NUR 660 Discussion 1 Case Study Discussion – Gastrointestinal Disorders
NUR 660 Discussion 1 Case Study Discussion – Gastrointestinal Disorders
1. Compare the typical signs of acute bacterial prostatitis, chronic bacterial prostatitis, and acute nonbacterial prostatitis.
Prostatitis is inflammation of the prostate and can be acute or chronic (Berkowitz, 2020, p. 169). In acute bacterial prostatitis, typical signs include fever, chills, and dysuria. Patients can also experience urgency and frequency, as well as back pain. Chronic bacterial prostatitis can present with frequency, urgency, dysuria, abdominal and back pain, and can additionally cause recurrent UTIs. Acute nonbacterial prostatitis can have above signs, usually with decreased systemic signs, but there will not be a positive bacterial growth in the culture (Berkowitz, 2020, p. 169).
2. Compare BPH and prostatic cancer in terms of the characteristic location of the tumor and the early signs. What are the risk factors for each condition?
Benign Prostatic Hypertrophy (BPH) is when the prostate enlarges or hypertrophies. In prostate cancer, the gland also enlarges usually in the posterior portion, but can further spread to other parts of the body. BPH cannot spread therefore it is benign. Due to the urethra running through the prostate, BPH includes signs of an obstruction such as frequency, hesitancy, dribbling, and decreased force of flow (Hubert & VanMeter, 2018, p. 519). Initially, there is often no obstruction with prostate cancer so patient can be symptomatic. Signs that may develop include blood in the urine, difficulty with erection, pain in hips or back, loss of bladder control, and other problems with urination (National Cancer Institute, n.d.).
The risk factors for BPH are age, ethnicity, familial history, obesity, diabetes, inactive lifestyle, and heart disease. The risk factors for prostate cancer include age, race, North American or Norther European location, familial history, nutrition, lifestyle or exposure to Agent Orange (Prostate Cancer Foundation, n.d.).
3. Describe each of the following: (1) second-degree uterine prolapse, (2) cystocele, and (3) retroversion of the uterus. Explain the secondary problems that may occur with second- or third-degree prolapse.
A uterine prolapse is when the uterus is displaced and begins to move downward into the vagina. A second-degree prolapse is when the it has slipped down to the level of the vaginal opening (Hubert & VanMeter, 2020, p. 525). A cystocele is when the bladder moves into the vagina, known as a bladder prolapse. A healthy uterus is mildly tipped forward, anteverted, and bent forward over the bladder, anteflexed. If it is tipped backward, this is known as a retroverted uterus.
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Due to the weak pelvic floor and surrounding tissue and muscle, the secondary problems that can occur with a second or third-degree prolapse include secondary prolapses, such as the bladder (cystocele) and rectum (rectocele). Other side effects can include changes in bladder and bowel function, pain or discomfort with intercourse, and poor body image (Cleveland Clinic, 2019).
4. How can infection in the vagina can cause PID? What signs and symptoms would you expect? Why is this considered a serious condition?
When the bacteria enters the vagina, usually arising from STDs, it can travel through cervix, into the uterus, and further into the fallopian tubes (Hubert & VanMeter, 2018). This invasion of bacteria triggers an inflammatory response. Signs and symptoms of PID include vaginitis or cervicitis, abdominal pain, nausea/vomiting, purulent discharge, fever, leukocytosis, and peritonitis. This is serious condition because complications include Fitz-Hugh-Curtis syndrome, tubo-ovarian abscess, infertility, ectopic pregnancy, and septicemia (Berkowitz, 2020, p. 174).
5. Describe the causative organisms for (1) chlamydial infection, (2) gonorrhea, (3) syphilis, (4) trichomoniasis, and (5) genital herpes.
The causative pathogen of chlamydial infection includes the bacterium C. trachomatis, a gram-negative obligate parasite. Gonorrhea is caused by N. gonorrohoeae, a gram-negative aerobic diplococcus. The bacterium, Treponema pallidum, an anaerobic spirochete is responsible for syphilis. Trichomoniasis is caused by an anaerobic flagellated protozoan called trichomonas vaginalis. Lastly, the viral infection of genital herpes is the herpes simplex 2 virus (Hubert & VanMeter, 2018, p. 539).
6. Compare the early manifestations of chlamydial infection, gonorrhea, trichomoniasis, syphilis, and genital herpes. Why are these STIs difficult to control (that is, why is it hard to reduce the incidence)?
