Download Genitourinary System

RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
1.
Behavioral Objectives
Define the terms listed in the content
column appropriate to the patient
situations.
I.
Content Outline
Terms
A. Amenorrhea
B. Bacteriuria
C. Calculus/calculi
D. Cellulitis
E. Cryosurgery
F. Cystocele/rectocele
G. Dysuria
H. Exudate
I. Frequency
J. Hematuria
K. Hyperplasia
L. Laser surgery
M. Macule
N. Menorrhagia
O. Metaplasia theory
P. Metrorrhagia
Q. Nephrolithiasis
R. Nocturia
S. Oligomenorrhea
T. Ovarian cyst
U. Papule
V. Parenchyma
W. Pessary
X. Purulent
Y. Pustule
Z. Pyuria
AA. Retrograde menstruation
BB. Retroversion/retroflexion
CC. Toxic Shock Syndrome (TSS)
DD. Toxin
EE. Transplantation theory
FF. Urge incontinence
GG. Urolithiasis
HH. Uterine prolapse
II. Venereal Disease (VD)
JJ. Vesicle
Clinical Objectives
Compare expected and
achieved outcomes of nursing
care.
Interpret verbal and nonverbal communication.
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Learning Opportunities
READINGS:
McKinney
Adams
Berman & Snyder
Lewis
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
2.
Compare and contrast the normal
anatomy and physiology to the
pathophysiology of the disease
processes in the content column.
3.
Identify factors included in the
assessment of the patient
experiencing commonly occurring
problems of the genitourinary
system, including the developmental
and cultural considerations.
Content Outline
KK. Vesicoureteral reflux
II. Anatomy & Physiology of selected systems
A. Genitourinary
B. Developmental considerations
1. Infant
2. Child
3. Adolescent
4. Adult
5. Older adult
III. Initial physical assessment.
A. Interview
1. Chief complaint
2. Precipitating factors
3. Medical history
4. OB/Gyn history
5. Family/social/occupational history
6. Medication history
(prescription/nonprescription)
7. Knowledge of health
maintenance/prevention
8. Risk factors
B. Physical exam – Genitourinary System
1. Intake & Output
2. Pain/itching
3. Discharge
a. Urethral
b. Cervical
c. Rectal
4. Change in urinary pattern
a. Frequency
b. Dysuria
c. Retention
5. Erythema
C. Diagnostic test
1. Laboratory
a. Urine culture & sensitivity
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
Content Outline
BUN/creatinine
PSA (acid phosphatase & prostate –
specific antigen)
d. Tissue culture
e. Thyroid function
f. Endocrine workup
g. Serum progesterone
h. Serum human chorionic
gonadotropin (hCG)
i. WBC
j. Pregnancy test
k. Urine calcium/uric acid
l. Urine oxalate excretion
m. Serum calcium, phosphorus, uric
acid
n. Gram stain of urine
o. VDRL (Venereal Disease Research
Laboratory)
p. RPR (Rapid plasma Reagin)
q. FTA-ABS (Fluorescent Treponemal
Antibody Absorption)
r. Immunofluorescent staining
s. Darkfield microscopy
t. Discharge smears
u. Pap smear
v. EIA (Enzyme Immunoassay,
Chlamydiazyme or test patch)
w. Direct immunofluorescence (Micro
Trak)
x. PCR (Polymerase Chain Reaction
Assay)
y. Urine test using PCR & LCR
(Ligase Chain Reaction)
z. Biopsy (if lesions bleed)
Radiology studies
a. Uroflowmetry (cystometry &
pressure flow studies)
b.
c.
2.
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
Content Outline
Ultrasonography
KUB (kidneys, ureters & bladder)
IVP (Intravenous pyelogram)
retrograde pyelography
e. CT (Computer Tomography) MRI
(Magnetic Resonance Imaging)
f. Voiding cystourethrography
3. Other
a. Cystoscopy
b. Laproscopy
D. Cultural influences
1. Heredity
2. Environmental
3. Health beliefs/practices
4. Spiritual/religious
5. Language
E. Developmental
1. Age specific assessment data
a. Vital signs
b. Fluid/electrolytes
c. Nutritional
d. Physical changes
F. Behavioral/emotional response
1. To health care providers
2. Family/significant others
b.
c.
d.
