NURS 620 Exam 3 Questions With 100% Correct Answers 2023/2024 Maryville (VERIFIED)

NURS 620 Exam 3 Questions With 100% Correct Answers 2023/2024 Maryville (VERIFIED). obstructions -antibiotic-resistant bacteria ---- presence of multiple strains of bacteria correct answers What are potential causes of chronic infection/UTI? -fever -N/V -Pain (abdominal, pelvic, back) -LMP -Contraceptive use -Sexual partners -hygeine habits -Vaginal discharge/irritation -hx of UTIs correct answers What additional HPI questions would you want to ask a patient with urinary complaints (dyuria, urgency, etc.)? -Usually bladder problem -UTI -Pyleonephritis -STI -inflammatory lesions of the prostate, bladder, & urethra -Bladder tumors Chronic renal failure -nephrolitiasis -vaginitis/prostatitis -Prolapsed uterus -pelvic peritonitis -cancer of cervix or prostate correct answers What are possible differential diagnosis of dysuria? UA correct answers What is the easiest, most noninvasive, and most economical way to identify UTI and/or other renal problems? Lower urinary tract infection correct answers Infection that occurs when the normal sterile condition of the urinary tract is invaded by pathogenic bacteria Urethra: urethritis Bladder: cystitis Bladder wall; Intersitital cystitis (IC) Prostate Gland: Prostatitis correct answers Name the types of lower urinary tract infections. Onset of UTI in a previously symptom-free individual. correct answers Acute lower urinary tract infections are characterized by what? NURS 620 Exam 3 Questions With 100% Correct Answers 2023/2024 Maryville (VERIFIED) UA C&S correct answers What tests would you order to diagnose lower UTI? -cloudy urine clarity -positive leukocytes esterase -positive nitrites (signals gram - organism, may have false -) -Protein: 1+-4+ (kidney problems) -Alkaline urine (PH 6.5-8) -RBCs may be present correct answers What results would make you suspect UTI? -2 or more symptomatic UTIs w/in 6 months -3 or within 12 months correct answers Who should receive prophylaxis for recurrent UTI? After previous UTI resolution is confirmed correct answers When should prophylaxis for recurrent UTI be intiated? -Daily dosing for 6 months -Post-coital prophylaxis -self medication (3-4 days of therapy when symptoms being correct answers Antibiotic regimin for recurrent UTI prophylaxis. -Dysuria -urinary frequency & urgency -hematuria -low back or suprapubic pain/tenderness -elderly=AMS correct answers What is the clinical presentation of uncomplicated UTI? -Bactrim 1 DS BID x 3 -Cefdinir 500 mg BID x 5 -Nitrofurantoin 100 mg BID x 5 correct answers WHat is the oral treatment for acute uncomplicated UTI? •Complete the antibiotic regimen •Proper hygiene •Drink plenty of water (8 - 8oz glasses) •Cotton undergarments •Empty bladder after sexual intercourse •Empty bladder frequently •No tub baths or bubble baths correct answers Patient education for uncomplicated UTI Chronic Pelvic Pain correct answers Non-cyclic pain of 6 or more months duration that is localized to the pelvis and is sufficient severity to cause functional disability Endometriosis Intersitial cystitis IBS correct answers 3 most common disorders causing Chronic pelvic pain? Interstitial cystitis (IC) correct answers Chronic inflammatory condition of the bladder clinically characterized by irritable voiding symptoms or urgency and frequency, in the absence of objective evidence of another disease. Intercouse and perimentrual status. correct answers What worsens IC related CPP? Dysfunction of the GAG layer correct answers Pathogenesis of IC -diagnosis of exclusion -gyn -ultrasound -IVP -cystoscopy -PUF scale (5, likely IC) -intravesical potassium sensitivity test correct answers What is the diagnostic criteria for IC? •Oral Pentosan polysulfate sodium: 100mg TID or 200mg BID •Course duration: 2-4 months minimum •Intravesical DMSO bladder instillation •Bladder training (reduce eliminations) • Hydrodistension of bladder, low acid diet, laser, NSAIDS, antidepressants, muscle relaxants correct answers Management of Interstitial cystitis. sexually active adults very young children frail older adults correct answers Which populations are lower UTIs most common in? Suppressed immune system pregnancy urinary obstruction catheter dependency neurogenic bladder DM correct answers What predisposing conditions put the patient at more risk for lower UTI? fecal contamination