Genitourinary Emergencies

ASSESSMENT Primary Survey Secondary Survey

RISK FACTORS PERSONAL HABITS DECREASED FLUID INTAKE IMMOBILITY DIET HIGH IN OXALATES POOR PERINEAL HYGIENE PREGNANCY DIABETES

RISK FACTORS SPINAL CORD INJURY FOLEY CATHETER INSERTION PREVIOUS INFECTIONS TRAUMA EXTREMES OF AGE

FOCUSED SURVEY SUBJECTIVE DATA HISTORY OF PRESENT ILLNESS MEDICAL HISTORY

OBJECTIVE DATA PHYSICAL EXAM A. GENERAL SURVEY B. INSPECTION C. PERCUSSION D. PALPATION

DIAGNOSTIC PROCEDURES LAB STUDIES RADIOGRAPHIC STUDIES

AGE RELATED CONSIDERATIONS PEDIATRIC A. GROWTH AND DEVELOPMENT B. PEARLS GERIATRIC A. AGE RELATED

ACUTE RENAL FAILURE THREE TYPES OF RENAL FAILURE A. PRERENAL B. INRARENAL (intrinsic) C. POSTRENAL

PRERENAL SHOCK CHF SEPSIS ANAPHYLAXIS PERICARDIAL TAMPONADE PULMONARY EMBOLISM

INTRARENAL ACUTE INERSTITAL NEPHRITIS EXPOSURE TO NEPHROTOXINS ACUTE GLOMERULONEPHRITIS VASCULITIS RENAL ARTERY OR VEIN STENOSIS

POSTRENAL URETHRAL OR BLADDER CANCER RENAL CALCULI PROSTATIC HYPERPLASIA OR CA CERVICAL CANCER URETHRAL STRICTURE

URINARY TRACT INFECTION

SIGNS AND SYMPTOMS FEVER HEMATURIA CHILLS AND FEVER DYSURIA AND/OR URGENCY DULL FLANK PAIN NAUSEA LEUKOCYTOSIS

PLANNING AND INTERVENTION ANTIBIOTICS ANALGESICS ANTYPYRETICS

DISCHARGE INSTRUCTIONS FINISH ALL ANTIBIOTICS CLEAN FROM FRONT TO BACK VOID FREQUENTLY AVOID BUBBLE BATHS VOID AFTER INTERCOURSE CLEAN FORESKIN IN MALES INCREASE FLUID INTAKE

PYELONEPHRITIS

PREDESPOSING FACTORS PREGNANCY DELAY IN TREATMENT OF UTI IMMUNOSUPRESSION MORE THAN 3 UTI IN ONE YEAR

SIGNS AND SYMPTOMS DULL UNILATERAL FLANK PAIN FEVER AND CHILLS RECENT UTI OR STD DYSURIA FREQUENCY HEMATURIA

PLANNING AND INTERVENTION FLUIDS ANALGESICS IV ANTIBIOTICS ANTIPYRETICS

URINARY CALCULI

RISK FACTORS HYPERCALCEMIA UTI GOUT DIET DEHYDRATION PREGNANCY

SIGNS AND SYMPTOMS ASYMPTOMATIC UNTIL STONE MOVES BACKACHE DYSURIA RENAL COLIC HEMATURIA NAUSEA SWEATING

PLANNING AND INTERVENTIOS IV FLUIDS PAIN MEDICATION X RAYS OR CT STRAIN URINE LITHOTRIPSY SURGERY

CRITERIA FOR ADMISSONS PAIN MANAGEMENT SOLITARY KINDEY ILEUS BLADDER STONES INFECTION

DISCHARGE PAIN MEDS INCREASE FLUIDS STRAIN URINE RETURN FOR INCREASE PAIN OF VOMITING

TESTICULAR TORSION

SIGNS AND SYMPTOMS UNILATERAL TESTICULAR PAIN SCROTAL SWELLING REDNESS AND TENDERNESS

DIAGNOSTIC UA CBC DOPPLER ULTRASOUND FLOW STUDY

EPIDIDYMIDITIS

SIGNS AND SYMPTOMS GRADUAL ONSET OF SCROTAL PAIN RED, SWOLLEN, WARM SCROTUM DYSURIA OR URETHRAL DISCHARGE TENDERNESS IN GROIN OR LOW ABD DUCK WADDLE GAIT

