Nr 601 Final Exam Review With Complete Solutions
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Most common type of UI in men and women? -ANS>Men is urgency and women is
stress
What is urge UI? -ANS>Feeling of needing to go right away. Rush to the bathroom.
What is stress UI? -ANS>Sneezing, coughing, laughing, pressure.
What is mixed incontinence? -ANS>Both stress and urgency
Risk factors for UI? -ANS>Female, obesity, dm, depression, stroke, fecal
incontinence, hysterectomy.
What is the first line therapy for most older patients with UI? -ANS>Behavioral
therapy
What does behavioral therapy include for UI? -ANS>Weightloss, stop caffeinated
beverages and alcohol, minimize fluid intake at night, stop smoking,loop diuretics
should be taken in afternoon. Bladder trainings, kegal exercises, and prompted
voiding.
Which med can be used for OAB? S/e? -ANS>Myrbetriq; can cause high BP.
,What medications can be used for urge incontinence and OAB? What are their
class? -ANS>Detrol (tolterodine), ditropan (oxybutinin)
These are anticholinergics/antimuscarinics
Antimuscarinics and anticholinergics should be avoided in which patients?
according to BEERS criteria -ANS>Patients with dementia or cognitive impairment
What is the gold standard treatment for women with stress incontinence? -
ANS>Surgery
What is the only evidenced based lifetsyle intervention for for moderately obese
younger older women with UI? -ANS>Weight loss
Treatment of UI in older persons should be be proceeded how? -ANS>Step wise
process. Stating with addressing first comorbidities and medications, then lifestyle
interventions, behavioral treatment, pharmacological treatment, minimally
invasive procedures or surgeries.
Management of UI should focus on what? -ANS>The most bothersome factors
All patients with UI should be screened for?ex? -ANS>Functional status and
depression.
Functional impairment can be assessed by timed up and go and minicog test
,Urinary frequency may reflect what ? -ANS>High fluid intake, and or use of
caffeinated drinks or alcohol.
Acute onset of UI or the presence of Suprapubic, lower abdominal, or pelvic pain
are what kind of symptoms? What should be done? -ANS>Red flag symptoms. For
underlying neurologic or neoplastic disease. Requires immediate referral to neuro,
uro, gyno.
What is the key difference between UI in younger and older persons? -ANS>UI may
be precipitated or worsened by outside factors of urinary tract, including meds,
mobility, environment, mentation, manual dexterity.
What is an assessment tool for UI bother and quality of life? And can be used to
assess for the effect of treatment? -ANS>Urogenital distress index 6, min dif in
score is 5/11
What kind of therapy is most efficacious for UI? -ANS>Both behavioral and drug
therapy. Than either alone
Morbidity with UI are? -ANS>Skin breakdown, falls. Fractures
Symptoms of UTI? -ANS>Dysuria, frequency, urgency, hematuria
UTI is the most common infection seen in who? -ANS>Older adults in nursing
homes, or hospitals.
, Asymptomatic bacteriuria increases with? -ANS>Age and debility
For older adults, treatment should not be initiated only based on symptoms...
why? -ANS>Common symptoms can mimic other diseases
Post menopausal women may also complain of? -ANS>Low back pain, nocturia,
incontinence, and constipation.
Why is bacteruria and UTI so common in older adults? -ANS>There are conditions
or diseases that lead to alterations in normal flora, urinary stasis and obstruction
as we age.
Shifts in perineal flora and ph bc if estrogen deficiency occurs.
Urinary stasis and obstruction can occur due to normal aging, which can lead to
increased UTI.
Urethra orifice can also be contaminated.
What is the UA results for UTI? -ANS>Positive for nitrates and leukocytes +
symptoms present
What are common signs and Symptoms of UTI in LTC? -ANS>Change in mental
Status and characteristics of urine
What is not a useful indicator for UTI? -ANS>Presence of pyuria >10 WBC