel to effectively provide patient care.
Advising the patient to make lifestyle modifications.
Advising the patient to follow up properly.
Properly documenting the care provided to the patient.
To provide proper reassurance to the patient.
To clear all the doubts of the patient and his family members.
Advise the patient to follow up regularly.
1) Explain/ define trauma of genitourinary trauma (renal, bladder, urethra, and ureters.)
Trauma occurs primarily in the urinary system.
Injuries to the urinary system include the kidneys,
Affects bladder, ureters and urethra.
Due to blunt and penetrating injuries, kidney,
Trauma occurs in the ureters, urethra, and bladder.
2) Explain the Etiology/cause of the genitourinary trauma.
Due to road traffic accident.
Due to sports injuries.
Due to blunt force.
Due to pelvic fracture.
Due to injury to the urethra.
Due to a motor vehicle accident.
Due to sports injuries.
Due to fall down.
Due to some type of medical procedure.
Assault.
Due to occupational injury.
due to contusion.
Due to intraperitoneal rupture.
due to extraperitoneal rupture.
Due to some type of surgical procedure.
3) Explain the clinical manifestation/ sign and symptoms of the patient with the genitourinary system trauma.
Hemenchuria,
Abdominal pain,
Lower abdominal pain,
Difficulty in urinating.
Oligouria (secret less amount of urine).
Anuria (Absence of urine output).
Swelling.
Tenderness.
Retroperitoneal bleeding.
Difficulty in urinating.
Perineal pain.
Ecchymosis.
To see the symptoms of shock.
Hypotension.
Tachycardia.
tachypnea.
Pale skin.
Altered level of consciousness.
Nausea.
Vomiting.
Pyelonephritis.
4) Explain the diagnostic evaluation of the patient with the genitourinary system trauma.
history taking and physical examination.
complete hemogram to check the hemoglobin level.
Ultrasound.
CT scan.
Laboratory test.
Urine analysis.
Renal Arteriography.
Aspartate aminotransferase.
Intravenous pyelography.
kidney, ureters, bladder (KUB) test.
Cytogram.
5) Explain the management of the genitourinary system trauma.
Keeping patient’s airway, breathing and circulation properly patent.
If the patient is in pain, provide analgesic medicine.
To provide comfort measures to the patient.
Conducting investigations like ultrasound, X-ray CT scan etc. to assess whether the patient has any further injury or not.
To monitor patient’s vital signs properly.
Administration of blood transfusion to the patient.
Catheterization of the patient properly.
If the patient has an infection, provide broad spectrum antibiotic medicine.
Proper close observation and monitoring of the patient.
If the patient is in shock condition, administer intravenous fluid.
Patient no
Properly monitoring the intake – output chart.
Advising the patient to take proper bed rest.
Advising the patient to follow up regularly.
6) Explain the Nursing management of patients with the genitourinary system trauma.
Properly assess the patient.
To properly monitor patient’s vital signs.
Properly assess the patient’s pain level.
Properly evaluate the patient’s urinary output.
Assess the patient for any signs and symptoms of bleeding infection.
If the patient is in pain, provide analgesic medicine.
Monitoring the patient’s urinary output.
Catheterize the patient properly.
Monitor the patient’s fluid and electrolytes properly.
Provide intravenous fluid to the patient.
Provide a comfortable position to the patient.
Providing comfort devices to relieve the patient’s pain.
Assess the patient for any further injuries.
Advise the patient to maintain aseptic technique to prevent infection.
Provide proper emotional support to the patient.
Advising the patient to take properly nutritious food.
Advise patient to intake adequate amount of fluid.
Provide a comfortable position if the patient is in pain.
Advise the patient to have plenty of fluid intake.
To provide reinsurance to the patient and his family members.
1) Define/Explain ureteral stricture.
In urethral stricture, the urethral lumen (the urethral lumen is a structure that helps to bring urine from the kidney to the bladder) narrowing (narrowing of the urethral lumen) occurs, due to which functional obstruction is seen.
The most common cause of urethral stricture is the ureteropelvic junction.
2) Explain the etiology/cause of the ureteral stricture. (State the causes of urethral stricture.)
Due to trauma.
Due to infection.
Due to inflammation.
Due to medical procedures.
Due to congenital factor.
idiopathic.
Due to the formation of scar tissue.
Due to congenital defect.
Due to taking other treatment of urogenic condition.
Due to stone and tumor formation.
Because of pelvic radiation therapy.
Due to any gynecological procedure.
Due to any external traumatic injury.
3) Explain the classification of ureteral stricture. (State the classification of urethral stricture.)
There are six classifications of urethral stricture.
1) intrinsic (intrinsic),
2) Extrinsic,
3) benign
4) malignant
5) Iatrogenic,
6) Noniatrogenic.
1) intrinsic (intrinsic),
Intrinsic urethral stricture is caused by a problem in any urethra itself.
2) Extrinsic,
Extrinsic urethral stricture is a stricture due to any factor outside of the ureters.
3) benign,
Benign urethral stricture occurs due to non-cancerous causes such as inflammation, infection, scarring, congenital anomalies.
4) malignant
Malignant texture is seen due to cancerous growth.
5) Iatrogenic,
Iatrogenic strictures are seen unintentionally. Caused by any medical procedure or intervention.
6) Noniatrogenic.
Noniatrogenic urethral stricture occurs without the direct involvement of any medical procedure.
4) Explain the clinical manifestation/ sign and symptoms of the ureteral stricture.
Decrease in urine flow.
Urinary urgency.
Unilateral pain.
Urinary tract infection.
Hematuria
(blood in urine).
Hydronephrosis.
Swelling in the kidneys.
Impaired kidney function.
Bleeding in seamen.
Passing bloody and dark urine.
Decreased urine output.
Difficulty in urinating.
Discharge from the urethra.
Difficulty in urinating.
Bladder enlargement.
Urinary incontinence.
Painful urination.
Pain in lower abdomen.
Pelvic pain.
Slowing of urine stream.
Enlarged lymph nodes.
Analgesic and tender prostate gland.
Slowing of urine stream.
5) Explain the Diagnostic evaluation of the ureteral stricture.
history taking and physical examination.
ct scan.
MRI.
Direct visualization.
Intravenous pyelogram.
Renal ultrasound.
Bladder Examination.
Urine analysis.
Urine culture and sensitivity test.
serum electrolyte test.
Assess the blood urea nitrogen level.
Ureteroscopy.
Renal ultrasonography.
Retrograde pyelography.
6) Explain the medical management of the ureteral stricture.
Antibiotic medicine should be provided if the patient has a condition of infection.
Provide the patient with alpha blocker medicine to relax the muscles of the ureters.
If the patient is in pain, provide nonsteroidal anti-inflammatory medicine (NSAID).
7) Explain the surgical management of patients with the ureteral stricture.
1) Balloon Dilation
The most common initial management of benign urethral stricture is balloon dilation.
2) Endoureterotomy
In endoscopic surgery, strictures in the ureters are opened.
3) Ureteral Metal stents
Metal stents are mainly used in end-stage malignant diseases.
4) Transureterostomy (transureterostomy)
Transureterostomy is primarily a urinary reconstruction technique in which one ureter is joined to another.
8) Explain the Nursing management of patients with the ureteral stricture.
Proper assessment of the patient.
To properly monitor the patient’s vital signs.
Provide proper fluid to the patient.
If the patient is in pain, provide analgesic medicine.
Provide adequate fluid to maintain patient’s hydration status.
Antibiotic medicine should be provided if the patient has urinary tract infection.
Provide education to the patient about his disease, its causes and its symptoms and signs.
Provide proper psychological support to the patient.
Advising the patient for proper follow up care.
1) Explain/ Define the definition of neurogenic bladder. (Write the definition of neurogenic bladder.)
Neurogenic bladder is a type of neurogenic dysfunction.
Neurogenic bladder is a dysfunction mainly in the urinary bladder which is mainly seen due to central and peripheral nervous system problems.
Neurogenic bladder is primarily a normal nerve path
Due to the occurrence of imperment in
Urinary retention due to neurogenic bladder,
Incontinence of urine, urinary tract infection,
Conditions like stone formation, renal failure
arise.
2) Explain the type of neurogenic bladder.
1) flassid neurogenic bladder.
2) spastic neurogenic bladder (spastic neurogenic bladder.)
1) flassid neurogenic bladder.
Flaccid bladder is mainly seen due to motor neuron lesion and any trauma.
Due to the reduced sensation of bladder filling, the bladder does not fully concentrate the force and due to this the bladder becomes full.
And the bladder becomes distended causing urinary incontinence.
2) spastic neurogenic bladder (spastic neurogenic bladder.)
Spastic bladder mainly causes uncontrolled and frequent bladder expulsion of urine.
This is mainly due to brain damage and spinal cord damage.
Due to this, urine emptying is incomplete.
3) Explain the cause/Etiology of the neurogenic bladder
Neurogenic bladder occurs at any age.
Alzheimer’s disease.
Alcohol neuropathy.
stroke.
Miningomyosheel.
Aids.
Parkinson’s disease.
Brain or spinal cord tumor.
Diabetic neuropathy.
Spina bifida.
Multiple Sclerosis.
nerve damage.
Due to any diabetes or alcoholic disorder.
Injury to the spinal cord.
Due to nine damage.
Deficiency of vitamin B12.
4) Explain the clinical manifestation/sign and symptoms (describe the symptoms and signs of neurogenic bladder)
Excessive urine production.
Bladder over active.
Urinary incontinence.
Frequent urination.
Urinary retention.
Urinary frequency and urgency.
Problem in expelling entire urine out of the bladder.
Bladder becomes swollen and urine leaks due to this.
Bladder control is lost.
Sensation of bladder fullness is lost.
Pain and burning during urination.
Erectile Dysfunction.
Urinary tract infection.
5) Explain the diagnostic evaluation (Write the diagnostic evaluation of neurogenic bladder.)
history taking and physical examination
complete Neurological examination.
post void residual volume.
renal ultrasonography.
serum creatinine.
Cytography.
cytoscopy.
cytometrography.
urodynamic testing.