DIAGNOSTIC UA WITH C&S GRAM STAIN IF ANY DISCHARGE ULTRASOUND

PLANNING AND INTERVENTION ANTIBIOTICS ANALGESICS SCROTAL SUPPORT WITH ELEVATION AVOID PHYSICAL STRAIN

URETHRAL INJURY

FEMALES RARE CHILDBIRTH OR VAGINAL SURGERY STRADDLE INJURIES PELVIC FRACTURE

MALES TRAUMA MUTILATION SEXUAL ACTIVITY INSTRUMENTATION

SIGNS AND SYMPTOMS PAIN HEMATURIA BLOOD AT URINARY MEATUS HEMATOMA OF ABD.OR PERNIEUM

DIAGNOSTIC LABS X RAYS

TREATMENT CATHETERIZATION SURGERY

BLADDER RUPTURE

SIGNS AND SYPTOMS PAIN INABILITY TO VOID POSSIBLE HEMATURIA BLOOD AT MEATUS ABD. TENDERNESS LOW ABD. OR PERINEAL HEMATOMA

DIAGNOSTIC LABS -- CBC, PT, PTT, UA X-RAYS – 3 VIEW ABD. PELVIS PELVIC ULTRASOUND

PLANNING AND INTERVENTION HEMODYNAMIC STABLE (ESPECIALLY WITH PELVIC FRACTURE SURGERY SUPRAPUBIC TAP PAIN MEDS ANTIBIOTICS

RENAL TRAUMA

SIGNS AND SYMPTOMS PAIN NAUSEA AND VOMITING RETROPERITONEAL HEMATOMA HEMATURIA OLIGURIA CONTUSIONS ABSENT OR DECREASED BOWEL SOUNDS

DIAGNOSTIC PROCEDURES LABS CBC, SERIAL HEMATOCRITS, LYTES, BUN, CREATININE, PT, PTT, UA, TYPE AND CROSS X-RAYS ABD FILMS, CT OF ABD

PLANNING AND INTERVENTION MONITOR HEMODYNAMIC STATUS BLOOD TRANSFUSIONS PAIN MEDS ANTIBIOTICS SURGERY

PRIAPISM

MEDICAL HISTORY SICKLE CELL CRISIS MEDICATION SPINAL CORD INJURY

SIGNS AND SYMPTOMS PENILE ERECTION BLADDER DISTENTION PARALYSIS WITH SPINAL CORD INJURY PAIN ANXIETY

DIAGNOSTIC PROCEDURES LABS

PLANNING AND INTERVENTION PAIN MANAGEMENT CATHETERIZATION UROLOGICAL CONSULT SURGICAL INTERVENTION NEEDLE ASPIRATION

FOREIGN BODIES

SIGNS AND SYMPTOMS PAIN MEDICAL HISTORY CHANGE IN URINARY PATTERN HEMATURIA URETHRAL DISCHARGE FB VISIBLE AT MEATUS

DIAGNOSTIC PROCEDURE UA URETHRAL CULTURE KUB

PLANNING AND INTERVENTION TREAT BLADDER DISTENTION ESTABLISH URINE OUTPUT TREAT PAIN PREPARE FOR MEDICAL INTERVENTION MEDS. PAIN, ANTIBIOTICS, CONSCIOUS SEDATION PSYCH CONSULT

DISCHARGE INSTRUCTIONS MEDICATIONS MONITOR URINE OUTPUT HYDRATION RETURN IF STREAM FORCE DECLINES HEMATURIA DOES NOT RESOLVE