NR-601 Week 6 Graded Discussion: Urologic Concerns
in the Maturing and Older Adult NR 601 Week 6 Graded
Discussions.omplete_ Week 6_ Urologic Concerns in
the Maturing and Older Adult Discussion.
,
This is a graded discussion: 50 points possible
Week 6: Urologic Concerns in the Maturing and Older Adult Discussion
10 40
Students will not receive credit for any discussions posted after Sunday 11:59pm MT.
Men and women both can experience urologic concerns with aging. This week's presentations and readings covered urologic
concerns and common problems. Utilize the national guidelines and scholarly references to develop your responses.
Urinary Tract Infections
What risk factors contribute to the development of a UTI in men versus women?
In which sex is a UTI more concerning and why?
It is important to know when to treat a UTI and when not to treat. Is there a particular situation where you would not treat a
UTI?
BPH
As a provider it is essential for you to know to interpret DRE findings and what your next step should be. The American Urology
Association has specific recommendations based on age. Be sure you know these because the guidelines will guide your patient
counseling and treatment plan.
What does the AUA state about drawing PSA levels?
If you do decide to draw a level what specific counseling should you include in your education today?
This topic was locked Apr 14 at 11:59pm.
1/44
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4/29/2019 Topic: Week 6: Urologic Concerns in the Maturing and Older Adult Discussion
Search entries or author Unread Subscribed
Week 6: Urologic Concerns in the Maturing and Older Adult Discussion
Hi Dr. Mompoint and Class,
Urinary Tract Infections
What risk factors contribute to the development of a UTI in men versus women?
A urinary tract infection (UTI) occurs when bacteria grow anywhere in the urinary tract which includes the kidneys, the bladder
and the urethra (Recurrent Urinary Tract Infections, 2016). Women are at a higher risk and tend to get urinary tract infections
more often than men. This is due to their anatomy, in which the urethra is shorter in women making it easier for the bacteria to
reach the bladder (Urinary Tract Infection, 2018). Additionally, women partaking in sex may also be a cause for higher UTI's in
women, since bacteria can be pushed into the urethra (Urinary Tract Infection, 2018). Furthermore, frequent UTI’s can be
caused by changes in the bacteria in the vagina. Women with menopause increases one’s risk for urinary tract infection since
menopause causes changes in vaginal bacteria (Urinary Tract Infection, 2018).
In which sex is a UTI more concerning and why?
UTI’s are more concerning in men since they are at a higher risk for complicated UTI’s (Michels & Sands, 2015). It is important to
note that distinguishing a complicated UTI from cystitis is important, because misdiagnosis increases the risk of treatment failure
(Michels & Sands, 2015). Therefore, knowing the risk factors for a complicated infection is of utmost importance. Complicated
UTI may include patient characteristics, and or previous medical / urologic conditions (Michels & Sands, 2015). In men,
prostatitis can present with dysuria and should Downloaded
not be confused with|
by: lisaulrich2018 UTI’s (Michels & Sands, 2015). According to the AAFP
2/44
, further investigation and a urology referral should be considered in patients with recurrent UTI, urolithiasis, known or suspected
urinary tract abnormality or cancer, history of urologic surgery, hematuria, persistent symptoms, or in men with abnormal
postvoid residual urine level greater than 100 mL(Michels & Sands, 2015).
It is important to know when to treat a UTI and when not to treat. Is there a particular situation where you would not treat a
UTI?
Asymptomatic bacteriuria (ASB) is defined as the presence of bacteria in the urine in the absence of clinical signs or symptoms
suggestive of a UTI (Rowe & Juthani-Mehta, 2014). Recognizing, UTI’s from ASB in older adults, although challenging, is
particularly important, as antibiotics are necessary for the treatment of symptomatic UTI, but not for ASB (Recurrent Urinary
Tract Infections, 2016). It is important to understand that UTI’s are the most common reason for antimicrobial use in older adults,
and inappropriate use of antibiotics leads to the development of multidrug-resistant organisms (MDROs) (Rowe & Juthani-
Mehta, 2014). So, although patients who present with nonspecific symptoms, identifying which patients require antibiotic
treatment of symptomatic UTI is challenging. I have found that in the setting of uncertainty, clinicians frequently elect treatment
with empiric antibiotics, however, this strategy often leads to the overuse of antimicrobials and high rates of bacterial resistance
(Rowe & Juthani-Mehta, 2014). Therefore, with most women who present nonspecific symptoms, clinicians should encourage
hydration and delay empiric antibiotic use until a diagnostic workup for UTI, such as urine microscopy and urine culture results
(Rowe & Juthani-Mehta, 2014).
BPH.
What does the AUA state about drawing PSA levels?
Firstly, the American Urology Association early detection of prostate cancer guideline recommends against PSA screening in
men under age 40 years (Carte, et al., 2018). They report that in ages younger that 40 there is a low prevalence of clinically
detectable prostate cancer, no evidence demonstrating benefit of screening and likely the same harms of screening as in other
age groups (Carte, et al., 2018). They also say that routine screening in men between ages 40 to 54 years at average risk
should not be done, however, for men younger than age 55 years at higher risk, decisions regarding prostate cancer screening
should be individualized (Carte, et al., 2018). At high risk includes men of African American race and those with a family history
spanning several generations, affecting multiple first-degree relatives, and that developed at younger ages (Carte, et al., 2018).
Next, the Panel strongly recommends shared decision-making for men age 55 to 69 years that are considering PSA screening
Downloaded by: lisaulrich2018 |
and proceeding based on a man's values and preferences (Carte, et al., 2018). Lastly, the greatest benefit of screening appears
3/44
in the Maturing and Older Adult NR 601 Week 6 Graded
Discussions.omplete_ Week 6_ Urologic Concerns in
the Maturing and Older Adult Discussion.
