CHAPTER 44 Urinary and Reproduct ive Disorders URINARY

CHAPTER 44 Urinary and Reproduct ive Disorders URINARY

CHAPTER 44 Urinary and Reproduct ive Disorders URINARY AND REPRODUCTIVE DISORDERS Urinary and reproductive disorders are common. Understanding these disorders

gives meaning to the required care. Disorders can occur in these major urinary system structures. The Kidneys Ureters Bladder Urethra Men can develop prostate problems. URINARY SYSTEM DISORDERS

Urinary tract infections (UTIs) Infection in one area can progress through the entire system. Microbes can enter the system through the urethra. Common causes include: Catheterization Urological exams Intercourse Poor perineal hygiene Immobility Poor fluid intake UTI is a common healthcareassociated infection. URINARY SYSTEM DISORDERS

(CONTD) Women are at high risk. Microbes can easily enter the short female urethra. Prostate gland secretions help protect men from UTIs. However, an enlarged prostate increases the risk of UTI. Older persons are at high risk for UTIs. The following increase the risk: Incomplete bladder emptying Perineal soiling from fecal incontinence

Poor fluid intake Poor nutrition URINARY SYSTEM DISORDERS (CONTD) Cystitis is a bladder infection caused by bacteria. These signs and symptoms are common: Urinary frequency Oliguria (scant amount of urine)

Urgency Dysuria (difficult or painful urination) Pain or burning on urination Foul-smelling urine Hematuria (blood in the urine) Pyuria (pus in the urine) Fever Treatment includes antibiotics and encouraging fluids. URINARY SYSTEM DISORDERS (CONTD) Pyelonephritis is inflammation of the kidney pelvis. Infection is the most

common cause. Cloudy urine may contain pus, mucus, and blood. Signs and symptoms include Chills, fever, back pain Nausea and vomiting The signs and symptoms of cystitis Treatment involves antibiotics and fluids. URINARY SYSTEM DISORDERS (CONTD)

Prostate enlargement The prostate is a gland in men. It lies in front of the rectum and just below the bladder. The prostate surrounds the urethra. The prostate enlarges as the man grows older. This is called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. Bladder function is gradually lost.

The enlarged prostate presses against the urethra obstructing urine flow. URINARY SYSTEM DISORDERS (CONTD) The following problems are common with prostate enlargement: A weak urine stream Frequent voidings of small amounts of urine Urgency and leaking or dribbling of urine Frequent voiding at night Urinary retention

Treatment depends on the extent of the problem. The doctor may order drugs to shrink the prostate or stop its growth. Some microwave and laser treatments destroy excess prostate tissue. Transurethral resection of the prostate (TURP) is a common surgical procedure. TURP URINARY SYSTEM DISORDERS (CONTD)

Urinary diversions Sometimes the bladder is surgically removed. Cancer and bladder injuries are common reasons. Urinary diversion is a surgically created pathway for urine to leave the body. An ostomy is often involved. A urostomy is a surgically created opening between a ureter and the abdomen. A pouch is applied over the stoma. Urine drains through the stoma into the pouch. Pouches are changed every 5 to 7 days. A pouch is replaced anytime it leaks. Good skin care is needed. Observe and report skin changes

around the stoma. URINARY SYSTEM DISORDERS (CONTD) Kidney stones (calculi) Most common in white men 40 years of age and older. Risk factors include: Bedrest Immobility Poor fluid intake Stones vary in size.

URINARY SYSTEM DISORDERS (CONTD) Signs and symptoms include: Severe, cramping pain in the back and side just below the ribs Pain in the abdomen, thigh, and urethra Nausea and vomiting Fever and chills Dysuria (difficult or painful urination) Urinary urgency Burning on urination

Hematuria (blood in the urine) Cloudy urine Foul-smelling urine URINARY SYSTEM DISORDERS (CONTD) Treatment involves: Drugs for pain relief Drinking 2000 to 3000 mL of fluid a

day All urine is strained. Medical or surgical removal of the stone may be necessary. Some diet changes can prevent stones. URINARY SYSTEM DISORDERS (CONTD) Kidney failure (renal failure) The kidneys do not function

or are severely impaired. Waste products are not removed from the blood. Fluid is retained. Heart failure and hypertension easily result. It may be acute or chronic. URINARY SYSTEM (CONTD) DISORDERS

Acute kidney failure is sudden. Blood flow to the kidneys is severely decreased. Causes include: Severe injury or bleeding Heart attack Heart failure Burns Infection Severe allergic reactions

Some persons develop chronic kidney failure. Treatment involves drugs, restricted fluids, and diet therapy. URINARY SYSTEM DISORDERS (CONTD) Chronic kidney failure The kidneys cannot meet the bodys needs. Nephrons in the kidney are destroyed over many years.

