1. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 42 Urinary and Reproductive System Disorders

2. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2  URINARY SYSTEM DISORDERS  Urinary tract infections (UTIs) Infection in one area can involve the entire system. Infection in one area can involve the entire system. Microbes can enter the system through the urethra. Microbes can enter the system through the urethra. Common causes include: Common causes include:  Catheterization  Urological exams  Intercourse  Poor perineal hygiene  Immobility  Poor fluid intake UTI is a common healthcare-associated infection. UTI is a common healthcare-associated infection.

3. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 3 Women are at high risk. Women are at high risk.  Microbes can easily enter the short female urethra. Prostate gland secretions help protect men from UTIs. Prostate gland secretions help protect men from UTIs.  An enlarged prostate increases the risk of UTI in older men. The following increase the risk of UTIs in older men and women: The following increase the risk of UTIs in older men and women:  Incomplete bladder emptying  Perineal soiling from fecal incontinence  Poor fluid intake  Poor nutrition

4. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4  Cystitis is a bladder infection caused by bacteria. The following signs and symptoms are common: The following 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. Treatment includes antibiotics and encouraging fluids.

5. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5  Pyelonephritis is inflammation of the kidney pelvis. Infection is the most common cause. Infection is the most common cause. Cloudy urine may contain pus, mucus, and blood. Cloudy urine may contain pus, mucus, and blood. Signs and symptoms include: Signs and symptoms include:  Chills, fever, back pain  Nausea and vomiting  The signs and symptoms of cystitis Treatment involves antibiotics and fluids. Treatment involves antibiotics and fluids.

6. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 6  Prostate enlargement The prostate is a gland in men. 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 prostrate enlarges as the man grows older. The prostrate enlarges as the man grows older.  This is called benign prostatic hyperplasia or benign prostatic hypertrophy (BPH). BPH causes urinary problems. BPH causes urinary problems.  The enlarged prostate presses against the urethra. This obstructs urine flow through the urethra.

7. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 7 These problems are common: These problems are common:  A weak urine stream  Frequent voidings of small amounts of urine  Urgency and leaking or dribbling of urine  Frequent urination at night  Urinary retention Treatment depends on the extent of the problem. 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 the excess prostate tissue.  Transurethral resection of the prostate (TURP) is a common surgical procedure.

8. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8  Urinary diversions Sometimes the urinary bladder is surgically removed. Sometimes the urinary bladder is surgically removed.  Cancer and bladder injuries are common reasons. A new pathway (urinary diversion) is needed for urine to exit the body. A new pathway (urinary diversion) is needed for urine to exit the body.  Often an ostomy is involved. A urostomy is a surgically created opening between the ureter and the abdomen. A urostomy is a surgically created opening between the ureter and the abdomen. A pouch is applied over the stoma. 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.

9. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 9  Renal calculi Renal calculi are kidney stones. Renal calculi are kidney stones. Risk factors include: Risk factors include:  Being a white male between the ages of 20 and 40 years  Bedrest  Immobility  Poor fluid intake Stones vary in size. Stones vary in size.

10. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10 Signs and symptoms include: 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 frequency  Urinary urgency  Burning on urination  Oliguria (scant amount of urine)  Hematuria (blood in the urine)  Cloudy urine  Foul-smelling urine

11. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 11 Treatment involves: Treatment involves:  Drugs for pain relief  Drinking 2000 to 3000 mL of fluid a day  Straining all urine  Surgical removal of the stone if necessary Some dietary changes can prevent stones. Some dietary changes can prevent stones.

12. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12  Renal failure (kidney failure) In renal failure, the kidneys do not function or are severely impaired. In renal failure, the kidneys do not function or are severely impaired.  Waste products are not removed from the blood.  The body retains fluid. –Heart failure and hypertension easily result.

13. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 13  Acute renal failure is sudden. There is severe decreased blood flow to the kidneys. There is severe decreased blood flow to the kidneys. Causes include: Causes include:  Severe injury or bleeding  Myocardial infarction  Heart failure  Burns  Infection  Severe allergic reactions Hospital care is needed. Hospital care is needed. Some persons develop chronic renal failure. Some persons develop chronic renal failure. Treatment involves drugs, restricted fluids, and diet therapy. Treatment involves drugs, restricted fluids, and diet therapy.

14. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 14  Chronic renal failure The kidneys cannot meet the body’s needs. The kidneys cannot meet the body’s needs.  Nephrons in the kidney are destroyed over many years. Common causes are: Common causes are:  Hypertension  Diabetes Other causes include: Other causes include:  Infections  Urinary tract obstructions  Tumors Signs and symptoms appear when 75% of kidney function is lost. Signs and symptoms appear when 75% of kidney function is lost.

15. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 15 Treatment involves fluid restriction, diet therapy, drugs, and dialysis. Treatment involves fluid restriction, diet therapy, drugs, and dialysis. Dialysis is the process of removing waste products from the blood. Dialysis is the process of removing waste products from the blood.  Hemodialysis removes waste and fluid by filtering the blood through an artificial kidney.  Peritoneal dialysis uses the lining of the abdominal cavity (peritoneal membrane) to remove waste and fluid from the blood.

16. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 16  REPRODUCTIVE DISORDERS  The male reproductive system: Produces and transports sperm Produces and transports sperm Deposits sperm in the female reproductive tract Deposits sperm in the female reproductive tract Secretes hormones Secretes hormones  The female reproductive system: Produces eggs (ova) Produces eggs (ova) Secretes hormones Secretes hormones Protects and nourishes the fetus during pregnancy Protects and nourishes the fetus during pregnancy  Aging, many injuries, diseases, and surgeries affect the structures and functions of the reproductive system.

17. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 17  A sexually transmitted disease (STD) is spread by oral, vaginal, or anal sex. People may not have signs and symptoms. People may not have signs and symptoms. Some may not be aware of an infection. Some may not be aware of an infection. Some know but do not seek treatment because of embarrassment. Some know but do not seek treatment because of embarrassment.  STDs occur: In the genital and rectal areas In the genital and rectal areas In the ears, mouth, nipples, throat, tongue, eyes, and nose In the ears, mouth, nipples, throat, tongue, eyes, and nose

18. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 18  Using condoms helps prevent the spread of STDs.  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. Standard Precautions and the Bloodborne Pathogen Standard are followed.