31. PATHOPHYSIOLOGY Colonization is more likely in bacteria with adhesion properties. Bacteria with virulent factors, such as E. coli hemolysin, enhance pathogenicity and allow bacteria to overcome the antimicrobial properties. A compromised host immune system also causes an increased susceptibility to bacterial cystitis. Trauma to the urinary bladder mucosa due to calculi, damaging catheterization and parturition causes erosion and hemorrhage. Retention of urine due to obstruction or neurogenic causes; it occurs when bacteria overcome normal defense mechanisms and attach to and colonize the urinary bladder mucosa. Cystitis
42. The tumor had taken up over half of the baby’s abdominal cavity when it was found. It pushed the baby’s liver to the left and her right kidneybwas also deformed. The operation lasted 2 hours.
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47. Wilms tumor (WT) NURSING DIAGNOSIS Pain, acute May be related to Tissue trauma, edema formation; cellular ischemia Fluid Volume, risk for deficient Risk factors may include Nausea/vomiting (generalized abdominal and pelvic nerve irritation from renal or ureteral colic), Postobstructive diuresis Urinary Elimination, impaired May be related to Mechanical obstruction, inflammation Infection, high risk for, related to surgical procedure, incisions, implantation of foreign device, decreased mobility. Knowledge, deficient [Learning Need] regarding condition, prognosis,treatment, self-care, and discharge needs May be related to Lack of exposure/recall; information misinterpretation, Unfamiliarity with information resources.
62. URINARY INCONTINENCE a. Urge Incontinence Leakage of urine (often large volumes, but variable) because of inability to delay voiding after sensation of bladder fullness is perceived. [Common causes: detrusor instability, CNS disorders, genitourinary conditions] b. Stress Incontinence Involuntary loss of urine (usually small amount) with increases in intraabdominal pressure (i.e. cough laugh , or exercise) [weakness & laxity of pelvic musculature and urethral sphincter] c. Overflow Incontinence Leakage of urine (usually small amounts) resulting from mechanical forces on an over distended bladder or from other effects of urinary retention on bladder and sphincter function. [anatomic obstruction by prostate or neurologic acontractility secondary to spinal cord injury, diabetes, etc.] ETIOLOGY
63. Genuine Stress Incontinence Hypermobility excessive descent of bladder neck, so poor transmission of increase in ab pressure to proximal urethra. Intrinsic Sphincter Deficiency poor urethral closure due to scarring - surgery, childbirth, neurological injury.