6) Explain the treatment (Explain the treatment of neurogenic bladder)
Provide medicine that relaxes the bladder.
Urinary tract infection and control.
Ask to intake a lot of water due to which urinary tract infections are reduced.
Ambulate the patient frequently.
Changing the patient’s position frequently.
Instruct the patient to take low doses of calcium.
Changing the patient’s position frequently.
7) Explain specific treatment
1) physical-psychological therapy.
2) Bladder evacuation.
3) electrical stimulatory therapy.
explain surgery
1) Transurethral resection of the bladder neck.
2) Urethral dilatation.
3) External sphincterotomy.
4) Urinary diversional procedure.
5) implantation of artificial sphincter.
6) Urethral stent.
8) Explain the nursing management of neurogenic bladder.
Monitor residual urine.
Monitor for signs and symptoms of any renal calculi.
Assess for urinary stasis.
To see if there is any sign of urinary tract infection and simple or not in urine color, its order, volume, frequency, urgencies.
Checking the patient’s intake output.
Administer vitamin C to the patient to prevent acidic urine and bacterial growth.
Assess patient’s voiding pattern.
Ask the patient to do kiggle exercises.
To provide different methods to empty the patient’s bladder like crede’s method, valsalva’s maneuver etc.
Use aseptic technique and sterile method while catheterizing the patient.
Prescribing drugs to maintain the saint in continence.
Ask the patient to take regular follow up.
Monitor the patient’s urine intake output chart.
Assess the patient for any signs and symptoms of urinary tract infection.
Provide vitamin C rich diet to the patient.
Provide education to the patient to perform Kegel exercises.
Advise the patient to maintain personal hygiene.
Assess the patient for any signs and symptoms of urinary incontinence.
Advising the patient to take medication regularly.
1) Define / Explain renal cyst.
A renal cyst is a fluid-filled sac that forms in the kidney.
These cysts are non-cancerous and come in different sizes.
If there is a single cyst, it occurs on the surface of the kidney, but when multiple cysts form, it affects one or both kidneys.
2) Explain the Etiology/cause of the renal cyst.
Due to age related changes.
Due to genetic factor
Due to acquired cystic kidney disease.
Due to obstruction of tubules.
Due to vascular factor.
Due to inflammatory conditions.
Due to kidney layer week.
3) Explain the clinical manifestation/sign and symptoms of the patient with the renal cyst.
Abdominal pain.
feel cold
Fever.
Impaired renal function.
Hemenchuria.
flank pain.
Urinary tract infection.
High blood pressure.
A palpable mass-like structure filling.
4) Explain the diagnostic evaluation of the patient with the renal cyst.
history taking and physical examination.
Ultrasound.
ct scan.
MRI.
Kidney function test.
Laboratory test.
5) Explain the medical management of the patient with the renal cyst.
Surgery to remove the cyst.
Sclerotherapy to block blood flow to the cyst.
If the patient is in pain, provide analgesic medicine.
If the patient has any infectious condition, then proceed with antibiotic medicine.
If the patient has a condition of hypertension, lifestyle modification should be done.
Providing genetic counseling to patients.
6) Explain the nursing management of patients with renal cyst. (State the nursing management of a patient with renal schist.)
To properly inform the patient about his disease condition.
Assess the patient for any pain infection and any other signs and symptoms.
If the patient is in pain, provide analgesic medicine.
Providing Mind Diversional Therapy to the patient.
To monitor patient’s vital signs regularly.
Advise patient to intake adequate amount of fluid.
Collaborate with other health care personnel for patient treatment.
Provide psychological support to patients.
Advising the patient to make his life style modification.
Advise the patient to avoid hot and spicy food.
Advise the patient to take a low protein diet to prevent the growth of schists.
Advise patient to limit salt intake.
Advising the patient to take regular follow up.
Advising the patient to take medicine regularly and consult a doctor.
1) Explain/ define Renal Abscess.
Renal abscess is a condition in which pus formation occurs in localized kidney tissues.
A renal abscess is primarily a kidney infection
is a complication of
Pus develops in the renal tissue and subsequently forms an abscess.
2) Explain the Etiology/ cause of the renal Abscess.
Due to urinary tract infection.
Due to hematogenous spread.
Due to urinary tract obstruction.
Due to structural abnormality.
Due to kidney infection.
Due to being immunocompromised.
Due to impaired immunity of diabetic patient.
In pregnant women.
In individuals who have chronic kidney disease.
In elderly peoples.
3) Explain the clinical manifestation/sign and symptoms of the patient with the renal abscess.
Body temperature increases.
Abdominal pain.
Loss of appetite.
Pain while passing urine.
Hematuria.
Hypotension.
Getting a fever.
Feeling cold.
Abdominal pain.
Frequent urination.
Nausea.
Vomiting.
Generalized malaise.
feeling tired
Hypo tension.
Pale skin.
Tachycardia.
4) Explain the diagnostic evaluation of the patient with the renal abscess.
history taking and physical examination.
ct scan.
MRI.
Urine Examination.
Blood investigation.
Urine culture.
Blood culture.
Complete blood count test.
5) Explain the medical management of the patient with the renal abscess.
Antibiotic medicine should be provided if the patient has any infectious condition.
If the abscess is not treated with antibiotics, perform a drainage procedure.
If the patient is in pain, provide analgesic medicine.
Maintain patient’s fluid and electrolyte balance.
Provide antipyretic medicine to patient for management of fever.
Advise the patient to take regular follow up.
6) Explain the nursing management of patients with the renal abscess.
Antipyretic medicine should be administered if the patient has a febrile condition.
If the patient is in pain, provide analgesic medicine to relieve it.
Monitoring the patient’s intake output chart.
Advise the patient to maintain aseptic technique.
Advise the patient to take adequate fluids.
1) Explain / Define Nephrotic syndrome.
Nephrotic syndrome is a combination of two words.
1) Nephron Meaning kidney.
2) syndrome denoting group of symptoms (syndrome meaning group of symptoms).
Nephrotic symptoms are a collection of symptoms that are primarily due to damage to the glomeruli in the kidney.
Four symptoms are mainly seen in nephrotic syndrome.
1) Excretion of high level of protein in urine from the body (proteinuria).
2) Decrease in the amount of protein in the blood (hypoalbuminemia).
3) Increasing the amount of lipids in the blood (hyperlipidemia).
4) Swelling in the body part (called edema).
These four main symptoms are seen in nephrotic syndrome.
Nephrotic syndrome affects people of all ages.
It is more common in children mainly between two to six years of age.
2) Explain the etiology/cause of the nephrotic syndrome. (State the cause of nephrotic syndrome.)
Due to damage of small blood vessels of kidney.
Due to certain disease conditions.
Mainly more seen in children.
Due to abnormal kidney function.
Due to diabetic kidney disease.
Due to some type of infection.
Because of the medication.
Focal segmental glomerulosclerosis (FSGS).
Scattered scarring of glomeruli.
Membranous nephropathy.
Due to heart failure.
Due to some type of infection like Hepatitis B, Hepatitis C, Malaria etc.
3) Explain the clinical manifestation / sign and symptoms of the patient with the nephrotic syndrome. (State the symptoms and signs of a patient with nephrotic syndrome)
Swelling.
Swelling is mainly seen on the lining of the eye socket and around the eye.
Swelling is mainly seen in feet and ankles due to prolonged sitting or standing.
Sometimes swelling is also seen in the whole body which is called Anasarka.
Oliguria (decreased urine output).
Weight gain.
Hematuria (blood in urine)
Respiratory distress.
Blood pressure increases.
Kidney failure.
Cholesterol level increases in the body.
feeling tired
Getting infected immediately.
Loss of appetite.
feeling tired
4) Explain the diagnostic evaluation of the patient with the nephrotic syndrome. Write the diagnostic evaluation of the patient with the nephrotic syndrome.
History taking and physical examination.
Urine test.
Blood test.
Kidney biopsy.
Blood pressure monitoring.
Blood chemistry.
An imaging study.
Ultrasound.
C-T scan.
5) Explain the medical management of the patient with the nephrotic syndrome.
Administer corticosteroids to patients to treat inflammatory conditions.
Providing immunosuppressive medicine to the patient.
Provide diuretic medicine to the patient.
Provide antihypertensive medicine to the patient.
Provide ACE inhibitor medicine to the patient.
To provide medicine of statin group to decrease the cholesterol level of the patient.
Advise the patient to restrict salt.
Advise the patient to reduce fluid intake.
Provide anticoagulant medicine to the patient.
6) Explain the nursing management of patients with the nephrotic syndrome. (State nursing management of patient with nephrotic syndrome)
Properly assess the patient.
To monitor patient’s vital sign.
Monitoring the patient’s fluid balance.
Monitor the patient’s weight regularly.
Monitor the patient’s intake output chart.
Elevate the extremities if the patient has a condition of edema.
If patient has condition of edema, compression stockings and fluid level monitoring.
To continuously maintain the nutritional status of the patient.
Advise the patient to avoid protein, salt.
Provide proper meditation to the patient.
Provide complete information to the patient about his disease condition, its causes, symptoms and signs and diagnostic evaluation.
Advise the patient to maintain personal hygiene to prevent infection.
Provide emotional support to the patient.
Collaborate with other health care personnel for proper patient care.
To provide complete education to the patient’s family members.
The patient and his family members need to clear the doubts.
1) Explain/Define Renal failure. (Define renal failure)
Renal failure is also known as kidney failure.
Renal failure is a condition in which the kidneys lose their ability to filter and remove waste products from the body.
Due to this condition, toxic material accumulates in the body and electrolyte imbalance occurs in the body.
Renal failure is a condition in which adequate kidney function fails.
There are two types of renal failure.
1) Acute Renal failure (Acute Renal Failure)
2) chronic renal failure
1) Define/ Explain the Acute Renal failure.
Acute renal failure is also known as acute kidney injury (AKI). In which kidney function declines suddenly and rapidly.
Acute kidney failure is a condition in which the functional ability of the kidney is suddenly impaired due to which the kidney cannot perform proper filtration and maintain electrolyte balance and fluid balance in the body.