4.
Differentiate between the etiology,
pathophysiology, and clinical
manifestations of elected commonly
occurring disease processes.
IV. Common occurring problems
A. Gender specific
1. Female
a. Uterine fibroids
b. Ovarian cyst
c. Endometriosis
d. Pelvic relaxation disorders
e. Premenstrual syndrome (PMS)
f. Pelvic inflammatory disease (PID)
g. Active Bladder
2. Male
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
5.
Discuss analysis, planning,
implementation, and evaluation of
the nursing management of patients
Content Outline
a. Prostatitis
b. Benign prostatic hypertrophy (BPH)
B. Non-gender specific
1. Toxic Shock Syndrome
2. Urinary calculi
3. Urinary tract infection
a. Cystitis
b. Pyelonephritis
C. Selected surgeries
1. Lithotripsy
2. Pyelolithotomy (open)
3. Hysterectomy
4. Cystocele/Rectocele repair
5. Transurethral Resection of the Prostate
(TURP)
6. Bladder Sling
D. Sexually transmitted diseases
1. Developmental Considerations
a. Infant/ newborn
b. Child
c. Adolescent
d. Adult
e. Pregnant patient
f. Older adult
2. Disease process
a. Candida
b. Chlamydia
c. Cytomegalovirus (CMV)
d. Gonorrhea
e. Herpes simplex II
f. Human papilloma virus/condyloma
g. Syphilis
h. Trichomoniasis
V. Selected nursing diagnoses/implementation
A. Pain (chronic & acute)
1. Independent
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
with commonly occurring selected
disease processes.
Content Outline
Chief complaint
Pain assessment scales
Physiological/behavioral response
Assess social support & usual
methods of coping
e. Respond immediately to complaints
of pain
f. Encourage patients to describe pain
episodes to identify factors
associated
g. Encourage patient to actively
participate in planning for pain
control
h. Teach and encourage the use of
alternate methods of pain relief such
as massage, visualization,
relaxation, distraction, and touching
to alter pain perception
i. Position for comfort
Collaborative care
a. Administer prescribed medication
and monitor for desired
effects/adverse effects/side effects
(1) Analgesics
(2) Narcotics
(3) Supplemental oxygen
(4) Anti-virals
(5) Antibacterials
(6) Antifungal
(7) Antiprotozoals
Evaluation of outcomes: Patient will
have decrease pain as evidenced by:
a. Using prescribed analgesic
medications correctly
b. Using nonpharmacologic pain
strategies as recommended
c. Actively participating in pain
a.
b.
c.
d.
2.
3.
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
Content Outline
management regimes
d. Ability to identify factors that
precipitate pain.
B. Potential for infection/recurrent infection
1. Dependent
a. Monitor for signs of infection
b. Monitor vital signs
c. Monitor lab/x-ray test
d. Encourage adequate fluids, and
optimal nutrition
e. Teach signs/symptoms/infection
control measures/preventive
measures
f. Change dressings if applicable
g. Instruct in wound care as
appropriate
2. Collaborative
a. Administer medication and monitor
for desired effects/adverse
effects/side effects
b. Medications
(1) Anti-infective
(2) Antibiotic
(3) Oxygen
(4) Antiviral
(5) Antibacterials
(6) Antifungal
(7) Antiprotozoals
3. Evaluation of outcome: Patient will
have potential for infection/recurrent
infection as evidenced by:
a. Describing signs/symptoms
b. Wound care
c. Monitor signs/symptoms
d. Optimal nutrition, fluids
e. Prevention measures
f. Describing disease process and
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
Content Outline
effects
C. Impaired skin integrity
1. Independent
a. Assess and monitor skin & mucous
membranes
b. Encourage mobility/turn q 2 hrs
c. Provide immediate care after
incontinent
d. Encourage adequate nutrition
e. Massage bony prominences
f. Keep skin clean and dry
g. Linen wrinkle free/avoid friction
2. Collaborative
a. Medications as ordered
b. Clean draining lesions and dress per
physician order
3. Evaluation of outcomes
a. Skin integrity will remain intact
D. Impaired social interaction
1. Independent
a. Provide a supportive environment
b. Refer to counseling, support groups,
community resources.