The early signs of STIs include:
- Chlamydia: mild dysuria, discharge, or asymptomatic
- Gonorrhea: dysuria, discharge, can be mild or asymptomatic
- Trichomoniasis: asymptomatic or discharge and dysuria
- Syphilis: Primary: painless ulcer or chancre at site of entry. Secondary: rash, fever, headache
- Genital herpes: vesicles and ulcers
It is difficult to reduce STIs because of poor condom use, increased use of hormonal therapy for contraception, divorce rates, multiple sexual partners, alcohol abuse, use of date rape drugs, increased drug resistance organisms, asymptomatic and spreading infection, poor report rates, and so on (Hubert & Van Meter, 2018, p. 538).
7. Describe three factors predisposing patients to vaginal candidiasis and identify the causative organism.
Vaginal candidiasis is a form of vaginitis causes by C. albicans. It is a yeast infection and not sexually transmitted. Three factors predisposing patients include the use of antibiotics because of their disruption to normal flora, immune-deficiency, and diabetes due to increased glucose levels (Hubert & VanMeter, 2018, p. 528).
Berkowitz, A. (2020). Clinical Pathophysiology Made Ridiculously Simple. MedMaster, Inc. Cleveland Clinic. (2019, December). Uterine Prolapse. https://my.clevelandclinic.org/health/diseases/16030-uterine-prolapse
Hubert, R. J., & VanMeter, K. C. (2018). Pathophysiology Online for Gould’s Pathophysiology for the Health Professions(6th ed.). Elsevier
National Cancer Institute. (n.d.). Understanding Prostate Changes: A Health Guide for Men. https://www.cancer.gov/types/prostate/understanding-prostate-changes#prostate-cancerProstate Cancer Foundation. (n.d.). Prostate Cancer Risk Factors. https://www.pcf.org/patient-resources/family-cancer-risk/prostate-cancer-risk-factors/
Explain how decreased fluid intake or dehydration predisposes to calculi in the urinary tract.
A decrease in fluid intake or dehydration can lead to a renal stone because there tends to be a higher concentration of filtrate (VanMeter & Hubert 2019 p.503). Once any solid material or debris forms, deposits continue to build upon this nidus or focus in eventually form a large mass (VanMeter & Hubert 2019 p.503). This mass is a renal stone. Renal stones can range in size and material composition dependent on the diet and activity of the individual.
Explain what the presence of the following in the urine indicates: blood (microscopic and gross), protein, pus, casts, and glucose.
A urinalysis can determine many things about the health of somebody’s kidneys and or bladder. Small blood in the urine and can be an indication of inflammation, infection, or tumors of the urinary tract; wow that large amounts of blood are known as gross hematuria can increase indicate an increase in glomerular permeability or hemorrhage in the urinary tract (VanMeter & Hubert 2019 p.495). Protein in the urine can indicate kidney damage. However, there is also a small amount of protein in your urine as a waste product (American Kidney Fund (AKF), 2020). Protein in the urine can also indicate high levels of stress pregnancy and dehydration (American Kidney Fund (AKF), 2020). Pus in the urine can be an indication of an infection within the kidneys or the bladder. Casts are microscopic size molds of tubules, consisting of one or more cells, bacteria, protein, and someone who can educate inflammation of the kidney tubules (VanMeter & Hubert 2019 p.495). Glucose found in the urine can indicate when diabetes Mellitus is not well controlled (VanMeter & Hubert 2019 p.495). Typically when there is glucose in the year in, ketones are indicated when diabetes Mellitus is not well-controlled (VanMeter & Hubert 2019 p.495).
Compare the signs/symptoms of cystitis and pyelonephritis. Which of these indicate that kidney involvement (local or systemic) is occurring?
Cystitis is inflammation of the lining of the bladder. Some signs and symptoms of cystitis are urgencies, a burning sensation when urinating, frequency, hematuria, foul-smelling urine, pelvic discomfort, bladder pressure, and a low-grade fever (Mayo Clinic, 2020). These signs and symptoms indicate a local infection.
