Exam (elaborations)
NURS 620 Maryville Exam 3: Questions/Solutions
NURS 620 Maryville Exam 3: Questions/Solutions
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NURS 620 Maryville Exam 3: Questions/SolutionsWhat are potential causes of chronic infection/UTI? Right Ans - -
obstructions
-antibiotic-resistant bacteria ---- presence of multiple strains of bacteria
What additional HPI questions would you want to ask a patient with urinary
complaints (dyuria, urgency, etc.)? Right Ans - -fever
-N/V
-Pain (abdominal, pelvic, back)
-LMP
-Contraceptive use
-Sexual partners
-hygeine habits
-Vaginal discharge/irritation
-hx of UTIs
What are possible differential diagnosis of dysuria? Right Ans - -Usually
bladder problem
-UTI
-Pyleonephritis
-STI
-inflammatory lesions of the prostate, bladder, & urethra
-Bladder tumors
Chronic renal failure
-nephrolitiasis
-vaginitis/prostatitis
-Prolapsed uterus
-pelvic peritonitis
-cancer of cervix or prostate
What is the easiest, most noninvasive, and most economical way to identify
UTI and/or other renal problems? Right Ans - UA
Infection that occurs when the normal sterile condition of the urinary tract is
invaded by pathogenic bacteria Right Ans - Lower urinary tract infection
Name the types of lower urinary tract infections. Right Ans - Urethra:
urethritis
,Bladder: cystitis
Bladder wall; Intersitital cystitis (IC)
Prostate Gland: Prostatitis
Acute lower urinary tract infections are characterized by what? Right Ans -
Onset of UTI in a previously symptom-free individual.
What tests would you order to diagnose lower UTI? Right Ans - UA C&S
What results would make you suspect UTI? Right Ans - -cloudy urine
clarity
-positive leukocytes esterase
-positive nitrites (signals gram - organism, may have false -)
-Protein: 1+-4+ (kidney problems)
-Alkaline urine (PH 6.5-8)
-RBCs may be present
Who should receive prophylaxis for recurrent UTI? Right Ans - -2 or more
symptomatic UTIs w/in 6 months
-3 or > within 12 months
When should prophylaxis for recurrent UTI be intiated? Right Ans - After
previous UTI resolution is confirmed
Antibiotic regimin for recurrent UTI prophylaxis. Right Ans - -Daily dosing
for 6 months
-Post-coital prophylaxis
-self medication (3-4 days of therapy when symptoms being
What is the clinical presentation of uncomplicated UTI? Right Ans - -
Dysuria
-urinary frequency & urgency
-hematuria
-low back or suprapubic pain/tenderness
-elderly=AMS
WHat is the oral treatment for acute uncomplicated UTI? Right Ans - -
Bactrim 1 DS BID x 3
-Cefdinir 500 mg BID x 5
,-Nitrofurantoin 100 mg BID x 5
Patient education for uncomplicated UTI Right Ans - •Complete the
antibiotic regimen
•Proper hygiene
•Drink plenty of water (8 - 8oz glasses)
•Cotton undergarments
•Empty bladder after sexual intercourse
•Empty bladder frequently
•No tub baths or bubble baths
Non-cyclic pain of 6 or more months duration that is localized to the pelvis
and is sufficient severity to cause functional disability Right Ans - Chronic
Pelvic Pain
3 most common disorders causing Chronic pelvic pain? Right Ans -
Endometriosis
Intersitial cystitis
IBS
Chronic inflammatory condition of the bladder clinically characterized by
irritable voiding symptoms or urgency and frequency, in the absence of
objective evidence of another disease. Right Ans - Interstitial cystitis (IC)
What worsens IC related CPP? Right Ans - Intercouse and perimentrual
status.
Pathogenesis of IC Right Ans - Dysfunction of the GAG layer
What is the diagnostic criteria for IC? Right Ans - -diagnosis of exclusion
-gyn
-ultrasound
-IVP
-cystoscopy
-PUF scale (>5, likely IC)
-intravesical potassium sensitivity test
Management of Interstitial cystitis. Right Ans - •Oral Pentosan polysulfate
sodium: 100mg TID or 200mg BID
, •Course duration: 2-4 months minimum
•Intravesical DMSO bladder instillation
•Bladder training (reduce eliminations)
• Hydrodistension of bladder, low acid diet, laser, NSAIDS, antidepressants,
muscle relaxants
Which populations are lower UTIs most common in? Right Ans - sexually
active adults
very young children
frail older adults
What predisposing conditions put the patient at more risk for lower UTI?
Right Ans - Suppressed immune system
pregnancy
urinary obstruction
catheter dependency
neurogenic bladder
DM
Most common cause of lower UTI? Right Ans - fecal contamination
secondary to poor perineal hygeine.
Additional causes of lower UTI? Right Ans - unprotected sexual intercourse
anatomically shortened urethra in women
spermicide
catheters
renal stones
How does elevated PH cause lower UTI? Right Ans - creates a medium in
which bacteria can grow and proliferate
Most common bacterial agent responsible for uncomplicated UTI in women.
Right Ans - E. Coli
Causitive agent in complicated UTI that fails to respond to antibiotic therapy.
Right Ans - Candida
Subjective findings with lower UTI? Right Ans - Dysuria
Urinary frequency or urgency
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