Chamberlain College of Nursing
NR 507 - Advanced Pathophysiology
Week 4 EDAPT Module - Urinary System Pathologies
This document includes the full module:
Full summary, all questions, all answers, and feedback for each
This is everything you need to complete the full EDAPT module which will a...
Chamberlain Nurse Practitioner Track
NR 507 - Advanced Pathophysiology (2023)
Edapt – Week 4 Urinary System Pathologies (6 Modules)
Modules: Urinary tract Infections, Benign Prostatic Hypertrophy (BPH), Renal
Calculi, Urinary Incontinence, Acute renal Failure, and Chronic Kidney Disease
Urinary Tract Infection
Which of the following is a risk factor for the development of a urinary tract infection (UTI)? Pregnancy Frequent showering Marathon running Perimenopause Feedback: Pregnancy is a risk factor the development of a UTI. Complicated Urinary Tract Infections
Which of the following is true regarding a complicated urinary tract infection? It is usually asymptomatic Can be caused by a structural urinary tract disorder
Bacteria is located mostly in the lower urinary tract Is associated with young adults Feedback: A complicated UTI can be caused by a structural issue in the urinary tract. Urinary Tract Infections
Women are at a higher risk for the development of a UTI because of having a shorter urethra.
True
False
Feedback: Women have a shorter urethra that puts them at higher risk for developing a UTI. Preventing UTIs
Which of the following can help to prevent a UTI? Douching to prevent the growth of bacteria Taking more Vitamin D Increase water consumption
Use spermicides during sexual intercourse Feedback: Water consumption prevents UTI as it keeps bacteria flushed out of the urinary tract.
Lower Urinary Tract Infections
A symptom of a lower urinary tract infection includes: Urgency
Flank pain Fever Decreased Urination Feedback: Urgency is a symptom of lower tract UTI.
Urinary Tract Infections
Urinary tract infections (UTI) are commonly seen in clinical practice. Bacteria from the gut can invade the urinary epithelium to cause inflammation and infection anywhere along the urinary tract such as the urethra, bladder, ureter, or kidney. Some individuals are predisposed to developing a UTI. It is more common for women to develop a UTI especially when pregnant, sexually active, during post-
menopause with estrogen-deficiency and when being treated with antibiotics where the normal bacteria flora is diminished. Although less common, men may develop a lower UTI. An upper UTI is less common in men due to the longer urethra and ureter structures that make it more difficult for bacteria to reach the kidney. An indwelling urinary catheter can also contribute the development of a UTI. Finally, individuals who experience urinary obstruction, diabetes or neurogenic bladder are also at risk for developing a UTI. A UTI can be discussed in terms of its severity. It can be complicated or uncomplicated. It can also be discussed according to its location, where it can occur anywhere along the urinary tract (upper vs. lower tract disorders). It is under these categories that UTI will be discussed. Finally, common organisms that cause UTI are covered. This information is essential as the NP is responsible for identifying the organism so that appropriate treatment can be initiated. The diagram below compares the male and female urinary tracts. Note that the female has a shorter urethra which predisposes her to an increased risk of infection than the male. The pathophysiology of a UTI is simple. First, bacteria enter and contaminate the lower urinary tract. This causes the colonization of bacteria in the urethra and the bladder which triggers an inflammatory response in the lower urinary tract. Neutrophils are recruited to the area where the bacteria are present. The bacteria multiply which allows them to evade the immune system due to virulent factors. For example, Escherichia coli can bind to cells in the lower urinary tract and hide from the immune cells. The bacteria can form biofilms. A biofilm is any group of microorganisms that allow them to stick to one another and adhere to surfaces that help them survive. If the UTI progresses or is not treated, or if the patient is immunocompromised, the bacteria can ascend to the kidneys and colonize there. At this point, the infection becomes an upper UTI. From there, if left untreated, the bacteria can spread into the circulation via the renal veins causing bacteremia that could potentially lead to septic shock.
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