Pyelonephritis is a type of urinary tract infection (UTI) (National Institute of Diabetes and Digestive and Kidney Diseases, 2021). Some signs and symptoms of pyelonephritis are chills, fever, pain in your back, side, or groin, nausea, vomiting, cloudy, dark, bloody, or foul-smelling urine, frequent, and painful urination (National Institute of Diabetes and Digestive and Kidney Diseases, 2021). These signs and symptoms indicate a systematic issue.
Where is the urinary bladder located relative to the uterus and rectum in a woman? Briefly explain two possible implications of this location.
The urinary bladder is located in front of the uterus. Starting from front to back, the bladder since first than the uterus than the rectum in women. “The bladder is located in the lesser pelvis when empty and extends into the abdominal cavity when full” (Shermadou 2021). Because of its location, the urinary bladder can be impacted by pregnancy or by constipation located in the rectum and can put pressure and increase discomfort for the individual. The location of the urinary bladder can also impact how the uterus suit and, depending on how the uterus is positioned, can cause dysmenorrhea or painful menstruation or dyspareunia, or painful intercourse (VanMeter & Hubert 2019 p.527). The urinary bladder can also be impacted by the removal or displacement, or prolapse of the uterus. How the uterus is affected can either place pressure on the urinary bladder or displace the bladder.
Why does male anatomy make it likely that a reproductive system infection may extend into the urinary system?
Infection may likely extend to the urinary system in a male reproductive system due to its function and structure. Due to which structure did the urethra is both a pathway for sperm and urine to be moved from the body to an external environment. Similar to the esophagus in the trachea in the throat, where there is a flap to make sure the food moves down the esophagus rather than down to the trachea, there is a structure similar to the pathway for urine and sperm within the male genitalia. At a point in the ampulla, a structure prevents sperm from going into the pathway when urinating (VanMeter & Hubert 2019 p.527). The same is true for when male ejaculates. If a male contracts an STD or develops a UTI, it can affect both the reproductive in urinary systems due to the structural and functional state of the male genitalia.
Explain the difference in causes of frequent voiding associated with cystitis versus those associated with renal insufficiency.
Frequency voiding related to cystitis is due to inflammation related to infection, which sets off the urinary nerve. This nerve set off ab individual’s urge to void. Renal insufficiency is “poor function of the kidneys that may be due to a reduction in blood-flow to the kidneys caused by renal artery disease” (UC Davis Health, Vascular Center 2020). In renal insufficiency, the individual will experience oliguria or lower urinary output due to the lack of perfusion to the kidneys.
How might urinary tract infections lead to calculus formation?
Typically the opposite is true that a calculus formation can lead to urinary tract infection (UTI). However, in some cases, a UTI might lead to a calculus formation. Some factors for the development of urinary stones are increased salt concentration, either by increased excretion of calcium or uric acid salts or by decreased urinary citrate excretion (Preminger, 2021). These factors can be the result of a UTI leading to stone formation.
American Kidney Fund (AKF). (2020). Protein in Urine (Proteinuria) Causes, Symptoms, & Treatments. Retrieved November 9, 2021, from https://www.kidneyfund.org/kidney-disease/kidney-problems/protein-in-urine.html
Mayo Clinic. (2020, May 14). Cystitis – Symptoms and causes. Retrieved November 9, 2021, from https://www.mayoclinic.org/diseases-conditions/cystitis/symptoms-causes/syc-20371306
National Institute of Diabetes and Digestive and Kidney Diseases. (2021, November 9). Symptoms & Causes of Kidney Infection (Pyelonephritis). Retrieved November 9, 2021, from https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-infection-pyelonephritis/symptoms-causes
Preminger, G. M. (2021, November 4). Urinary Calculi. Merck Manuals Professional Edition. Retrieved November 9, 2021, from https://www.merckmanuals.com/professional/genitourinary-disorders/urinary-calculi/urinary-calculi
Shermadou ES, Rahman S, Leslie SW. Anatomy, Abdomen and Pelvis, Bladder. [Updated 2021 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531465/
VanMeter, K. C., & Hubert, R. J. (2018) Study guide for Gould’s pathophysiology for the health professions. (6th ed.) Elsevier Saunders.
UC Davis Health, Vascular Center> Renal Insufficiency | UC Davis Health Vascular Center. Copyright UC Regents. For More Information Regarding the University of California’s Copyright Terms, Visit Https://Www.Ucop.Edu/Services/Terms.Html. Retrieved November 9, 2021, from https://health.ucdavis.edu/vascular/diseases/renal_insufficiency.html
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