secondary to poor perineal hygeine. correct answers Most common cause of lower UTI? unprotected sexual intercourse anatomically shortened urethra in women spermicide catheters renal stones correct answers Additional causes of lower UTI? creates a medium in which bacteria can grow and proliferate correct answers How does elevated PH cause lower UTI? E. Coli correct answers Most common bacterial agent responsible for uncomplicated UTI in women. Candida correct answers Causitive agent in complicated UTI that fails to respond to antibiotic therapy. Dysuria Urinary frequency or urgency nocturia low back or suprapubic pain urinary incontinence correct answers Subjective findings with lower UTI? Hematuria cloudy, foul smelling urine alkaline PH elevate levels of nitrites leukocyte esterase urine sedements of RBCs, WBCs, mucus, and bacterial overgrowth correct answers Objective findings with lower UTI? clean-catch midstream urine specimen correct answers Preferred collection method for UA? 100,000 organisms/ml plus presence of characteristic clinical symptoms. correct answers What characteristics of UA/C&S indicates infection? Urine culture correct answers Gold standard of laboratory confirmation of UTI UA/C&S IC: potassium sensitivity test (PST) correct answers Diagnostic testing for lower UTI gram negative bacteria correct answers What do nitrates signal on a UA? Proteinuria correct answers Which diagnostic is often the first indicator of renal problem? Hematuria may be only symptom May present with altered MS Dizziness-early symptom correct answers What symptoms may be different for the geriatric population with UTI? Pyleonephritis correct answers Low back pain is an indication of what form of complicated UTI? Pregnant geriatric correct answers What population is at increased risk of pyleonephritis? Pyleonephritis (upper UTI) STI Tumor/bladder cancer Interstital cystitis Vaginitis correct answers Possible differential diagnosis for lower/uncomplicated UTI? Fever Chills WBC casts CVAT correct answers What signs of sepsis will not be seen with lower/uncomplicated UTI? pharmacological antimicrobial tx correct answers What is the mainstay of treatment for uncomplicated UTI? Ampicillin and sulfonamides correct answers Which classes of antibiotics are becoming increasingly resistant to bacteria associated with UTI? gram-negative correct answers Which bacteria is nitrofurantoin most effective on? 1 DS BID x 3 days correct answers What is the antibiotic regimin for bactrim or septra with uncomplicated UTI? 500 mg BID x 5 days correct answers What is the antibiotic regmin for cefdinir with uncomplicated UTI? 100 mg BID x 5-7 days correct answers What is the antibiotic regimin for nitrofurantoin with uncomplicated UTI? Bactrim correct answers Which antibiotic is teratogenic and should be avoided in the 1st trimester of pregnancy? Nitrofurantoin (Macrobid) correct answers Which antibiotic is on the Beers list for geriatric patients? Cefdinir correct answers Which antibiotic has a low interaction rate with other medications and is also a good consideration for geriatric patients? 3-5 day dosing correct answers How many days can a healthy patient be successfully treated for uncomplicated UTI? 7 days correct answers How long should patients who are geriatric or present with comorbidities, immunocompromise, etc. be treated for uncomplicated UTI? Area resistance Patient history of antibiotic use Bacteria resistance (culture) correct answers What is a key factor to consider when determining which antibiotic to use for uncomplicated UTI? Fluoroguinolones correct answers Which antibiotic class is known to have widespread efficacy in treating UTI? Amoxicillin, nitrofurantoin, or cephalexin x 1 week correct answers Empirical therapy for lower UTI? Flouroguinolones correct answers Which class of antibiotc should be avoided if possible for lower UTI? premature delivery correct answers What complications may arise during pregnancy with UTI? Fluconazole 200 mg qd x 7-14 days correct answers What is the treatment for fungal UTI? Pre-urological procedures After removal of a bladder catheter Any patient with underlying structural abnormality correct answers When is antibiotic treatment considered in patients who may not present with current lower UTI? 2 or more symptomatic UTIs w/in 6 months 3 or more within 12 months correct answers Who should receive