Disorders Bladder and Lower Urinary Tract Study Guide

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Nursing

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Nov 24, 2024

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1 Disorders of the Bladder and Lower Urinary Tract Study Guide Before you get started: We’re now shifting gears to disorders below the kidney … disorders of bladder and lower urinary tract. Specifically, we’ll be looking at various disorders that affect bladder function, urinary incontinence, and bladder cancer. Alterations in Bladder Function Lower Urinary Tract Obstruction and Stasis: urine is produced normally by the kidneys but retained in the bladder. Can result in vesicoureteral reflex and cause kidney damage … serious disorder. 1. Discuss the causes and compensatory/decompensatory changes of lower urinary tract obstruction and stasis (p. 913-914). Causes: congenital, prostate enlargement compressing urethra, sexually transmitted infections > urethral strictures, tumors Compensatory Changes: Bladder begins to hypertrophy or atrophy. Becomes hyper- or hypo-sensitive to stimuli from the stretch receptors in the bladder wall. Decreased ability to _ suppress _ urination > bladder spasms and urgency/frequency. Stasis of urine predisposes patient to what? UTI Decompensatory Changes: Detrusor muscle contraction too short to expel urine completely, residual urine remains in bladder. Symptoms of obstruction become pronounced. List here (chart 35-1): Bladder distention Hesitancy Straining when initiating urination Small and weak stream Frequency Feeling of incomplete bladder emptying Overflow incontinence With progressive decompensation, bladder severely overstretched with residual volume of 1000- 3000 ml (that’s 1 to 3 quarts, YIKES!). Skim Neurogenic Bladder Disorders: failure to store urine (spastic bladder) vs. failure to empty urine (flaccid bladder). 2. Describe the causes and characteristics of the different types of urinary incontinence (p. 916-918). Urinary incontinence: involuntary loss or leakage of urine. Complete the table. Types and Causes Characteristics (table 35-3) Stress Women: aging, childbirth, surgery Men: prostate disease, surgery Involuntary loss of urine associated with activities, such as coughing, that increase intra-abdominal pressure Overactive bladder/urge Urgency and frequency associated with hyperactivity
2 Types and Causes Characteristics (table 35-3) incontinence of the detrusor muscle; may or may not involve involuntary loss of urine Overflow Involuntary loss of urine when intravesicular pressure exceeds maximal urethral pressure in the absence of detrusor activity Functional Lack of cognitive function to go to the bathroom, commode, or urinal/bedpan resulting in spontaneous urination 3. Describe the etiology/pathophysiology and clinical manifestations of bladder cancer (p. 920-921). Most common form derived from urothelium cells that line the bladder. Etiology: perhaps related to local inflammation, i.e. carcinogens that are excreted as urine, stored in bladder (dyes, rubber, textiles, paints, smoking, etc.) Clinical manifestations: most common sign is what? painless hematuria What else manifests? Gross hematuria microscopic hematuria Frequency, urgency, and dysuria You are finished with renal! Bravo! Reference: Norris, T. L. (2020). Porth’s Essentials of Pathophysiology, 5 th edition. Wolters Kluwer.
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