response one page each with reference of 3 each please

Week 7 Discussion Initial Post

When discussing the disorders of the renal urologic system, urethritis is a more common problem. Urethritis is the inflammation of the urethra, which is most commonly linked to sexual transmitted infections, but can be caused be other means as well, such as catheter insertion (Harvard Health Publishing, 2019). This does have some variance in gender. This discussion will involve the pathophysiology, treatment, and the gender differences of urethritis.

Pathophysiology

Urethritis is the inflammatory process of the urethra and is typically caused by infection, but can be from trauma as well. The typical infectious process is from sexual transmitted infection, such as gonorrhea (Harvard Health Publishing, 2019). This infectious process can cause inflammation in the pelvic region, including the urethra. Trauma from procedures, such as catheter insertion, can also cause irritation and inflammation. This results in pain and should be promptly assessed and treated.

Treatment

Treatment for urethritis should first consider the infectious. If it is determined that the urethritis is caused from trauma or chemical exposure, the irritating factor should be removed and monitored for improvement (Harvard Health Publishing, 2019). Antibiotics and anti-inflammatories should be used to treat the infection or potential infection and to also control pain. Anti-inflammatories should be used a first line pain medicine since the cause of the pain is of an inflammatory means.

Gender

There is variance in urethritis presentation in male patients versus female patients. In men, symptoms typically include penile tingling, penile itching, and dysuria (Brill, 2010). In women, dysuria, pelvic pain, and urethral discharge are the symptoms of urethritis (Fairview Health, 2019). These symptoms, while being similar, will present very differently. Men typically delay in care or may have minimal symptoms. Women will typically present with urethral discharge and pain. This pain involves both from the inflammation urethra and can be exacerbated with urination.

References

Brill, J. R. (2010, April 1). Diagnosis and Treatment of Urethritis in Men. Retrieved April 6, 2020, from https://www.aafp.org/afp/2010/0401/p873.html

Fairview Health. (2019). Patient Education. Retrieved April 6, 2020, from https://www.fairview.org/patient-education/40448

Harvard Health Publishing. (2019). Urethritis. Retrieved April 6, 2020, from https://www.health.harvard.edu/a_to_z/urethritis-a-to-z

REPLY QUOTE EMAIL AUTHOR

19 hours agoAndrea Good
Nephrolithiasis-Andrea Good
COLLAPSE
According to McCance & Huether (2019), renal calculi (nephrolithiasis) come from substances such as crystals or protein and can be located in the kidneys, ureters, and urinary bladder. Nephrolithiasis is the most common cause of urinary tract obstruction in adults. There are many factors influencing calculus formation, including age, sex, race, geographic location, genetic predisposition, and other conditions, including urinary tract infection, hypertension, atherosclerosis, metabolic syndrome, obesity, and diabetes. In addition, most people develop their first kidney stone before the age of 50 years. Additionally, decreased water consumption and physical inactivity increase the risk of calculus development. Urinary calculi are classified according to the primary minerals that make up the stone. About 85% of stones are made of calcium, about 10% of uric acid, 5% of magnesium, and less than 1% of cystine.

Pathophysiology

There appears to be supersaturation or a higher concentration of salts within the urine. The salts are not being properly diluted, and the formation from crystals are retained and grow into stones. The urine pH is also essential in the risk of calculus formation. The higher the pH, the higher the risk of developing calcium phosphate stones, whereas acidic urine increases the risk of uric acid stones. Due to the inability of prompt flushing, the papillary collecting ducts are the primary site for crystal particles to retain due to urinary stasis, anatomic abnormalities, or inflamed epithelium within the urinary tract. Stones that are smaller than 5mm can be passed spontaneously. However, people who have already passed a kidney stone are able to excrete larger stones due to ureteral dilation.

Maladaptive and Physiological

The maladaptive response to renal calculus comes when the stones move and obstruct the ureter. This causes severe and incapacitating pain, nausea and vomiting can also accompany the symptoms. In addition, if patients develop anuria or acute renal failure due to bilateral obstruction, percutaneous nephrostomy, or retrograde ureteral stent insertion must take place as soon as possible (Portis & Sundaram, 2001).

The physiological response may present itself as people develop gross or microscopic hematuria. Additionally, complications from untreated urolithiasis can result in renal failure, ureteral stricture, sepsis, urine extravasation, perinephric abscess, and pyelonephritis (Portis & Sundaram, 2001).