Acute kidney failure occurs within 7 to 90 days.
Mainly in acute kidney failure
Decreased glomerular filtration rate,
The concentration of blood urea nitrogen increases, the amount of creatinine increases,
Urine output is less than 400ml throughout the day.
A condition of hyperkalemia arises and
Retention of sodium is seen in the body.
2) Explain the Etiology/cause of the Acute Renal failure.
1) pre renal cause
Due to impaired blood supply to kidney.
Due to dehydration.
Diarrhea.
Vomiting.
Hemorrhage.
burn.
Due to excessive use of diuretic medicine.
Due to decreased cardiac output.
due to congestive heart failure.
Due to cardiogenic shock.
due to acute pulmonary embolism.
Due to constriction of the blood vessels supplying blood to the kidney.
Due to dilation of the blood vessels supplying blood to the kidney.
2) Intrarenal
Intrarenal failure is mainly due to structural damage in glomeruli, kidney tubules, nephrons.
due to prolonged renal ischemia.
Blood clots, due to deposits of cholesterol around the veins and arteries.
Due to infection.
Due to hemolytic uremic syndrome.
Due to severe transfusion reaction.
Due to exposure to any nephrotoxic agent.
Like:=
NSAID Drug,
ACE inhibitors,
aminoglycoside lupus,
multiple myeloma,
3) Postrenal
Due to obstructed urine flow.
Due to enlargement of the prostate gland.
Being a kidney stone.
Being a cancer of the urinary tract organ.
Due to certain types of medication.
Being a bladder stone.
Due to enlargement of prostate gland.
Being bladder cancer.
Due to the occurrence of neurological disorders.
3) Explain the risk factor of the acute renal failure.
Due to advanced age.
Due to blood vessel blockage.
Due to diabetes.
Due to high blood pressure.
Due to kidney disease.
Due to heart failure.
Due to liver disease.
4) Explain the clinical manifestation/ sign and symptoms of the patient with the acute renal failure.
Oligouria (decreased urine output),
Anuria (no urine output),
Fluid retention occurs.
To be in ED.
Electrolyte imbalance.
Muscle weakness.
Uremic symptoms.
Hyper tension.
Bruising and bleeding.
Respiratory distress.
Neurological symptoms.
Cardiovascular complications.
Pesnut feels critically ill and lethargic.
Passing dark colored urine.
foamy or bubbly urine.
Dry skin and mucus membrane.
Azotimia.
Rapid heart rate.
Flank pain.
Shortness of breath.
Metabolic acidosis occurs.
Anemia and platelet dysfunction.
Increased susceptibility to secondary infection.
Generalize Malay.
feel tired
Cardiac problem.
Increased susceptibility to secondary infections.
Fluid and electrolyte imbalance.
Fluid overload.
Hyperkalemia.
Hyponatremia.
Hypocalcemia.
Hypermagnesemia.
Loss of appetite.
Nausea.
Vomiting.
Diarrhea.
Constipation.
Mucus membrane drying.
Metallic test coming from the mouth.
Abdominal pain.
headache.
falling asleep
Irritability.
Confusion.
Peripheral neuropathy.
to be startled
Coma.
5) Explain the diagnostic evaluation of the patient with acute renal failure. (Write the diagnostic evolution of the patient with acute renal failure)
history taking and physical examination.
Blood test.
Potassium test.
Electrolyte test.
Urine test.
ECG.
Kidney biopsy.
Imaging test.
Kidney biopsy.
6) Explain the medical management of the patient with the renal failure.
Identifying the specific cause of a patient with renal failure.
Assessing whether the patient has a urinary tract infection or not.
Assess the patient’s fluid level.
Provide proper diuretic medicine to the patient.
Monitor the patient’s electrolyte levels.
Dialysis if patient has severe renal failure.
Provide proper medicine to the patient.
Provide nutritional support to the patient.
Provide antihypertensive medicine to the patient.
Provide medication to patient to control anemia.
Continuously monitor the patient’s renal function.
Continuously monitor patient’s electrolyte level.
Advising the patient for lifestyle modification.
7) Explain the nursing management of patients with acute renal failure.
Properly assess the patient.
To properly monitor patient’s vital signs.
Properly monitor the patient’s fluid balance.
Properly monitoring the patient’s intake output chart.
Monitor patient’s blood urea nitrogen level.
Assess the patient for any signs and symptoms of fluid overload.
Collaborating with health care members.
Monitor the patient’s electrolyte levels.
Provide proper medication to the patient.
Provide antihypertensive medicine to the patient.
Provide proper nutritional support to the patient.
Advise the patient on fluid restriction.
To provide proper dialysis care to the patient.
Provide proper skin care to the patient.
Properly monitor the patient’s skin integrity.
Advise the patient to do dietary restriction.
Provide psychological support to patients.
Advise the patient to maintain proper hygienic condition.
Proper collaboration of the patient with the health care member.
Monitor the patient’s intake output chart.
Monitor the patient’s weight daily.
Properly monitor the patient’s blood pressure.
Monitor the patient’s blood urea nitrogen level, creatinine and electrolyte levels.
Monitoring the nutritional status of the patient.
High calorie to the patient,
Provide low protein, low sodium, low potassium diet and vitamin supplementation.
Provide food to the patient in small and frequent amounts.
Advise patient to maintain streak aseptic technique.
To provide good oral care to the patient.
Properly monitor the patient’s heart activity.
1) Explain/ define the chronic renal failure. (Define chronic renal failure)
Chronic renal failure is also known as chronic kidney disease (CKD).
Kidney function in chronic kidney failure is rapidly
and progressively deterioration occurs
This causes electrolyte imbalance and fluid imbalance
It causes conditions like uremia and azotemia
Arises in some months and years.
Chronic renal failure results in slow, insidious, and irreversible impairment of renal excretory and regulatory function.
The final stage of chronic kidney disease is called end-stage renal disease (ESRD).
Chronic kidney disease is a condition in which the kidneys gradually become unable to filter the waste products and fluids in the body, thus toxin substances accumulate in the body.
This condition is mainly due to different reasons like diabetes, hypertension, glomerulonephritis, polycystic kidney disease etc.
2) Explain the etiology/cause of the chronic renal failure. (Give reasons for chronic renal failure)
Due to diabetes mellitus.
Due to hyper tension.
Having a family history of kidney disease.
due to frequent episodes of acute renal failure.
Long-term infections such as chronic pyelonephritis
Due to infections like nephritis and tuberculosis.
Due to an autoimmune disorder.
Due to polycystic kidney disease.
due to nephrotoxic agents.
Due to certain chemicals.
Due to reflux nephropathy.
Due to any injury or trauma.
Due to kidney stone and infection.
3) Explain the clinical manifestation / sign and symptoms of the patient with the chronic kidney disease. (State the symptoms and signs of chronic kidney disease)
feeling tired
Weakness.
Fluid retention.
Being in ED.
Changes in urination.
Urinary frequency increases.
Hypertension.
Electrolyte imbalance.
Anemia.
Bone pain.
Fracture.
Mineral imbalance.
Itching (pruritus).
Difficulty breathing.
Neuropathy.
Numbness.
tingling.
Weakness.
Nausea.
Vomiting.
loss of appetite.
Weight loss.
Cognitive impairment.
Personality changes.
Confusion.
Inability to concentrate.
Disorientation.
A flapping hand.
Restlessness.
Burning sensation in feet.
Chest pain.
Hyper lipidemia.
Hyperkalemia.
4) Explain the diagnostic evaluation of the patient with the chronic kidney disease. (State the diagnostic evaluation of a patient with chronic kidney disease)
history taking and physical examination.
Blood test.
Serum creatinine test.
Blood urea nitrogen test.
Urine test.
Albumin to creatinine ratio.
An imaging study.
Ultrasound.
ct scan.
MRI.
Kidney biopsy.
Glomerular filtration rate.
Assess the electrolyte level.
Assay the hemoglobin level.
Assess the hematocrit level.
Blood pressure monitoring.
5) Explain the medical management of the patient with the chronic kidney disease. (State the medical management of patients with chronic kidney disease)
If the patient has a condition of high blood pressure, provide anti-hypertensive medicine.
If the patient has a diabetic condition, provide antidiabetic medicine.
Provide A.C.E inhibitor medication to the patient.
Providing medicine of statin group to reduce the patient’s blood cholesterol.
Provide iron supplementation to the patient for treatment of anemia.
Provide phosphate binder medicine if patient has hyperphosphatemia condition.
Provide calcium and vitamin D supplements to the patient.
Provide diuretic medication to prevent patient from fluid retention.
Providing properly nutritious food to the patient.
Monitoring the patient properly.
Advising the patient to modify his life style.
Advise the patient to quit smoking.
Advise patients to monitor healthy weight.
Advise the patient to exercise regularly.
Advise the patient to limit alcohol.
To properly refer patients to specialized care.
To provide proper care to the patient to avoid any other complications.
6) Explain the nursing management of patients with chronic kidney disease. State the nursing management of a patient with chronic kidney disease.
Properly assess the patient.
To properly monitor the patient’s vital signs.
Properly monitoring the patient’s fluid balance.
Assessing whether the patient has any other complications.
Providing the prescribed medicine to the patient.
Monitor patient’s fluid and electrolyte levels.
Proper nutritional counseling of the patient.
Properly monitor patient’s hemoglobin level.
Properly monitor the patient’s blood pressure.
Providing proper education to the patient.
Assessing the patient for any other presenting symptoms.
Provide proper psychological support to the patient.
Advising the patient to make lifestyle modifications to prevent other complications.
Collaborating with other health care personnel for proper patient care.
To provide proper psychological support to the patient and his family members.
1) Explain/Define the Dialysis. Avoid dialysis.
Dialysis is a medical procedure.
Dialysis is performed when kidney function is impaired.
Dialysis is mainly done when the kidney is not able to perform its function and therefore is not able to remove the toxic substances from the body, to filter the blood, remove the toxic substances and fluids from the body and maintain the electrolyte balance. Dialysis is done to
Dialysis is a procedure in which fluid and molecules are transferred from one compartment to another through a semipermeable membrane.
