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NRNP 6550 FINAL EXAM,,QUESTIONS AND ANSWERS [RATED A] 2024-25 $14.59   Add to cart

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NRNP 6550 FINAL EXAM,,QUESTIONS AND ANSWERS [RATED A] 2024-25

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NRNP 6550 FINAL EXAM,,QUESTIONS AND ANSWERS [RATED A] 2024-25 Cultura of urine with UTI 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 fal...

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  • November 18, 2024
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  • NRNP 6550 .
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NRNP 6550 FINAL EXAM,,QUESTIONS AND ANSWERS
[RATED A] 2024-25


Cultura of urine with UTI

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 positief met tumor, urethritis en foutieve collectie techniek

Herhaling in pregnant women

Lower urinary tract UTI and upper urinary tract UTI

bladder en urethra: cystitis/ urethritis/ prostatitis

kidney and ureters: pyelonephritis/ renal abcess

Uncoplicated and complicated uti

Uncomplicated: in normal working urinary tract

Complicated: defects in urinary tract or with other health problems

Common pathogens for UTI

E.coli (elderly women)

Staphylococcus

proteus mirabilis (elderly men)

Klebsiella

enterecoccus

pseudomonas

,Providencia institutionalized

Fungus: candida

Risk factors for UTI

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

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

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

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

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

- admit

- aminoglycosides: gentamicin/ tobramycin (not for mono therapy), base on renal
function, through less than 2 and peak level 5-10mg/L and do not give for CKD

- ampicillin

- cefazolin

- cefotaxime and ceftaxion base on obesity and pulm disease



Urine analysis : glucose and ketones

Serum glucose at least 180mg/dl for glucose to appear in urine



Glucose in ua caused by:

- Fancone Syndromeenemy wall: caused by ahminoglycosides for example

- DM

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