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