2) Explain the Goal of the Dialysis. State the goal of dialysis.
To remove end products of protein metabolism such as urea creatinine from the body.
To maintain safe concentrations of serum electrolytes.
To correct acidosis.
To remove excess fluid in the body.
To prevent the accumulated toxin substance in the body.
3) Explain the indication of the Dialysis. State the indications of dialysis.
In patients who have irreversible kidney disease.
To control uremia.
In individuals with impaired kidney function.
In individuals with end-stage renal disease (ESRD).
In the condition of acute renal failure.
In the condition of chronic renal failure.
4) Explain the three principles of the Dialysis. Describe the principles of dialysis.
There are three main principles of dialysis.
1) Diffusion,
2) Osmosis,
3) Ultrafiltration
1) Diffusion,
In diffusion, the solvent is semipermeable
High concentration in the membrane results in low transfer.
2) Osmosis,
In the procedure, the solute moves from a lesser concentration to a greater concentration.
In this procedure mainly excess water is removed from the blood.
3) Ultrafiltration
In ultra filtration process water moves from high pressure to low pressure.
Ultrafiltration is mainly performed by applying negative pressure across the dialysis membrane.
This process is mainly efficient in removing water from the body.
Dialysis is mainly of two types.
1) Peritoneal Dialysis (Peritoneal Dialysis)
2) Hemodialysis (Hemodialysis).
1) Explain/Define the Hemodialysis. Describe hemodialysis.
Hemodialysis removes waste, toxic materials and extra fluid from the body and balances electrolytes (sodium, potassium bicarbonate, chloride, calcium, magnesium and phosphate).
Hemodialysis is a medical procedure in which the blood of a person with kidney failure is filtered and toxic materials and waste products are removed.
Hemodialysis is a procedure in which blood is continuously removed from the body and passed through an artificial kidney for cleaning.
A dialysis machine pumps the blood through the dialyzer.
The cleaned blood is then returned to the patient’s body.
Hemodialysis is the removal of extra fluid and waste products in the blood by continuously moving the blood through the filter.
This filter is known as dialyzer or artificial kidney.
In the average person
Contains 10 to 12 pints of blood.
During dialysis, only one pint of blood is passed through the dialyzer.
2) Explain/Define the Dialyzer. Weave the dialyzer.
Dialyzer is known as the key of hemodialysis.
A dialyzer acts as a man made membrane and an artificial kidney.
The dialyzer consists of a semipermeable hollow fiber membrane that contains thousands of tiny cellophane tubules that work as a semipermeable membrane made of cellulose and other synthetic materials.
There are two sections in the dialyzer.
One section which is for dialysate and another section which is for blood and they are divided from each other by semipermeable membrane due to which they can be prevented from mixing with each other.
A semipermeable membrane has microscopic holes that allow only certain substances to cross.
The toxic substances in the blood are removed by this dialyzer.
Only water, waste products such as urea, potassium and extra fluid pass through the semipermeable membrane in the dialyzer, but blood cells and proteins do not pass through it because they are bigger than the holes in the semipermeable membrane.
3) Explain the Dialysate. Describe the dialysate.
Dialysate is called dialysis fluid, dialysis solution, or bath.
A dialysate solution is composed of pure water, electrolytes, and salts such as bicarbonate and sodium.
The purpose of dialysate is mainly to remove the toxin substances in the blood and pull them into the dialysate.
Toxic materials present in the blood are removed by the diffusion process in the dialysate.
4) Explain the vascular access. Describe vascular access.
An important step before starting dialysis is to prepare the vascular access.
Access is mainly done to remove the blood in which toxic material is present from the body by circulating it through the dialysis machine and returning the removed toxic material back to the body through access.
After access, the access heals, then two needles are connected to the tubing and inserted into the access, from which the toxic blood in the body is removed through one needle and that blood enters the dialysis machine and is filtered, after which the filtered Blood is returned to the body through another niddle.
Formation of vascular access is done weeks or months before starting dialysis.
There are three types of access formation in hemodialysis.
1) AV FISTULA (Atriovenous fistula),
2) AV GRAFT (Arteriovenous Graft),
3) Central venous catheter (central venous catheter).
•••>
1) AV FISTULA (Atriovenous fistula),
Atriovenous fistula is the preferred type for vascular access.
This is a type of surgical procedure that is mainly used to make a connection between an artery and a vein.
•> In this atrio venustula the connection is made mainly between the site of artery to the site of vein.
Or
•> A connection is made between the site of the artery and the end of the vein.
Or
•> A connection is made between the end of the artery and the site of the vein.
Or
•> And a connection is made between the end of the battery and the end of the vein.
Atrio-Venous fistula is mainly performed in upper arm and lower arm.
It takes four to six weeks for this fistula to mature.
Atriovenous fistula is the best access for dialysis because it has a low rate of complications and a long duration.
2) AV GRAFT (Arteriovenous Graft),
Often the vein in the patient’s arm is not suitable for creating a fistula.
In such cases the surgeon mainly uses a flexible rubber tube to create a path between the artery and the vein called a synthetic bridge graft.
This graft is primarily a surgical anastomosis between an artery (brachial) and a vein (antecubital).
This graft is mainly done in forearm, upperarm and thigh.
An atriovenous graft matures faster than an atriovenous fistula. But the atriovenous graft is artificial, narrow and more infected.
3) Central venous catheter (Central venous catheter).
Central venous catheters are mainly used when dialysis is needed immediately and when patients with atrio-venous fistula and atrio-venous grafts are not in use.
A flexible tube through a central venous catheter is placed into a large vein for dialysis.
5) Explain the Hemodialysis procedure. Describe the procedure of hemodialysis.
To check the patient’s vital signs when he is admitted for dialysis.
Assess the patient’s weight.
Instilling the patient with anticoagulant medicine heparin in small doses between dialysis procedures to prevent blood clotting and shut obstruction.
The patient is then “put on the machine”.
Inserting two needles through a patient who has formed a vascular access, one needle that draws blood from the body and another needle that helps to re-enter the body.
A dialyzer consists of two compartments that are separated by a semipermeable membrane.
Blood mainly flows from the blood compartment in one direction.200-500ml/min.
and dialysate flows in the opposite direction from the dialysate compartment.300-900ml/min.
A dialysis session takes 2 to 6 hours.
Continuously monitor the patient’s heart rate, blood pressure, and respiration in this dialysis session.
Blood samples are collected before the dialysis procedure and after the procedure to assess the changes in it.
People who require dialysis require dialysis three times a week and one dialysis takes 3 to 5 hours to complete. During dialysis, the patient replaces the hormone that the kidney is unable to produce with medication. Is performed.
6) Explain the carrying for excess. Explain about care of access.
Access care is important to prevent complications.
Wash the area where access is formed daily with soap and water and wash it properly even before dialysis.
Do not scratch the accessed area.
Assess the patient for signs and symptoms of any infection at the accessed site.
Checking for proper blood flow to the accessed area.
Vibrating on the access side If absent, immediately notify the health care provider.
Take proper care that no trespassing occurs on the accessed premises.
Do not wear any type of title cloth, jewelry and do not lift any heavy items.
Do not provide blood sample, blood pressure measurement, and any type of injection from the arm on which access is formed.
While removing the needle inserted at the access site, apply gentle pressure over the needle site briefly to stop bleeding.
If bleeding at the access site does not stop within 30 minutes, inform the health care provider immediately.
6) Explain the complications of the Hemodialysis.
get infected,
Aneurysm,
stenosis,
blood loss,
heart failure,
Chest pain.
7) Explain the Risk of Hemodialysis. State the risks of hemodialysis.
anemia,
Nozia,
infection,
infectious diseases,
Vomiting.
8) Explain the Nursing interventions of the patient with the Hemodialysis. State the nursing management of a patient on hemodialysis.
Properly assess the patient.
Assess patient’s vital signs regularly.
Properly assess the patient’s fluid status.
Proper weight monitoring of patient before and after dialysis.
Properly assessing the access site to assess whether any infection is present or not.
Properly monitoring the patient’s fluid intake can prevent fluid overload.
Weigh the patient daily so that fluid can be provided properly.
Providing the prescribed medication to the patient.
To monitor the patient for any side effect of the drug or not.
Advise to maintain proper hygiene to prevent access site from any infection.
Do not advise the patient or perform any heavy procedure from the access site side.
Advise patient to control diet containing potassium, phosphorus and sodium.
Provide proper psychological support to the patient.
Continuously monitor patient’s laboratory values like serum creatinine, electrolyte, hemoglobin level.
Advise patients to maintain proper hygienic conditions to prevent infection.
Collaborate appropriately with other health care personnel to provide proper patient care.
While doing dialysis, keep emergency medication and treatment ready so that care can be provided immediately to the patient in case of an emergency situation during dialysis.
Advising the patient to take regular medication and follow up.
1) Explain the peritoneal dialysis. Describe peritoneal dialysis.
Peritoneal dialysis is a form of dialysis.
In peritoneal dialysis, a special fluid called dialysate is infused into the peritoneal cavity. A peritoneal cavity is a container around which arteries and veins are located, allowing blood flow and excess waste products to be removed from the peritoneal cavity.
In peritoneal dialysis, the peritoneal cavity acts as a semipermeable membrane and helps remove waste material from the body.
In peritoneal dialysis, the dialysate solution is instilled into the peritoneal cavity.
{ Dwell time := The period for which the cleansing solution (Dialysate) entered in the peritoneal cavity remains in the peritoneal cavity is known as dwell time.}
In peritoneal dialysis, the dialysate solution is repeatedly instilled into the CVD and then excess waste products and toxic substances in the body are removed.
Dwell time of dialysate solution is 30 to 40 minutes.
Maximum exchange takes place in the first 5 minutes.
Equilibrium between blood and dialysate solution occurs within 15 to 30 minutes.
Peritoneal dialysis is primarily used to remove toxic substances and metabolic waste products from the body and reestablish normal fluid and electrolyte balance.
