NR 507 week 4-8 CORRECT QUESTIONS & SOLUTIONS(GRADED A)
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Course
NR 507 ADVANCED PATHOPHYSIOLOGY
Institution
NR 507 ADVANCED PATHOPHYSIOLOGY
Lower Urinary Tract Infections
A symptom of a lower urinary tract infection includes:
A. Fever
B. Urgency
C. Flank pain
D. Decreased Urination - ANSWER Urgency is a symptom of lower tract UTI..
Urinary Tract Infection
Which of the following is a risk factor for the development of a urinary...
NR 507 week 4-8 CORRECT QUESTIONS &
SOLUTIONS(GRADED A)
Lower Urinary Tract Infections
A symptom of a lower urinary tract infection includes:
A. Fever
B. Urgency
C. Flank pain
D. Decreased Urination - ANSWER Urgency is a symptom of lower tract UTI..
Urinary Tract Infection
Which of the following is a risk factor for the development of a urinary tract infection (UTI)?
A. Perimenopause
B. Frequent showering
C. Pregnancy
D. Marathon running - ANSWER 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?
A. Can be caused by a structural urinary tract disorder
B. It is usually asymptomatic
C. Is associated with young adults
D. Bacteria is located mostly in the lower urinary tract - ANSWER 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 - ANSWER True: 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?
A. Use spermicides during sexual intercourse
B. Taking more Vitamin D
C. Douching to prevent the growth of bacteria
D. Increase water consumption - ANSWER Increase water consumption. Water consumption prevents
UTI as it keeps bacteria flushed out of the urinary tract.
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 de - ANSWER
UTI Risk Factors
There are several risk factors that predispose individuals to the development of a UTI. For women,
pregnancy is a risk factor. During pregnancy, progesterone relaxes smooth muscle that causes stasis of
urine, allowing the bacteria to colonize. Also, the female ureter is shorter and allows for the entrance of
bacteria into the urethra.
Post-menopausal women are also at risk for developing a UTI. The lack of estrogen results in vaginal and
urethral dryness that promotes an environment for bacteria to grow. Sexual intercourse also contributes
to the development of a UTI where bacteria can be easily introduced into the urethra. If spermicides are
used during sexual intercourse, this also puts the woman at risk for a UTI.
Indwelling urinary catheterization is also a major cause of a UTI, especially in females. The catheter itself
can introduce infections directly into the bladder. The bacteria will coloni - ANSWER
Lower vs. Upper Tract Disorders
, A UTI can be discussed in terms of its location. Note that a UTI can occur anywhere along the urinary
tract and can be associated with another issue in the area. For example, if the infection occurs at the
opening of the urethra, then the condition is termed urethritis. Overall, cystitis is a condition of the
lower urinary tract that denotes a bladder infection. Cystitis can occur in both females and males. In
males, the cystitis may be associated with prostatitis.
Recognizing the signs and symptoms of the UTI is important in categorizing it as either a lower or upper
urinary tract disorder. In a lower urinary tract disorder, the individual experiences urgency associated
with burning on urination. Other common symptoms of a lower UTI is frequency, dysuria, and
suprapubic pain. The urine may also appear cloudy and have an odor.
An infection of the lower urinary tract can progress to an - ANSWER
Uncomplicated vs. Complicated Urinary Tract Infections (UTI)
A UTI may be classified as complicated or uncomplicated in terms of its severity. An uncomplicated UTI
indicates that the urinary tract and renal function is normal. In a complicated UTI, there is decreased
renal function and an abnormal urinary tract. In differentiating between a lower and upper UTI above,
the presence of WBC casts indicates the presence of kidney involvement which requires a more
complicated treatment plan. The patient is also at higher risk for extensive and permanent kidney
damage as well as sepsis. If sepsis is suspected, a blood culture may be drawn to identify the causative
organism or rule it out.
The severity of the UTI can also be determined based on the interventions that are necessary to treat
the infection. The more intervention required, the more complicated the infection. In general, individuals
are treated for a UTI only whe - ANSWER Uncomplicated UTI
Occurs in the normal urinary tract
Simple cystitis in non-pregnant women without any urologic abnormalities
Responds well to a short course of antibiotic therapy
Complicated UTI
A UTI that extends beyond the bladder
Caused by structural or functional urinary tract abnormalities or untreated UTI
Infants and older adults affected
Associated with:
indwelling catheters
renal calculi
, Diabetes
Pregnancy
Common Organisms that Cause Urinary Tract Infections
The most common organisms that cause a UTI is Escherichia coli (E. Coli), Staphylococcus saprophyticus,
Proteus Mirabilis, and Klebsiella. E. coli causes approximately 80% of the cases of UTI because it is the
most common organism contained in the fecal matter that is easily accessible from the anus to the
urethra. Bacteria enter the urethra and colonize in the bladder to eventually cause a UTI. In healthy
individuals, they can maintain a sterile urinary tract and bladder. Even when bacteria enter the bladder,
the immune defenses can prevent it from clinging to the walls of the bladder or the upper urinary tract.
A UTI will occur when bacteria overwhelm the individual's defense mechanisms allowing it to quickly
reproduce.
A urinalysis is used to diagnose a UTI. If nitrites are present, this indicates that the causative organism is
gram negative. A urine culture may - ANSWER
Using the Urinalysis to Diagnose a Urinary Tract Infection
A urinalysis can be used in a couple of ways to diagnosis a UTI. A dipstick can be used to identify
leukocyte esterase and nitrites. Nitrites detect the presence of the Enterobacteriaceae (gram negative
bacteria) family that converts nitrates into nitrites. It is important to also note that some bacteria are
unable to produce nitrites. This is the case of Enterococcus. Therefore, the individual may still have a UTI
even if nitrites are not present via the dipstick. The presence of nitrites is the most specific finding and
has the highest positive predictive value.
Leukocyte esterase, WBCs and even bacteria on microscopic exam are not specific and therefore, do not
necessarily indicate infection. The diagnosis of a UTI needs to also consider the presence of symptoms
and a positive urine culture if one is completed. It is typically not completed in a young, and - ANSWER
Patient Education
The NP should take advantage of the opportunity to educate patients on the prevention of UTIs while
the patient is in the office. Some of the most basic information to convey to a patient is:
Drink more water.
Although there are differences of opinions, cranberry juice and vitamin C can help to acidify the urine.
Urinate before and after sexual intercourse to remove bacteria from the urethral area.
Encourage the female to avoid holding urine for extended periods of time.
Avoid the use of hygiene sprays and spermicides because they alter the normal microbial flora to
enhance the risk for infection.
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