1. Genitourinary Emergencies

2. ASSESSMENT
Primary Survey
Secondary Survey

3. RISK FACTORS PERSONAL HABITS DECREASED FLUID INTAKE IMMOBILITY
DIET HIGH IN OXALATES
POOR PERINEAL HYGIENE
PREGNANCY
DIABETES

4. RISK FACTORS SPINAL CORD INJURY FOLEY CATHETER INSERTION
PREVIOUS INFECTIONS
TRAUMA
EXTREMES OF AGE

5. FOCUSED SURVEY SUBJECTIVE DATA
HISTORY OF PRESENT ILLNESS
MEDICAL HISTORY

6. OBJECTIVE DATA PHYSICAL EXAM A. GENERAL SURVEY B. INSPECTION
C. PERCUSSION
D. PALPATION

7. DIAGNOSTIC PROCEDURES
LAB STUDIES
RADIOGRAPHIC STUDIES

8. AGE RELATED CONSIDERATIONS
PEDIATRIC
A. GROWTH AND DEVELOPMENT
B. PEARLS
GERIATRIC
A. AGE RELATED

9. ACUTE RENAL FAILURE THREE TYPES OF RENAL FAILURE A. PRERENAL
B. INRARENAL (intrinsic)
C. POSTRENAL

10. PRERENAL SHOCK CHF SEPSIS ANAPHYLAXIS PERICARDIAL TAMPONADE
PULMONARY EMBOLISM

11. INTRARENAL ACUTE INERSTITAL NEPHRITIS EXPOSURE TO NEPHROTOXINS
ACUTE GLOMERULONEPHRITIS
VASCULITIS
RENAL ARTERY OR VEIN STENOSIS

12. POSTRENAL URETHRAL OR BLADDER CANCER RENAL CALCULI
PROSTATIC HYPERPLASIA OR CA
CERVICAL CANCER
URETHRAL STRICTURE

13. URINARY TRACT INFECTION

14. SIGNS AND SYMPTOMS FEVER HEMATURIA CHILLS AND FEVER
DYSURIA AND/OR URGENCY
DULL FLANK PAIN
NAUSEA
LEUKOCYTOSIS

15. PLANNING AND INTERVENTION
ANTIBIOTICS
ANALGESICS
ANTYPYRETICS

16. DISCHARGE INSTRUCTIONS
FINISH ALL ANTIBIOTICS
CLEAN FROM FRONT TO BACK
VOID FREQUENTLY
AVOID BUBBLE BATHS
VOID AFTER INTERCOURSE
CLEAN FORESKIN IN MALES
INCREASE FLUID INTAKE

17. PYELONEPHRITIS

18. PREDESPOSING FACTORS PREGNANCY DELAY IN TREATMENT OF UTI
IMMUNOSUPRESSION
MORE THAN 3 UTI IN ONE YEAR

19. SIGNS AND SYMPTOMS DULL UNILATERAL FLANK PAIN FEVER AND CHILLS
RECENT UTI OR STD
DYSURIA
FREQUENCY
HEMATURIA

20. PLANNING AND INTERVENTION
FLUIDS
ANALGESICS
IV ANTIBIOTICS
ANTIPYRETICS

21. URINARY CALCULI

22. RISK FACTORS
HYPERCALCEMIA
UTI
GOUT
DIET
DEHYDRATION
PREGNANCY

23. SIGNS AND SYMPTOMS ASYMPTOMATIC UNTIL STONE MOVES BACKACHE DYSURIA
RENAL COLIC
HEMATURIA
NAUSEA
SWEATING

24. PLANNING AND INTERVENTIOS
IV FLUIDS
PAIN MEDICATION
X RAYS OR CT
STRAIN URINE
LITHOTRIPSY
SURGERY

25. CRITERIA FOR ADMISSONS
PAIN MANAGEMENT
SOLITARY KINDEY
ILEUS
BLADDER STONES
INFECTION

26. DISCHARGE PAIN MEDS INCREASE FLUIDS STRAIN URINE
RETURN FOR INCREASE PAIN OF VOMITING

27. TESTICULAR TORSION

28. SIGNS AND SYMPTOMS UNILATERAL TESTICULAR PAIN SCROTAL SWELLING
REDNESS AND TENDERNESS

29. DIAGNOSTIC UA
CBC
DOPPLER ULTRASOUND FLOW STUDY

30. EPIDIDYMIDITIS

31. SIGNS AND SYMPTOMS GRADUAL ONSET OF SCROTAL PAIN
RED, SWOLLEN, WARM SCROTUM
DYSURIA OR URETHRAL DISCHARGE
TENDERNESS IN GROIN OR LOW ABD
DUCK WADDLE GAIT