2) Explain the types of peritoneal dialysis. State the types of peritoneal dialysis.
1) CAPD (Continuous Ambulatory Peritoneal Dialysis),
2) APD (Automated Peritonial Dialysis)
•••>
1) CAPD (Continuous Ambulatory Peritoneal Dialysis),
This type of peritoneal dialysis does not require any machinery.
This type of dialysis is mainly done by the patient and the caregiver.
In continuous ambulatory peritoneal dialysis, 1.5 to 3.0 liters of dialysate is instilled daily into the abdominal cavity.
Continuous ambulatory peritoneal dialysis is performed four to five times throughout the day.
Three dialyses are done at day time.
A long dialysis which is mainly done at night and usually takes about 8 hours.
In this procedure, two liters of dialysate solution is instilled into the peritoneal cavity using a plastic tube.
The tube is then attached to a permanent catheter on one side and a spike on the other side of the bag.
The dialysate solution is then instilled into the peritoneal cavity and the bag and tubing are disconnected.
When the equilibrium period of dialysate solution and blood is completed, the tubing is reconnected and the dialysate solution in the peritoneal cavity is drained and two liters of solution is infused back into the peritoneal cavity.
Thus three dialysis sessions are performed during the day and one long dialysis session during the night.
2) APD (Automated Peritonial Dialysis)
In automated peritoneal dialysis cycler equipment is used to instill the dialysate solution into the peritoneal cavity.
In the automated cycler equipment (cycler equipment), the time of filling, dwell and drain of dialysate solution is set.
Automated peritoneal dialysis has four to eight exchanges per night and a one to two hour dwell time.
Sometimes medications are also added to the dialysing solution such as heparin to prevent blood clotting, insulin to diabetic patients and antibiotic medication to prevent infection to the patient.
There are three types of automated peritoneal dialysis.
1) continuous Cyclic Peritoneal Dialysis (Continuous Cyclic Peritoneal Dialysis),
2) IPD (Intermittent Peritoneal Dialysis),
3) NPD (Nightly Peritoneal Dialysis)
•••>
1) Continuous Cyclic Peritoneal Dialysis
(Continuous Cyclic Peritoneal Dialysis),
This is the most common type of peritoneal dialysis.
Exchange in continuous cyclic peritoneal dialysis is mainly done by cycler equipment.
This type of dialysis is mainly done when the patient is in a sleeping position at night.
In this dialysis, a dialysate solution is infused through a machine, after which it is removed after two to three hours and fresh solution is infused again.
A session (4 cycles) takes 10 to 12 hours to complete.
2) IPD (Intermittent Peritoneal Dialysis),
Intermittent peritoneal dialysis is not a continuous procedure of dialysis.
This type of dialysis is performed three to four times in a week.
In this type of dialysis, the machine administers the same dialysate solution into the peritoneal cavity and the drain is done by the machine itself. This session takes 12 to 24 hours to complete.
3) NPD (Nightly Peritoneal Dialysis)
This type of dialysis is mainly performed at night time.
3) Explain the equipment used for peritoneal dialysis. State the equipment for peritoneal dialysis.
Intra peritoneal dialysis solution.
Peritoneal dialysis catheter.
Peritoneal dialysis set (infusion and drainage).
Dressing tray.
Emergency medicine tray.
Injection tray.
T.P.R And B.p. tray.
I.v. stand.
Bucket for disposal drainage fluid.
4) Explain the procedure for peritoneal dialysis. Explain the procedure of peritoneal dialysis.
1) Preparation of the patient:=
To fully prepare the patient for dialysis before catheter insertion.
Providing information about dialysis to the client who has to undergo dialysis procedure.
To provide thourouly explanation about dialysis to the patient.
To properly monitor patient’s vital signs.
To monitor patient’s temperature, pulse, respiration, blood pressure.
Monitor patient’s weight daily.
Monitor patient’s serum electrolyte level before dialysis.
Advise the patient to completely empty the bowel and bladder before the dialysis procedure.
Properly measure the patient’s central venous pressure.
To properly monitor the patient’s cardiac output.
Provide proper supine position to patient before dialysis and wear mask to prevent air born infection.
Before instilling the dialysate solution in the abdominal cavity, warm the dialysate solution to body temperature and then instill it in the abdominal cavity, because of which discomfort and abdominal pain can be prevented and the blood vessels can be dilated so that the clearance of urea can be done properly.
Instillation of heparin with solution to prevent blood clotting in the catheter.
Administer broad spectrum antibiotic medication to prevent patient from infection.
2) Peritoneal Dialysis Access.
In peritoneal dialysis access, a catheter or flexible hollow tube is surgically placed in the lower abdomen.
This catheter is usually inserted two to five centimeters below the umbilicus.
This catheter is mainly inserted in the operation room by providing local anesthesia.
Before the procedure, the skin is prepared with an antiseptic solution to prevent infection.
The physician advises the patient to raise his head and tighten the abdominal muscles, after which the abdomen is punctured with the help of a trochar.
A peritoneal catheter is then inserted into the peritoneal space.
This catheter is used to remove toxic materials.
Then this catheter is properly secured by purse-string suture.
Antimicrobial ointment and sterile dressing are then applied to prevent infection.
3) Peritoneal Dialysis treatment:=
In peritoneal dialysis, a catheter is placed through which the exchange process is performed.
Exchange is a process in which a dialysate solution is instilled into the abdominal cavity, the solution is allowed to remain in the abdominal cavity until the toxic material is exchanged, and the dialysate solution is then drained from the body.
This exchange procedure generally takes one to four hours.
As such, the procedure of peritoneal dialysis is performed in a peritoneal cavity.
1) Explain the KIDNEY CANCER.
Kidney cancer is also called Renal cancer.
This leads to abnormal and uncomfortable growth in kidney cells and formation of tumors.
This tumor can be both benign and malignant.
Kidney cancer is mainly not kidney. An excess of both is produced.
the Renal tubule, (Renal cell carcinoma),
The Renal pelvis (transitional cell carcinoma).
If a patient has a renal tumor, he complains of blood in the urine (hematuria) or masses and pans.
2) Explain the Etiology of the renal cancer.
exact cause is unknown,
cigarette smoking,
obesity,
High blood pressure,
long term dialysis,
occupational exposure to toxic agents,
certain analgesics,
childhood chemotherapy,
previous radiation therapy.
3) Explain the clinical manifestation of the renal cancer.
Abnormal urine color like :=dark ,rusty, brown.
back pain,
hydronephrosis
(accumulation of fluid in the kidney),
Abdominal mass or lump,
fever,
hypertension,
malaise,
weight loss,
anorexia,
cold intolerance
(Inability to tolerate cold),
chronic fatigue
(feel very tired),
leg and ankle Swelling
Serve at night,
difficulty seeing,
Increased level of calcium in the body (hypercalcemia),
4) Explain the diagnostic evaluation of the renal cancer.
history tacking and physical examination,
intra venous urography,
Cytological examination,
Renal angiogram,
ultrasonography,
ct scan.
5) Explain the Management of the renal cancer Explain the management of renal cancer.
radiation therapy,
chemotherapy,
Hormonal therapy,
surgery, :=
-> Nephrectomy
Simple Nephrectomy: In this only the tumor is removed.
•partial
Nephrectomy: In this the tumor and some area around it is removed.
•Radical Nephrectomy:=
In this, kidney, tumor, adrenal gland, lymph node and its surrounding tissue are removed.
6) Explain the nursing management of the renal cancer
preoperative and* post operative Nursing management:=
pre operative Nursing management:=
Provide psychological support to the patient.
Explaining the procedure to the patient and his relative.
Checking the patient’s intake output.
Provide intravenous fluid to the patient.
To provide blood transfusion to the patient.
Provide oxygen to the patient.
Shaving the patient on the operative area.
To provide work and comfortable environment to the patient and his relatives.
Post operative Nursing management :=
Close observation of the patient after operation.
To check patient’s vital signs every 15 minutes.
Checking the patient’s blood pressure every 15 minutes.
Provide oxygen to the patient if needed.
Provide intravenous fluid.
Maintain the patient’s nutritional and hydration status.
To provide psychological support to the patient and his family members.
Provide proper antibiotic and analgesic medicine to the patient.
Properly dressing the operation area of the patient.
To clear all the doubts of the patient and his family members.
1) Explain the BLADDER CANCER Explain the bladder cancer.
In bladder cancer, abnormal and uncontrollable growth of the epithelial cells of the bladder leads to the formation of tumors. These tumors are benign and
May be malignant.
About 90% of urinary system cancers are bladder cancer.
There are types of cancer in the urinary system according to its cells.
urethelial carcinoma (in urethial carcinoma),
squamous cell carcinoma,
Adenocarcinoma (in adenocarcinoma).
2) Explain the Etiology of the bladder cancer Explain the reasons for bladder cancer.
Age := Mainly seen between 50 to 70 years.
sex := Affects men more than women.
(3:1),
cigarette smoking,
chemical exposure,
Diet := It is more common in people who eat fried meat and animal fats.
Race := White people are more likely to develop bladder cancer.
personal history of bladder cancer,
family history of bladder cancer,
chronic bladder inflammation,
birth defects,
External beam radiation.
treatment of certain drugs.
3) Explain the clinical manifestation of the bladder cancer State the symptoms and signs of bladder cancer.
blood in urine (hematuria := blood in urine),
pain during urination,
frequent urination,
pelvic pain,
back pain,
Alteration in voiding.
4) Explain the diagnostic evaluation of the bladder cancer. State the diagnostic evaluation of bladder cancer.
history taking and physical examination
cytoscopy,
Excretory urography (excretory urography),
ct scan,
ultrasonography,
Biannual examination,
tumor biopsy,
Cytological examination
5) Explain the medical management of the bladder cancer.
radiation therapy,
chemotherapy,
Immunotherapy,
surgery:
•Partial cystectomy, (In this only the affected portion of the bladder is removed).
pre operative and post operative nursing management:=
This includes checking the patient’s urine output every hour in pre-operative and post-operative management.
