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NRNP 6550 FINAL EXAM,,QUESTIONS AND ANSWERS [RATED A]

Name: NRNP 6550 FINAL EXAM,,QUESTIONS AND ANSWERS [RATED A]
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NRNP 6550 FINAL EXAM,,QUESTIONS AND ANSWERS [RATED A]

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urine culture with uti correct answer 100000 colonies in asymptomatic bacteruria 10 10000 colonies in symptomatic patients but also pyuria pyuria more than 10 leukocytes elevated erythrocytes w

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NRNP 6550

NRNP 6550 FINAL
EXAM,,QUESTIONS AND ANSWERS [RATED
A]2022

,NRNP 6550 Final Exam,,Questions and Answers [Rated A] 2022

Urine culture with UTI Correct answer- 100.000 colonies in asymptomatic: bacteruria
10 - 10.000 colonies in symptomatic patients but also pyuria
pyuria: more than 10 leukocytes
elevated erythrocytes with pyelonephritis
WBC in urine

false positive with tumor, urethritis and poor collection technique

Repeat in pregnant women

Lower urinary tract UTI and upper urinary tract UTI Correct answer- bladder and
urethra: cystitis/ urethritis/ prostatitis
kidney and ureters: pyelonephritis/ renal abcess

Uncomplicated and complicated uti Correct answer- Uncomplicated: in normal working
urinary tract
Complicated: defects in urinary tract or with other health problems

Common pathogens for UTI Correct answer- E.coli (elderly women)
Staphylococcus
proteus mirabilis (elderly men)
Klebsiella
enterecoccus
pseudomonas
Providencia (institutionalized)
Fungus: candida

Risk factors for UTI Correct answer- Female
critically ill
elderly
catheter (caused by biofilm)
DM
calculi, tumor, stricture
neurogenic bladder
Women:
sexual intercourse or new sex partner
pregnancy
previous UTI
Men:
prostate enlargement
prostatitis

,lack of circumcision
gay
HIV

Findings UTI Correct answer- Lower:
Dysuria/ urgency/ frequency/ incontinence
suprapubic pain
hematuria
fever/ chills uncommon
No flank pain

Upper:
flank pain
fever and chills
hematuria
n/v
ams (in elderly)
malaise
tachycardia/ tachypnea

Testing and results for UTI Correct answer- Gold standard: urine culture and sensitivity:
detection of bacteria. Start with POC: urine analysis.
UA: pos for nitrite or leukocyte or blood
CBC: leukocyte with left shift in pyelonephritis
For recurrent UTI in women or UTI in men rule out obstruction, calculi, or necrosis with:
xr voiding
CT abdomen
US pelvis
MRI pelvis

Management acute cystitis Correct answer- First line:
- Single dose Fosfomycin (monurol)
- 3 day: sulfa: trimethoprim/ sulfa (bactrim) (do not give near delivery of baby, give
cephalexin instead) or sulfa
- 5 days: nitrofurantoin, caution in elderly

Second line:
- qiunolones: ciprofloxain or levofloxacin for 3 days (not for pregnant women!)
- B-lactams: amoxi-clav, cefdinir for 3 - 7 days

Management uncomplicated upper UTI Correct answer- Outpt:
quinolone: ciprofloxacin for 7 days or levofloxacin for 5 days
Sulfa: trimethoprim/ sulfa (bactrim) for 14 days

Inpt:
Ceftriaxone or cefotaxime

, Ampicillin

CAUTI:
bacterial: treat with AB for 7 days
Candiduria: fluconazole for 14 days

Discomfort: Pyridium

Management acute complicated bacterial pyelonephritis Correct answer- - Admit
- Aminoglycosides: gentamicin/ tobramycin (not for monotherapy), based on renal
function (trough less than 2 and peak level 5-10mg/L) and do not give for CKD
- Ampicillin
- Cefazolin
- Cefotaxime and Ceftriaxon based on obesity and pulm disease

Urine analysis: glucose and ketones Correct answer- Serum glucose at least 180mg/dl
for glucose to appear in urine

Glucose in ua caused by:
- Fancone Syndrome (bad wall: caused by ahminoglycosides for example)
- DM
- Cushing's
- Vit C can give false negative

Ketones in urine:
- Alcohol
- Diabetic
- Starvation

Acute Kidney Injury Correct answer- -Acute renal function loss with inability to excrete
metabolic waste products (urea nitrogen and creatinine) to inability to maintain fluid and
electrolyte balance.
- Resolves within 3mo
- classified with RIFLE or etiology

RIFLE Correct answer- Risk: creatinine up x 1.5 from baseline, GFR decrease more
than 25% and UO less than 0.5ml/kg/hr for 6hr

Injury: creatinine up x 2 from baseline, GFR decrease more than 50% and UO less than
0.5ml/kg/hr for 12hr

Failure: creatinine up x 1.5 from baseline, GFR decrease more than 25% and UO less
than 0.3ml/kg/hr for 12hr or anuria for 12hr

Loss: Complete loss of renal function for more than 4 weeks

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