c. Promote interaction between patient,
significant others and family
d. Assess social support and usual
methods of coping
e. Develop a trusting, therapeutic
relationship
f. Encourage the patient and
significant other to discuss their
fears and concerns with each other
g. Provide the patient and significant
other with factual information about
disease and its effects
2. Evaluation of outcomes: Patient will
have impaired social interaction as
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
Content Outline
evidenced by:
a. Discussing feelings and alternatives
with significant other
b. Participating in community/support
groups
E. Altered health maintenance: Knowledge
deficit regarding disease process
1. Independent
a. Assess readiness to learn, ability,
knowledge level
b. Avoid aggravating factors
c. Promotion of alleviating factors
d. Reportable signs/symptoms
e. Medication teaching
f. Rest/activity
g. Risk factors
h. Prevention of spread of infection
i. Life style modification
j. Nutrition
k. Information about disease prognosis
and treatment
l. Community resources
2. Evaluation of outcomes: Patient will
have decreased knowledge deficit as
evidenced by:
a. Have counseling and
support/community resources
b. Have interaction with significant
others and family
c. Have a trusting relationship with
staff, family, and significant others
d. Discuss concerns/fears openly
e. Describe accurate information about
the disease process & outcomes of
treatment.
f. Verbalizes knowledge of medication
g. Verbalizes understanding of
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
Content Outline
infection prevention
h. Verbalizes understanding of
nutritional needs
F. Knowledge deficit about factors related to
surgical procedures
1. Independent
a. Assess readiness to learn, ability,
and knowledge level
b. Review anatomy and how they
function in relation to the urinary
and reproductive systems
c. Provide information regarding
diagnostic tests, surgery, and after
care.
(1) Instruct about drainage systems,
anesthesia, and recovery
procedures.
(2) Encourage questions and
provide support as needed.
(3) Reportable signs and symptoms
(4) Medication teaching
(5) Risk factors
(6) Life style changes
(7) Infection prevention
2. Evaluation of outcomes: Patient will
have decreased knowledge deficit as
evidenced by:
a. Able to describe anatomy of
affected parts and how they function
b. Verbalizes what to expect during
test, surgery, and pre/post
operatively
G. High risk for sexual dysfunction
1. Independent
a. Inform patient of effects of surgery
on sexual function
b. Allow patient/partners to verbalize
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of Patient Experiencing Commonly Occurring Health Care Problems
Part A – Genitourinary Problems
Behavioral Objectives
Content Outline
feelings
c. Provide information about aftercare
alternatives
2. Collaborative
a. Participate in intra-disciplinary
planning.
b. Evaluation of outcomes
c. Patient and significant other
verbalize understanding of risk
factors for sexual dysfunction
H. High risk for recurrent Urinary Tract
Infection (UTI), Renal colic, Pyelonephritis
1. Independent
a. History of signs/symptoms
b. Assess knowledge deficit of
preventive measures
c. Instruct on strict hygienic measures
d. Instruct on bathing in shower (no
tubs)
e. Assess and instruct on nutrition &
fluid needs
f. Monitor lab/test values
g. Assess need of home health follow
up
2. Collaborative
a. Administer medications as ordered
3. Evaluation of outcomes: Patient will
have decreased risk for recurrent UTI,
renal colic, pyelonephritis as exhibited
by:
a. Verbalizing understanding of
preventive measures
b. Demonstrating hygiene, care of
drainage etc
c. Assessing nutrition
N:\ADN\Transition/RNSG1327/UnitV-A/Genitourinary Problems
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Clinical Objectives
Learning Opportunities
Revised 03/12
Reviewed 03/13