Proper hospitalization of the patient and keeping him under close observation of nurses and handling personnel.
Inform the patient and health care personnel immediately if any complications arise.
pre operative:=
Checking the patient’s urine output.
Catheter insertion in the patient.
Properly explain to the patient about the surgery and its complications and its benefits and side effects.
To check patient’s vital sign.
Preparing the patient for surgery.
Obtaining consent for surgery from family members of the patient.
To remove all the patient’s clothes and jewelry.
The area of the patient’s body that is to be operated should be shaved properly.
Providing psychological support to the patient and his family members.
Providing intravenous fluid to the patient.
Painting the patient’s body area with proper savlon and spirit.
Post operative nursing management:=
Keeping the patient under close observation after the operation.
Patient Nadar 15 minutes to check vital signs.
Keeping blood transfusion ready for the patient.
Provide intravenous fluid to the patient.
Properly dressing the operative area of the patient.
Provide proper antibiotic and analgesic medicine to the patient.
Maintain septic technique while handling the patient.
To clear all the doubts of the patient and his family members.
Tell the patient not to do hard activity.
Tell the patient not to take very spicy food and fatty food.
Maintain patient’s intake output chart.
Ask the patient to maintain personal hygiene.
Conduct all blood investigations of the patient.
Providing psychological support to the patient and his family members.
1) Explain/Define the uremia. Define uremia.
Uremia is a type of medical condition in which due to kidney failure or inadequate function, urea and toxic waste material accumulate in the blood and due to this the condition of uremia arises.
2) Explain the etiology/cause of the uremia. State the cause of uremia.
chronic kidney disease,
Acute kidney injury.
Glomerulonephritis.
Diabetes.
Hyper tension.
Polycystic kidney disease.
Due to an autoimmune disorder.
Due to obstruction.
3) Explain the clinical manifestation / sign and symptoms of the patient with the uremia. State the symptoms and signs of a patient with uremia.
feeling tired
Swelling.
Changes in urination.
Nausea and vomiting.
Loss of appetite.
Itching.
Neurological symptoms are observed.
Hypertension.
Anemia.
Pain in bones and joints.
Cardio vascular complications.
4) Explain the diagnostic evaluation of the patient with the uremia. State the diagnostic evaluation of a patient with uremia.
history taking and physical examination.
Blood test.
Assess calcium levels.
Assess the phosphorus level.
Assess the glomerular filtration rate (GFR).
Assess the blood urea nitrogen level.
Assess the creatinine level.
Assess the calcium, potassium, and phosphorus level.
Urine test.
Radioisotope test.
Assess complete blood count test.
Urine analysis.
Imaging test.
Ultrasound.
CT scan.
MRI.
Renal biopsy.
Medical imaging test.
5) Explain the management of the patient with the uremia. State the management of patients with uremia.
Treatment of the condition due to which uremia has occurred.
Assess the patient’s fluid intake so that fluid intake can be prevented.
Assess the patient’s electrolyte level.
Dialysis of the patient properly.
Provide proper medication to the patient.
Provide patient with phosphate binder medicine to control hyperphosphatemia.
Provide patients with erythropoietin stimulating agents to treat anemic conditions.
Provide vitamin D analogue medicine to the patient.
Provide antihypertensive medicine to the patient.
Advise the patient for nutritious food intake.
Properly monitor the nutritional status of the patient.
Provide patients with erythropoietin therapy to treat anemic conditions and improve red blood cell production.
Treating the patient if he has any other complications.
Properly monitor the patient’s renal function and electrolyte levels.
Making the treatment plan of the patient properly.
Provide patient education for medication lifestyle modification.
To provide complete information to the patient about his disease condition, its causes, its symptoms and signs, and its treatment.
Providing education to patients about renal transplantation.
6) Explain the nursing management of patients with uremia. State the nursing management of a patient with uremia.
Provide comprehensive patient care and support.
Properly assess the patient.
To properly assess the patient’s vital signs.
Assess the patient’s fluid level properly.
Properly assess the patient’s neurological status.
Properly assess the patient’s laboratory values.
To properly assess the patient’s blood urea nitrogen (BUN) level, electrolyte level, and complete blood count (CBC).
Properly assess the patient’s fluid and electrolyte levels.
Properly monitor the patient’s intake output chart.
Collaborating with other health care team members for patient treatment.
To provide complete information about dialysis to the patient.
Properly assess the patient’s vascular access for signs and symptoms of infection.
Providing the prescribed medication to the patient.
Provide proper nutritional support to the patient.
If the patient has any other signs and symptoms, treat them appropriately.
Provide proper emotional support to the patient.
To provide complete information to the patient about his disease condition, its causes, its symptoms and signs and its treatment.
To properly care for the patient if he is on dialysis.
Provide proper psychological support to the patient.
Collaborate with other health care personnel for proper patient care.
Provide proper psychological support to the patient.
Advising the patient to follow up properly.
1) Explain the care of patient with the KIDNEY transplantation. (Describe the care of a patient with kidney transplantation).
Kidney transplantation is a surgical procedure and a permanent medical procedure.
In kidney transplantation, a kidney is obtained from a living or dead person and then the kidney is transplanted into a person whose kidney cannot function properly or a person who has end stage renal disease. This is called kidney transplantation.
2) Explain the Etiology/cause of KIDNEY transplantation. State the reasons for kidney transplantation.
Due to chronic kidney disease.
Due to any type of genetic diseases.
Due to polycystic kidney disease.
Due to any type of autoimmune disease.
Due to malignant hypertension.
Due to any type of infection.
Due to diabetes mellitus.
Due to the condition of glomerulo nephritis.
3) Explain the source of KIDNEY transplantation. State the source of kidney transplantation.
1) Living Related Donor (Living Related Donor)
In Living Related Donors those very close relatives such as parents, siblings, children, grandparents who are close relatives who can donate a kidney are called Living Related Donors.
This is mainly due to the fact that two kidneys are present in a normal person and if both the kidneys are working properly then any person can survive properly on one of his kidneys so he can donate one kidney by donating one kidney. It does not change in the person’s physical capacity and life style and can survive properly even on one kidney.
2) Cadaver Donors
Cadaver donors means a person who has not died due to any kidney related cause but brain dead due to any kind of accident or stroke and if the kidney is obtained from such a person then it is known as cadaver donor.
3) Emotionally Related Recipient Donor (Emotionally Related Recipient Donor)
In situations where a cadaver donor is not possible and a living related donor is unfit, any emotionally related donor such as husband/wife, cousin, uncle, aunt in-law, etc. can donate a kidney, known as an emotionally related kidney donor. is coming.
4) Unrelated kidney donors
When cadaver donor, living related donor and emotionally related donor are impossible then kidney is obtained from unrelated kidney donors it is called unrelated kidney donor but chances of rejection are more in unrelated kidney donors so costal medication is provided like cyclosporine type. Medicine is provided.
4) Explain the types of kidney transplantation.
There are 3 types of kidney transplantation.
1) Diseased donor kidney transplantation (diseased donor kidney transplantation)
If a kidney is taken from a person who has died some time ago and transplanted into the recipient, it is called deceased donor kidney transplant.
2) living donor kidney transplantation (living donor kidney transplantation)
A person who is a relative and both their kidneys are functioning properly and that person donates one kidney and provides it to the recipient is called a living donor kidney transplant.
3) Primitive kidney transplantation
Primitive kidney transplantation is mainly done in developed countries.
In this type of kidney transplantation, the patient’s kidney has a low functioning kidney or any type of chronic kidney
Have DCs and
If the person has already undergone kidney transplantation, it is called primitive kidney transplantation.
5) Explain the donor recipient match for the kidney transplantation. Describe the donor-recipient match for kidney transplantation.
1) Blood group:=
Both the person who is the donor and the recipient should have matching blood group.
2) HLA (Human Leukocytes Antigen)
These are antigens that are present on the surface of white blood cells. Every person has six human leukocyte antigens (HLA) present, three human leukocyte antigens from the father and three human leukocyte antigens (HLA) from the person’s mother. Thus there are total six types of human leukocyte antigens.
For kidney transplantation, the donor and the recipient should match more and more these antigens, only when the kidney transplantation is complete.
3) Negative cross match
In this, the blood of the donor and the recipient is mixed in a test tube and if there is no reaction between the two bloods, then the kidney transplantation is proper.
6) Explain the risk or complications of the kidney transplantation. State the risks and complications of kidney transplantation.
Bleeding.
Post operative infection.
Trauma and injury.
Organ rejection.
7) Explain the important facts of kidney transplantation. State the important facts of kidney transplantation.
Kidney transplantation takes about four hours.
In kidney transplantation, the patient is discharged from the hospital within 1 week.
If the kidney is taken from a living donor, it functions faster.
If the kidney is taken from someone who has died, it takes a little longer to work.
After a kidney transplant, the kidney is removed only if it infects the body, otherwise it is not removed.
8) information about kidney:=
The first successful kidney transplantation was on 23 December 1954
Dr.Joseph E.Murrey (joeseph E.Murrey) and his colleagues (colleagues)
Peter Bent Brigham (peter Bent Brigham) hospital that is present in the US (Bostum) was done between two identical twins (merrick brothers).
9) Explain the nursing management of patients with renal transplantation. State the nursing management of renal transplantation Wada patient.
pre operative management:=
Taking a complete history of the patient and doing a physical examination.
Provide immunosuppressive medicine to the patient before kidney transplantation.
Providing antibiotic medicine to the patient.
Provide antiemetic medicine to the patient.
Provide psychological support to the patient.
To properly monitor the patient’s vital signs.
Explain the procedure completely to the patient.
To properly clear all types of doubts of the patient.
post operative management:=
Assess the patient for any signs and symptoms of kidney rejection.
Provide proper aseptic technique to prevent patient from infection.
To monitor patient’s vital sign properly.
To assess whether the patient has any other type of complications or not.
Monitoring the patient’s intake output.
Monitor the patient’s renal function.
Monitor patient’s blood urea nitrogen level.
Assess the patient’s serum creatinine level.
Provide the patient in semi-fowler position.