Pain Management

Pain medications are the primary drugs to treat nephrolithiasis. NSAIDs such as ibuprofen, aspirin, diclofenac are incredibly useful in pain management. In addition, ketorolac is a narcotic-like analgesic that has superior effects when compared with Demerol. However, ketorolac is contraindicated in nephrolithiasis due to the fact that extracorporeal shock wave lithotripsy that would increase the risk of perinephric bleeding. Outpatient pain management uses oral narcotics and NSAIDs (Portis & Sundaram, 2001).

Patient Factor-Pregnant women

The main risk during acute renal colic in pregnancy is a potential source of morbidity to mother and child, as this can result in sepsis and preterm delivery. In addition, the diagnostic options are limited due to hazards exposure to the fetus. Furthermore, NSAIDs should be prescribed with strict precautions in the third trimester of pregnancy (Jung & Osther, 2015).

References

Jung, H., & Osther, P. J. S. (2015). Acute management of stones: when to treat or not to treat? World Journal of Urology, 33(2), 203–211. https://doi-org.ezp.waldenulibrary.org/10.1007/s00345-014-1353-y

McCance, K., & Huether, S. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Elsevier/Mosby

Portis, A. J., & Sundaram, C. P. (2001). Diagnosis and Initial Management of Kidney Stones. Retrieved from https://www.aafp.org/afp/2001/0401/p1329.html

REPLY QUOTE EMAIL AUTHOR

5 hours agoKathleen Brewer WALDEN INSTRUCTOR MANAGER
RE: Nephrolithiasis-Andrea Good
COLLAPSE
Dear Andrea:

Thanks so very much for this interesting post. I appreciate the comprehensive way you presented this information. Did you see any salient information about how diet might contribute to the development of kidney stones? What education might you share with your patient who develops these stones? Thanks for the discussion. Nicely written.

Regards, Kathleen

Required Readings (click to expand/reduce)

Arcangelo, V., Peterson, A., Wilbur, V., & Reinhold, J. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 32, “Urinary Tract Infection” (pp. 519–526)
Pharmacotherapeutics for Advanced Practice: A Practical Approach 4th Edition by Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. Copyright 2016 by LWW. Reprinted by permission of LWW via the Copyright Clearance Center.

Arcangelo, V., Peterson, A., Wilbur, V., & Reinhold, J. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 34, “Overactive Bladder” (pp. 545–564)
Pharmacotherapeutics for Advanced Practice: A Practical Approach 4th Edition by Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. Copyright 2016 by LWW. Reprinted by permission of LWW via the Copyright Clearance Center.

McCance, K., & Huether, S. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Elsevier/Mosby.

Chapter 38, “Structure and Function of the Renal and Urologic System” (pp. 1228–1245)
Chapter 39, “Alterations of Renal and Urinary Tract Function” (pp. 1246–1277)
American Academy of Neurology. (2019). Policy and guidelines: Multiple sclerosis. Retrieved from https://www.aan.com/Guidelines/home/ByTopic?topicId=18

American College of Physicians. (2013). ACP releases guideline on screening, monitoring, and treatment of stage 1 to stage 3 chronic kidney disease. Annals of Internal Medicine, 90(2), 121–122. Retrieved from https://www.aafp.org/afp/2014/0715/p121.pdf

American Family Physician. (2010). Diagnosis and treatment of urethritis is men. Retrieved from https://www.aafp.org/afp/2010/0401/p873.html

Huang, W. J., Chen, W. W., & Zhang, X. (2017). Multiple sclerosis: Pathology, diagnosis and treatments. Experimental and Therapeutic Medicine, 13(6), 3163–3166. https://doi-org.ezp.waldenulibrary.org/10.3892/etm.2017.4410

National Multiple Sclerosis Society. (n.d.). Medications. Retrieved September 12, 2019, from https://www.nationalmssociety.org/Treating-MS/Medications

Portis, A. J., & Sundaram, C. P. (2001). Diagnosis and initial management of kidney stones. American Family Physician, 63(7), 1329–1339. Retrieved from https://www.aafp.org/afp/2001/0401/p1329.htm

Zephir, H. (2018). Progress in understanding the pathophysiology of multiple sclerosis. Revue Neurologique, 174(6), 358–363.

Discussion: Pathophysiology and Pharmacology of Renal and Urologic System Disorders
For this Discussion, you will follow the same format as in Weeks 4 and 5, but you will be assigned a different disorder from the renal or urologic systems.

Photo Credit: Getty Images/Cultura RF

To prepare:

Your Instructor will assign you to one of the following renal or urologic disorders:
nephrolithiasis
renal failure
urethritis

Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)
Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)
Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.
0 (0%) – 34 (34%)
Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by Day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post main post by Day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)
Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)
Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on three different days.
Total Points: 100
Name: NURS_6380_Week7_Discussion_Rubric