,
This is a graded discussion: 50 points possible
Week 6: Urologic Concerns in the Maturing and Older Adult Discussion
10 40
Students will not receive credit for any discussions posted after Sunday 11:59pm MT.
Men and women both can experience urologic concerns with aging. This week's presentations and readings covered urologic
concerns and common problems. Utilize the national guidelines and scholarly references to develop your responses.
Urinary Tract Infections
What risk factors contribute to the development of a UTI in men versus women?
In which sex is a UTI more concerning and why?
It is important to know when to treat a UTI and when not to treat. Is there a particular situation where you would not treat a
UTI?
BPH
As a provider it is essential for you to know to interpret DRE findings and what your next step should be. The American Urology
Association has specific recommendations based on age. Be sure you know these because the guidelines will guide your patient
counseling and treatment plan.
What does the AUA state about drawing PSA levels?
If you do decide to draw a level what specific counseling should you include in your education today?
This topic was locked Apr 14 at 11:59pm.
1/44
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
4/29/2019 Topic: Week 6: Urologic Concerns in the Maturing and Older Adult Discussion
Search entries or author Unread Subscribed
Week 6: Urologic Concerns in the Maturing and Older Adult Discussion
Hi Dr. Mompoint and Class,
Urinary Tract Infections
What risk factors contribute to the development of a UTI in men versus women?
A urinary tract infection (UTI) occurs when bacteria grow anywhere in the urinary tract which includes the kidneys, the bladder
and the urethra (Recurrent Urinary Tract Infections, 2016). Women are at a higher risk and tend to get urinary tract infections
more often than men. This is due to their anatomy, in which the urethra is shorter in women making it easier for the bacteria to
reach the bladder (Urinary Tract Infection, 2018). Additionally, women partaking in sex may also be a cause for higher UTI's in
women, since bacteria can be pushed into the urethra (Urinary Tract Infection, 2018). Furthermore, frequent UTI’s can be
caused by changes in the bacteria in the vagina. Women with menopause increases one’s risk for urinary tract infection since
menopause causes changes in vaginal bacteria (Urinary Tract Infection, 2018).
In which sex is a UTI more concerning and why?
UTI’s are more concerning in men since they are at a higher risk for complicated UTI’s (Michels & Sands, 2015). It is important to
note that distinguishing a complicated UTI from cystitis is important, because misdiagnosis increases the risk of treatment failure
(Michels & Sands, 2015). Therefore, knowing the risk factors for a complicated infection is of utmost importance. Complicated
UTI may include patient characteristics, and or previous medical / urologic conditions (Michels & Sands, 2015). In men,
prostatitis can present with dysuria and should Downloaded
not be confused with|
by: lisaulrich2018 UTI’s (Michels & Sands, 2015). According to the AAFP
2/44
, further investigation and a urology referral should be considered in patients with recurrent UTI, urolithiasis, known or suspected
urinary tract abnormality or cancer, history of urologic surgery, hematuria, persistent symptoms, or in men with abnormal
postvoid residual urine level greater than 100 mL(Michels & Sands, 2015).
It is important to know when to treat a UTI and when not to treat. Is there a particular situation where you would not treat a
UTI?
Asymptomatic bacteriuria (ASB) is defined as the presence of bacteria in the urine in the absence of clinical signs or symptoms
suggestive of a UTI (Rowe & Juthani-Mehta, 2014). Recognizing, UTI’s from ASB in older adults, although challenging, is
particularly important, as antibiotics are necessary for the treatment of symptomatic UTI, but not for ASB (Recurrent Urinary
Tract Infections, 2016). It is important to understand that UTI’s are the most common reason for antimicrobial use in older adults,
and inappropriate use of antibiotics leads to the development of multidrug-resistant organisms (MDROs) (Rowe & Juthani-
Mehta, 2014). So, although patients who present with nonspecific symptoms, identifying which patients require antibiotic
treatment of symptomatic UTI is challenging. I have found that in the setting of uncertainty, clinicians frequently elect treatment
with empiric antibiotics, however, this strategy often leads to the overuse of antimicrobials and high rates of bacterial resistance
(Rowe & Juthani-Mehta, 2014). Therefore, with most women who present nonspecific symptoms, clinicians should encourage
hydration and delay empiric antibiotic use until a diagnostic workup for UTI, such as urine microscopy and urine culture results
(Rowe & Juthani-Mehta, 2014).
BPH.
What does the AUA state about drawing PSA levels?
Firstly, the American Urology Association early detection of prostate cancer guideline recommends against PSA screening in
men under age 40 years (Carte, et al., 2018). They report that in ages younger that 40 there is a low prevalence of clinically
detectable prostate cancer, no evidence demonstrating benefit of screening and likely the same harms of screening as in other
age groups (Carte, et al., 2018). They also say that routine screening in men between ages 40 to 54 years at average risk
should not be done, however, for men younger than age 55 years at higher risk, decisions regarding prostate cancer screening
should be individualized (Carte, et al., 2018). At high risk includes men of African American race and those with a family history
spanning several generations, affecting multiple first-degree relatives, and that developed at younger ages (Carte, et al., 2018).
Next, the Panel strongly recommends shared decision-making for men age 55 to 69 years that are considering PSA screening
Downloaded by: lisaulrich2018 |
and proceeding based on a man's values and preferences (Carte, et al., 2018). Lastly, the greatest benefit of screening appears
3/44