Advise the patient to maintain good hygienic condition.
Advise the patient to take proper care of the woundside.
Provide proper psychological support to the patient.
Provide proper medication to the patient.
Properly to the patient
Advising on follow-up.
Advise the patient to report immediately to health care personnel if any complications arise.
Disorder of the male genitourinary track. :=
1) Explain/Define the Hydrocele. Define hydrocele.
Hydrocele is a condition in which fluid collects around the testicles, causing swelling in the scrotum and groin area. This fluid collection is called a hydrocele.
The condition of hydrocele mainly arises when the fluid surrounding the testicles is naturally absorbed in the body, when this absorption does not take place, the fluid builds up around the testicles and the condition of hydrocele arises.
2) Explain the Etiology/cause of the Hydrocele. State the causes of hydrocele.
Except cause is unknown.
This is mainly due to any kind of injury in the scrotum and surgery in the groin area.
Due to infection.
Due to inflammation.
Due to cancer of the testicles.
Due to any kind of injury and trauma.
3) Explain the clinical manifestation / sign and symptoms of the patient with the Hydrocele. State the symptoms and signs of a patient with hydrocele.
Swelling in scrotum.
Heaviness and discomfort.
to be in pain
Redness in the scrotum.
Tenderness.
Difficulty in palpating the testicles.
Enlargement of the scrotum.
filling of fullness.
Overnight size reduction of the testicles.
4) Explain the Diagnostic evaluation of the Hydrocele. Write the diagnostic evaluation of a patient with hydrocele.
history taking and physical examination.
Transillumination test.
Ultrasound of scrotum.
Blood test.
Laboratory Investigation.
5) Explain the medical management of the patient with the Hydrocele. State the medical management of a patient with hydrocele.
Fine needle aspiration.
In this procedure, fluid that has accumulated around the testicles is aspirated.
Sclerotherapy
In this procedure, after aspirating the fluid around the testicles, a scarring agent is inserted around the testicles to prevent fluid buildup.
Surgery is performed if the hydrocele is uncomfortable.
Anti-inflammatory medication
Provide the patient with a non-steroidal anti-inflammatory drug to reduce the inflammation and discomfort caused by the hydrocele.
6) Explain the nursing management of patients with the Hydrocele.
Properly of the patient
Making an assessment.
Assessing the patient’s pain level.
Provide analgesic medicine to reduce the patient’s pain.
Provide mind diversional therapy to reduce patient discomfort.
If the patient has undergone surgery or aspirated fluid, advise to maintain aseptic technique of wound care.
Collaborate with other health care personnel for proper patient care.
Advising the patient to take medication properly.
Advise the patient to avoid riding a bike for three weeks as an athlete.
Advise the patient to avoid strenuous activity.
Advise the patient to maintain hygienic conditions to prevent infection.
Advise patient to apply ice pack if scrotal pain occurs.
Advising the patient to follow up properly.
1) Explain/Define the Phimosis. Define phimosis.
Phimosis is a condition in which the foreskin over the penis is tightened and does not retract properly and the gland is tight on the penis. This condition is called phimosis.
This condition is mainly congenital but can also occur due to any infection.
Phimosis disease condition causes pain and discomfort during urination and sexual activity.
2) Explain the etiology/cause of the phimosis. State the causes of phimosis.
Due to congenital deformity.
Due to any infection and inflammation.
Due to trauma and injury.
Due to some type of medical condition.
Balanitis xerotica obliterans
This is a type of chronic and progressive condition in which infection, inflammation and scarring are seen in the foreskin above the glans penis.
Due to repeated skin infections.
Due to improper hygienic conditions.
Due to catheterization.
3) Explain the clinical manifestation / sign and symptoms of the Phimosis. State the symptoms and signs of phimosis.
Swelling.
Redness.
Tenderness.
Purulent discharge.
tight foreskin.
Pain and discomfort.
Inflammation.
Recurrent infection.
4) Explain the diagnostic evaluation of the patient with the phimosis. State the diagnostic evaluation of a patient with phimosis.
history taking and physical examination.
Urine Analysis.
Blood analysis.
Savob culture.
Biopsy.
5) Explain the medical management of the patient with the Phimosis. State the medical management of phimosis vada patient.
Provide topical corticosteroid application cream to reduce patient inflammation.
Advise the patient to perform gentle foreskin stretching.
Provide topical antifungal cream to the patient.
Provide patient with topicalol antibiotic cream.
Advising the patient to maintain proper hygienic condition.
Advise the patient to take regular follow up.
Advising the patient to take proper medication.
6) Explain the Nursing management of patients with the Phimosis. State the nursing management of phimosis vada patient.
Provide proper medication to the patient.
Advise the patient to maintain proper hygienic condition.
Advise the patient on proper application of topical medication.
Advising the patient to follow up regularly.
If the patient is in pain, provide analgesic medicine.
Provide mind diversional therapy if the patient is uncomfortable.
Provide proper emotional support to the patient.
Communicating properly with other health care personnel for proper patient care.
To provide complete information to the patient about his disease, its causes, its symptoms and signs, and its treatment.
To provide proper psychological support to the patient and his family members.
1) Define/Explain prostate cancer Define prostate cancer.
Prostate cancer occurs in the prostate gland.
Abnormal and uncontrollable growth of prostate gland cells in the prostate gland leads to tumor formation.
And this tumor develops into a cancerous tumor and causes cancer.
Prostate cancer can also spread to surrounding tissue.
And this cancer can spread to all parts of the body like liver bone lungs etc.
2) Explain the Etiology/cause of the prostate cancer Tell the reason for prostate cancer.
advance age
hereditary,
Hormonal influence,
environment factor,
cigarette smoking,
toxins, chemicals.
industrial products.
diet high in saturated fat,
increase age
3) Explain the clinical manifestation/ sign and symptoms of the prostate cancer. Explain the symptoms and signs of prostate cancer.
burning or pain during urination,
inability to urinate,
a sensation of incomplete emptying of the bladder even after passing urination,
frequent nocturnal urination.
weak or interrupted flow of urine,
blood in urine,
blood in seven,
(hematospermia),
Pelvic pain,
back or hip pain,
abdominal pain,
chest pain,
weight loss.
4) Explain the Diagnostic evaluation of the prostate cancer Explain the diagnostic evolution of prostate cancer.
history taking and physical examination
biopsy,
blood test,
urine test,
X Ray,
ct scan,
MRI,
5) Explain the management of the management of the prostate cancer.
radiation therapy,
chemotherapy,
biotherapy,
gene therapy,
immunotherapy,
Hormonal therapy,
cryotherapy,
6) Explain the nursing management of the prostate cancer.
assessment
Perform a head to toe examination of the patient.
To check patient’s vital sign.
Maintaining intake output chart of patient.
Assess the patient’s pain level.
Assess patient skin integrity.
Assess the patient’s bowel and bladder habits.
Maintain patient’s oral hygiene.
To see if the patient has hair loss or any side effects due to chemotherapy and radiation therapy.
Nursing diagnosis
1) Pain related to disease condition
Nursing interventions:=
Reliving pain level:=
Assess the patient’s pain level.
Position the patient comfortably.
Providing Mind Diversional Therapy to the patient.
Provide the patient with his/her essential medicines.
To provide work and comfortable environment to the patient.
2) Self care deficit related to disease condition.
Nursing interventions
provide hygiene conditions to the patient
Provide very clean clothes and bed sheet to the patient.
Provide bed bath and sponge bath to the patient.
Provide clean and wrinkle free bed sheet to the patient.
Maintain oral care of the patient.
Ask the patient to practice proper hand washing.
3) Impaired skin integrity related to cancerous condition.
Nursing interventions:=
maintain skin integrity.
Assess the patient’s skin integrity.
Checking the patient’s skin turgor.
To see if any type of bleeding occurs from the patient’s body.
Ask the patient to drink two to three liters of water.
Ask the patient to apply body lotion.
Tell the patient not to rub and scratch the skin.
Ask the patient to wear cotton clothes.
Refraining the patient from wearing tight clothing.
4) Impaired nutrition status of patient less than body requirement related to diarrhea and vomiting.
Nursing interventions:=
improve nutritional status:=
Assess the nutritional status of the patient.
Providing a comfortable environment to the patient.
Ask the patient to wash hands while eating.
Providing appetizers to the patient.
Remove any bed-order items around the patient while they are eating.
Keeping the patient and emotional and non-emotional things in mind.
Give food to the patient in little intervals.
Give the patient as much food as he likes.
Keeping the patient’s environment clean while eating.
5) Disturbed body image (hair loss) related to radiotherapy and chemotherapy.
Nursing interventions:=
improve body image* of patient:
Maintain good interpersonal relationships with patients.
Maintain good rapport with patients.
Telling the patient that hair loss is temporary.
Tell the patient that weight loss is common when undergoing chemo therapy and radiation therapy.
Providing psychological support to the patient.
6) Activity intolerance related to the weakness.
Nursing interventions:=
improve the activities of the client.
Assessing the patient’s activity level.
Maintain good interpersonal relationship with patients.
Ask the patient to do daily routine activities in moderation.
Tell the patient to take some rest between activities.
Tell the patient to do proper exercise and yoga.
7) High risk of infection related to *hospitalizations.
Nursing interventions
reduce the risk of infection:=
Assess the patient’s infection side.
Maintain aseptic technique while handling the patient.
Maintain aseptic technique while dressing the patient’s body parts.
To provide proper clean and hygienic condition to the patient.
Giving the patient McLean cloth to wear.
Giving the patient high protein rich food that helps the patient to fight infection.
Providing proper antibiotic medicine to the patient.
8) Depression and fear related to treatment of cancer.
Nursing interventions:=
Reduce the fear level of the client.
Checking the patient’s anxiety and fear level.
To maintain good interpersonal relationship with patients.
Helping the patient to solve his doubts and problems.
Listening to the patient and his family members properly.
To answer all the questions of the patient.
Providing psychological support to the patient.
To provide coping abilities on how the patient can deal with the situation in such a bad situation.
1) Explain/Define the orchitis. Define orchitis.