Common causes are: Hypertension Diabetes Other causes include: Infections Urinary tract obstructions Tumors Signs and symptoms appear when 75% of kidney function is

lost. URINARY SYSTEM DISORDERS (CONTD) Treatment for chronic kidney failure includes: Fluid restriction Diet therapy Drugs

Dialysis Dialysis is the process of removing waste products from the blood. Hemodialysis removes waste and fluid by filtering the blood through an artificial kidney (Done over several hours; 3-5 times per week, depending). Peritoneal dialysis uses the lining of the abdominal cavity (peritoneal membrane) to remove waste and fluid from the blood (typically performed every night for 8-10

hours). Sexualit CHAPTER 48 y MALE REPRODUCTIVE SYSTEM FEMALE REPRODUCTIVE SYSTEM THE WHOLE PERSON Patients and residents are viewed as whole persons. They have needs. Physical

Safety Love and belonging Self-esteem Self-actualization Sexuality involves the whole person. Illness, injury, and aging can affect sexuality . SEX AND SEXUALITY Sex is the physical activities involving the reproductive organs. It is done for pleasure or to have children. Sexuality is the physical, emotional, social, cultural, and spiritual factors that affect a persons feelings and attitudes about his or her sex. Sexuality involves the personality and the body. It affects how a person behaves, thinks, dresses,

and responds to others. Sexuality is important throughout life. Attitudes and sex needs change with aging. SEXUALITY AND OLDER PERSONS Reproductive organs change with aging. Frequency of sex may decrease. Some older people do not have intercourse. This does not mean loss of sexual needs or desires.

Often, needs are expressed in other ways. Sexual partners are lost through Death Divorce Relationship break-ups A partner needing hospital or nursing center care SEXUAL RELATIONSHIPS A heterosexual is attracted to members of the other sex.

Sexual behavior is male-female. A homosexual is attracted to members of the same sex. Gay refers to homosexuality. Homosexual men are called gay men. Lesbian refers to a female homosexual. Bisexuals are attracted to both sexes. SEXUAL RELATIONSHIPS (CONTD) Transvestites dress and behave like the other sex for emotional and sexual relief. Transsexuals believe that they are members of the other sex. They often feel trapped in the wrong body. Transgender is a broad term used to describe people

who express their sexuality or gender in other than the expected way. The term also describes persons undergoing hormone therapy or surgery for sexual reassignment. Female to male; male to female INJURY, ILLNESS, AND SURGERY Injury, illness, and surgery can affect sexual function. Sexual ability may change. Most chronic illnesses affect sexual function. Reproductive system surgeries have physical and mental effects. Removal of the uterus, ovaries, or a breast

affects women. In men, prostate or testes removal affects erections. REPRODUCTIVE DISORDERS Male reproductive system Produces and transports sperm Deposits sperm in the female reproductive tract

Secretes hormones Female reproductive system Produces eggs (ova) Secretes hormones Protects and nourishes the fetus during pregnancy Aging, many injuries, diseases, and surgeries can affect reproductive structures and functions. STIS REPRODUCTIVE DISORDERS (CONTD)

A sexually transmitted infection (STI) is spread by oral, vaginal, or anal sex. Some people do not have signs and symptoms. Some are not aware of an infection. Others know but do not seek treatment because of embarrassment. STDs occur in the: Genital and rectal areas Ears, mouth, nipples,

throat, tongue, eyes, and nose STIS Gonorrhea Chlamydia Trichomonas Hepatitis Syphilis HIV HepB HPV STI CLINIC Maricopa County Department of Public Health STD Clinic at 1645 E Roosevelt St,

Phoenix, Arizona Phone: (602) 506-2934 Address: 1645 E Roosevelt St Phoenix, Arizona 85006 Website: maricopa.gov REPRODUCTIVE DISORDERS (CONTD) Condom use helps prevent the spread of STDs. Especially the human

immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) Some STDs are also spread through skin breaks, by contact with infected body fluids, or by contaminated blood or needles. Standard Precautions and the Bloodborne Pathogen Standard are followed.

THE SEXUALLY AGGRESSIVE PERSON Some persons want the health team to meet their sexual needs. Often, there are reasons for the persons behavior. Understanding this helps you deal with the matter. Causes of sexually aggressive behaviors include: Nervous system disorders Confusion, disorientation, and dementia Drug side effects Fever Poor vision THE SEXUALLY AGGRESSIVE PERSON (CONTD)

Touch is sometimes to gain attention. Sometimes, masturbation is a sexually aggressive behavior. Urinary or reproductive system disorders, poor hygiene, and being wet or soiled from urine or feces can cause genital soreness and itching. THE SEXUALLY AGGRESSIVE PERSON (CONTD) Touch can have a sexual purpose. You must be professional about the matter. Ask the person not to touch you. Tell the person that you will not do what he or she wants. Tell the person what behaviors make you

uncomfortable. Allow privacy if the person is becoming aroused. Discuss the matter with the nurse. Follow the care plan. THE SEXUALLY AGGRESSIVE PERSON (CONTD) Protecting the person The person must be protected from unwanted sexual comments and advances. This is sexual abuse. Tell the nurse right away. Sexual abuse is a serious matter.

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