NR507 / NR 507 Final Exam (Latest 2023 / 2024): Advanced Pathophysiology - Chamberlain

NR 507 Final Exam Which of the following is true regarding a complicated urinary tract infection? - ✅Can be caused by a structural urinary tract disorder Which of the following is a risk factor for the development of a urinary tract infection (UTI)? - ✅pregnancy A symptom of a lower urinary tract infection includes: - ✅urgency Women are at a higher risk for the development of a UTI because of having a shorter urethra. - ✅true Which of the following can help to prevent a UTI? - ✅increase water consumption Risk factors fo r a UTI - ✅pregnancy sexually active post-menopause estrogen -deficiency women (shorter urethra) catheterization 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 kidn ey. - ✅true 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 cathetersrenal calculiDiabetesPregnancy uncomplicated UTI - ✅-Occurs in the normal urinary tract -Responds well to a short course of antibiotic therapy -Simple cystitis in non -pregnant women without any urologic abnormalities Most common cause of UTI bacteria - ✅E coli Uncomplicated UTI - ✅Protein +/_ Leukocyte Esterase + Nitrites +/_ RBCs +/_ WBCs +/> 5000/hpf Casts - None Complicated UTI - ✅Protein +/_ Leukocyte Esterase + Nitrites +/_ RBCs + WBCs +/> 100,000/hpf Casts + NP education - ✅-Drink more water. -Although t here 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. -Encourage the female to wipe from the front to the back after a bowel movement to avoid spreading bacteria to the urethra -Encourages showers rather than bathing to avoid the spread of bacteria. A 25 year - old female presents to the primary care office with urinary burning and frequency for the last 3 days. She denies any fever, chills, back pain. Her gynecological history is negative and reports no vaginal discharge. The only new information reported is that she recently had sexual intercourse with a new male partner. The NP obtains a urinalysis and determines that the urine contains leukocytes, RBCs, nitrites, and WBCs. No c asts are identified. Based on symptom presentation and UA results, the patient can be diagnosed with: - ✅cystitis J.S. is an 80 -year-old patient who resides in a local nursing home. He recently became confused and then fell while ambulating to the bathro om three days ago. Because of his confusion and fall, he was transferred to the acute care facility for evaluation and treatment. Lab work revealed that the patient was very dehydrated with hypernatremia identified and appropriate intravenous fluids starte d. Cystitis was also identified from the urinalysis. He was also noted to have red and excoriated skin between the buttocks and inner thighs due to urinary frequency and dribbling. To help with skin healing and to prevent further urine leakage, an indwelli ng catheter was inserted. Two days after the catheter was placed, the patient spiked a fever of 102 degrees Fahrenheit associated with shaking chills. An intense, foul odor was noted in the urine. On examination of the flank area, the patient yelled out wh en touched. A urine culture was obtained and came back positive for nitrites and RBCs. Urine microscopy revealed >100,000 WBC/hpf and casts. Based on the information provided in the case, the patient can most likely be diagnosed with: - ✅pyelonephritis Identify the major risk factor J.S. has that is associated with pyelonephritis: - ✅indwelling foley catheter The urinalysis of a patient with a complicated UTI will show WBCs and casts - ✅true