Infectious inflammation of the testis in the male reproductive system is called orchitis.
In the condition of orchitis, inflammation is seen in one or both testicles leading to infection.
(orchitis := infection or inflammation of the one or both testicles it’s called as an orchitis. )
2) Explain the etiology/cause of the orchitis. State the causes of orchitis.
Due to bacterial infection.
Due to viral infection.
Causes of trauma.
Due to autoimmune conditions.
Due to urinary tract infection.
Due to autoimmune diseases.
Due to recurrent urinary tract infection.
Due to insertion of Follicle catheter.
Due to a weakened immune system.
3) Explain the clinical manifestation/ sign and symptoms of the orchitis.
Testicular pain.
Testicular swelling.
Tenderness.
Nausea.
Fever.
Discharge from the penis.
Having blood in the semen.
Passage of blood in the urine (hematuria).
Pain in grow in area.
Pain during urination.
Inflammation of the epididymis.
Swelling in the inguinal lymph nodes.
Swelling at the affected site.
4) Explain the diagnostic evaluation of the orchitis.
history taking and physical examination.
Complete blood count.
Testicular ultrasound.
Sexually Transmitted Diseases Screening.
Urine Analysis.
Nuclear scan of the testicles
Blood test.
Imaging test.
5) Explain the medical management of the patient with orchitis. State the medical management of a patient with oorchitis.
If the patient’s condition of orchitis is caused by bacteria, then provide antibiotic medicine to the patient.
Provide antiviral medication to the patient.
If the patient has pain condition then provide analgesic medicine.
If the patient is uncomfortable, apply ice.
Advise the patient to take adequate rest.
Provide supportive care to the patient.
Advising the patient to follow up properly.
6) Explain the nursing management of patients with orchitis. State the nursing management of a patient with oorchitis.
If the patient is in pain, provide analgesic medicine.
To provide proper comfort measures to the patient.
Advise on proper fluid intake to maintain patient’s hydration status.
Advise the patient to take proper rest.
Provide education to the patient to make modifications in his daily routine activities.
Monitor the patient for any other complications.
Provide proper emotional support to the patient.
Advise the patient to maintain proper hygienic conditions to prevent infection.
Collaborate with other health care personnel for proper patient care.
Provide proper psychological support to the patient.
To provide complete information to the patient about his disease, its causes, its symptoms and signs, and its treatment.
1) Explain/Define the Epididymitis. Define epididymitis.
Epididymis:= Epididymis is a coiled tube that lies above and behind the testicles and plays an important role in storing and transporting sperm.
This infection and inflammation of the epididymis is called epididymitis.
This condition of epididymitis is mainly seen due to any infection and inflammation due to which redness, warmth, swelling is seen in the scrotum (sac containing testicles).
If the condition of epididymitis (inflammation) spreads to the testicles, it is called epididymo orchitis.
2) Explain the Etiology/cause of the Epididymitis. State the cause of epididymitis.
Due to bacterial infection.
Due to sexually transmitted infection.
Due to urinary tract infection.
Due to trauma.
Due to urinary reflux.
Epididymitis is mainly seen in young men (men between 19-35 years).
Caused by Mycobacterium tuberculosis.
Due to any structural problem in the urinary track.
due to catheterization.
Because of multiple sex partners.
Due to enlargement of the prostate.
3) Explain the clinical manifestation / sign and symptoms of the patient with the Epididymitis. State the symptoms and signs of a patient with epididymitis.
Groin pain.
Swelling.
Redness and warmth.
Getting a fever.
Urethral discharge.
Pain during urination.
Lump and mass like structure.
Bleeding in semen.
Discharge from the urethra.
Discomfort in lower abdomen and pelvis.
Frequent urination.
Pain during ejaculation.
Pain and burning sensation during urination.
Tenderness in the affected side.
4) Explain the diagnostic evaluation of the patient with the Epididymitis. State the diagnostic evaluation of a patient with epididymitis.
history taking and physical examination.
Laboratory test.
Ultrasound.
Blood test.
Sexually Transmitted Infection Screening.
Complete blood count test.
Testicular scan.
Urinalysis.
Urine culture.
5) Explain the management of the patient with the Epididymitis. State the management of a patient with epididymitis.
If the patient has an infection caused by bacteria, provide antibiotic medicine.
If the patient is in pain, provide analgesic medicine.
Advise the patient to take proper bed rest.
elevation of the scrotum for reduce swallowing and discomfort.
Advise the patient for proper water intake. So that the patient’s hydration status can be properly maintained.
Applying ice to reduce the patient’s pain.
If the patient has severe inflammation, provide a non-steroidal anti-inflammatory drug (NSAID).
Regular screening of infected sexual partners.
Advise the patient to follow up regularly.
6) Explain the Nursing management of patients with the Epididymitis. State the nursing management of a patient with epididymitis.
Properly assess the patient.
To monitor patient’s vital signs properly.
To provide proper comfort measures to manage the patient’s pain.
Provide proper education to the patient.
Advise the patient on fluid intake so that his hydration status can be properly maintained.
Provide proper emotional support to the patient.
Antibiotic medicine should be provided if the patient has a condition of infection.
Collaborate with other health care personnel for proper patient care.
Advise the patient to adopt safe sexual activity.
Advise the patient to take regular follow up.
1) Explain / define the penile cancer. Define penile cancer.
Penile cancer is a rare type of cancer that mainly arises in the male reproductive organ penis.
In penile cancer, there is abnormal and uncontrollable growth of penile cells and formation of malignant cells and it results in cancer.
Pineal cancer is more common in men after the age of 50.
If penile cancer is not detected and treated early, it spreads to other parts of the body.
2) Explain the types of penile cancer. State the types of pineal cancer.
There are total four types of penile cancer.
1) Epidermoid/squamous cell carcinoma (in epidermoid or squamous cell carcinoma),
2) Basal cell penile cancer (Basal cell penile cancer),
3) Melanoma,
4) Sarcoma
•••>
1) Epidermoid/squamous cell carcinoma (in epidermoid or squamous cell carcinoma),
95% of pineal cancers are epidermoid or squamous cell carcinoma.
Squamous cell carcinoma develops primarily within the fore skin.
2) Basal cell penile cancer (Basal cell penile cancer),
If the cancer in the penis arises mainly from basal cells, it is called basal cell carcinoma.
Less than 2% of cancers are basal cell carcinomas.
3) Melanoma,
Cancer in melino mainly arises from melinocytes which are the cells responsible for the color of the skin.
4) Sarcoma
About 1% of penile cancers are sarcomas.
Sarcoma cancer mainly arises in tissues that support and connect the body such as blood vessels, smooth vessels and fat.
2) Explain the etiology/cause of the penile cancer. State the causes of penile cancer.
Caused by human papilloma virus (HPV).
Because of smoking.
Age related.
Phimosis (tightening of the foreskin).
Due to chronic inflammation.
Due to poor hygienic conditions.
Due to human immunodeficiency (HIV) virus infection.
4) Explain the clinical manifestation / sign and symptoms of the patient with the penile cancer. (State the symptoms and signs of penile cancer.
Changes in the skin of the penis.
Lump and mass like structure feeling.
Ulcer and sore formation.
Changes in the shape and size of the penis.
Discharge from the penis.
to be in pain
Swelling in the penis.
Genital lesion in the penis.
Changes in the color of the penis.
Thickening of the skin of the penis.
Discharge with foul odor from fore skin of penis.
Bleeding from the tip of the foreskin of the penis.
Irregular or growing bluish brown flat lesions.
Swollen lymph nodes of the groin.
5) Explain the diagnostic evaluation of the penile cancer. State the diagnostic evolution of penile cancer.
history taking and physical examination.
biopsy.
Fine needle aspiration.
sentinel lymph node biopsy.
Inguinal lymph node dissection.
x ray
Computed Tomography (computed Tomography).
Magnetic resonance imaging (MRI).
Positron emission tomography (PET).
Lymph node biopsy.
Cytoscopy.
Blood test.
Human papilloma virus test (HPV).
6) Explain the stages of penile cancer. State the stage of penile cancer.
stage :=0
Abnormal cells in the zero stage are mainly found on the surface of the skin of the penis.
These abnormal cells mainly result in cancer and spread to nearby tissues.
Stage 0 is called carcinoma in situ.
Stage :=1
In stage 1, the cancer has spread to nearby connective tissues and just under the skin of the penis.
stage:=2
In stage 2, the cancer spreads from the connective tissues just under the skin of the penis to the lymph node on one side of the groin area.
stage := 3
In stage 3, cancer is found in the connective tissues, under the skin of the penis, from the left node of one side of the groin area to the lymph node of the groin area of the other side, that is, in stage 3, involvement of more than one lymph node is seen.
stage := 4
In stage four, the cancer spreads to the groin area, pelvis and distant parts of the body.
7) Explain the management of penile cancer. (State the management of penile cancer.)
The management of penile cancer mainly depends on its spread and the size of the tumor.
1) Surgery :=
Surgery is the most common treatment for penile cancer.
The goal of surgery is to remove the cancerous cells and tissues that are present in the penile cancer.
Laser surgery.
Cryosurgery.
Lymph node dissection.
Radiation therapy.
Chemotherapy.
Biological therapy.
8) Explain the nursing management of patients with penile cancer. State the nursing management of penile cancer vada patient.
Proper assessment of cancer patients.
If surgery is to be performed, properly explain to the patient.
If the patient has undergone surgery, assess whether he has any post-operative complication or not.
If the patient is in pain, provide analgesic medicine.
If the patient is uncomfortable, provide relaxation techniques.
Collaborate with the health care provider immediately if the patient has any side effects of the treatment.
Provide proper wound care and hygienic conditions to the patient.
Provide proper psychological support to the patient.
To provide complete information to the patient about his disease, its causes, its symptoms and signs, and its treatment.
To provide psychological support for the patient to cope with his disease.
Provide education to the patient to consume a properly nutritious diet.
To assess whether the patient has any other type of complication or not.
Advising the patient to take proper medication.
Advise the patient to take regular follow up.