32. DIAGNOSTIC
UA WITH C&S
GRAM STAIN IF ANY DISCHARGE
ULTRASOUND

33. PLANNING AND INTERVENTION
ANTIBIOTICS
ANALGESICS
SCROTAL SUPPORT WITH ELEVATION
AVOID PHYSICAL STRAIN

34. URETHRAL INJURY

35. FEMALES RARE CHILDBIRTH OR VAGINAL SURGERY STRADDLE INJURIES
PELVIC FRACTURE

36. MALES
TRAUMA
MUTILATION
SEXUAL ACTIVITY
INSTRUMENTATION

37. SIGNS AND SYMPTOMS PAIN HEMATURIA BLOOD AT URINARY MEATUS
HEMATOMA OF ABD.OR PERNIEUM

38. DIAGNOSTIC
LABS
X RAYS

39. TREATMENT
CATHETERIZATION
SURGERY

40. BLADDER RUPTURE

41. SIGNS AND SYPTOMS PAIN INABILITY TO VOID POSSIBLE HEMATURIA
BLOOD AT MEATUS
ABD. TENDERNESS
LOW ABD. OR PERINEAL HEMATOMA

42. DIAGNOSTIC LABS -- CBC, PT, PTT, UA X-RAYS – 3 VIEW ABD. PELVIS
PELVIC ULTRASOUND

43. PLANNING AND INTERVENTION
HEMODYNAMIC STABLE (ESPECIALLY WITH PELVIC FRACTURE
SURGERY
SUPRAPUBIC TAP
PAIN MEDS
ANTIBIOTICS

44. RENAL TRAUMA

45. SIGNS AND SYMPTOMS PAIN NAUSEA AND VOMITING RETROPERITONEAL HEMATOMA
HEMATURIA
OLIGURIA
CONTUSIONS
ABSENT OR DECREASED BOWEL SOUNDS

46. DIAGNOSTIC PROCEDURES
LABS CBC, SERIAL HEMATOCRITS, LYTES, BUN, CREATININE, PT, PTT, UA, TYPE AND CROSS
X-RAYS ABD FILMS, CT OF ABD

47. PLANNING AND INTERVENTION
MONITOR HEMODYNAMIC STATUS
BLOOD TRANSFUSIONS
PAIN MEDS
ANTIBIOTICS
SURGERY

48. PRIAPISM

49. MEDICAL HISTORY
SICKLE CELL CRISIS
MEDICATION
SPINAL CORD INJURY

50. SIGNS AND SYMPTOMS PENILE ERECTION BLADDER DISTENTION
PARALYSIS WITH SPINAL CORD INJURY
PAIN
ANXIETY

51. DIAGNOSTIC PROCEDURES
LABS

52. PLANNING AND INTERVENTION
PAIN MANAGEMENT
CATHETERIZATION
UROLOGICAL CONSULT
SURGICAL INTERVENTION
NEEDLE ASPIRATION

53. FOREIGN BODIES

54. SIGNS AND SYMPTOMS PAIN MEDICAL HISTORY CHANGE IN URINARY PATTERN
HEMATURIA
URETHRAL DISCHARGE
FB VISIBLE AT MEATUS

55. DIAGNOSTIC PROCEDURE UA
URETHRAL CULTURE
KUB

56. PLANNING AND INTERVENTION
TREAT BLADDER DISTENTION
ESTABLISH URINE OUTPUT
TREAT PAIN
PREPARE FOR MEDICAL INTERVENTION
MEDS. PAIN, ANTIBIOTICS, CONSCIOUS SEDATION
PSYCH CONSULT

57. DISCHARGE INSTRUCTIONS
MEDICATIONS
MONITOR URINE OUTPUT
HYDRATION
RETURN IF STREAM FORCE DECLINES
HEMATURIA DOES NOT RESOLVE