antibiotic prophylaxis for recurrent UTI? Once negative urine culture is obtained. correct answers When should prophylaxis be started for recurrent UTI? Take antibiotics 3-4 days after intercourse or when symptoms begin correct answers What is the regimin for post-coital or self-medication UTI prophylaxis? Daily dosing of low dose antibiotic therapy for 6 months. correct answers What is the antibiotic regimin for prophylactix with chronic UTI? It does not correct answers How does interstitial cystitis respond to antibiotic treatment? Q 4-6 weeks correct answers How often should indwelling catheters be changed? -Maintain adequate hydration and monitor UO -Obstruction must be identified and removed -Prescribe analgesics for patients to reduce pain associated with UTI. correct answers Important follow up points for lower UTI Notify if flank pain, hematuria, or lack of response to tx occurs. correct answers Patient instructions for physician notification following visit and prescribed treatment for lower UTI. -Complete full course of antibiotic -increase fluid intake to 8-8oz glasses of H20/day -Take cranberry supplement/drink cranbery juice -self-medicate as indicated -Avoid harsh soaps or feminie hygeine products -Use condoms -Use proper self-cath techniques -Empty bladder frequently -Take showers instead of tub baths -Keep voiding diary that includes symptoms -Empty bladder completely. -Proper hygeine-wipe front to back -cotton undergarments -empty bladder after sexual intercourse -Avoid bladder irritants-caffeine, sugary drinks, etc. correct answers Important patient teaching points regaring uncomplicated UTI Chronic pelvic pain correct answers Non-cyclic pain of 6 or more months duration that is localized to the pelvis and is of sufficient severity to cause functional disability endometriosis interstital cystitis IBS correct answers 3 most common causes of chronic pelvic pain. interstitial cystitis correct answers Noninfectious; similar presentation to UTI interstitial cystitis correct answers •Chronic inflammatory condition of the bladder clinically characterized by irritable voiding symptoms or urgency and frequency, in the absence of objective evidence of another disease" Intercourse perimentraul status correct answers Worsening factors of Interstitial cystitis Determine what the underlying cause of the symptoms is correct answers Important goal of intersitial cystitis diagnosis and treatment. None specific. Is a diagnosis of exclusion correct answers Lab tests for interstitial cystitis UTI bladder cancer Kidney stone pyelonephritis correct answers What are some potential differential diagnoses to exclude with interstitial cystitis? Gynecological-PAP IVP cystoscopy correct answers What are important diagnostic tests that should be included when excluding other causes for diagnosis of interstitial cystitis? 5 correct answers What score on the PUF scale is indicative of likely interstitial cystitis? Avoid acidic foods and beverges such a cranberry juice, tomatoe juice, etc. correct answers WHat dietary recommendations are present with interstitial cystitis? Longer urethra correct answers Why is UTI less common in males? Dysuria Urgency/frequency Cloudy urine Penile discharge-not likely but should be addressed. correct answers Clinical presentation of UTI in male population. Pyleonephritis prostatitis BPH Prostate cancer correct answers Differential diagnosis for UTI in males? Nitrofurantoin correct answers Which antibiotic used in females is not used in the male population because it does not adhere well due to length of urethra? hesitency correct answers Which urinary symptom in males may be good indication of need for urology referral for IVP/cystoscopy? 10-14 days correct answers How long should antibiotic treatment be for male UTI? Pyleonephritis (upper UTI) correct answers Complicated infection of the kidney characterized by infection within the renal pelvis, tubules, or interstital tissue. Acute correct answers Type of pyleonephritis that is caused by an ascending infection from the bladder. Chronic correct answers Type of pyleonephritis that is caused by no specific pathological explanation usually. -Anatomical abnormalities such as ureterovesical reflux -Urinary obstruction -Stress incontinence -Multiple or recurrent UTIs - Renal disease -Kidney trauma -Pregnancy -Metabolic disorders -Agressive bacterial infection -geriatrics