NURS 620 Maryville Exam 3
-obstructions
-antibiotic-resistant bacteria ---- presence of multiple strains of bacteria - ANSWhat 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 - ANSWhat 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 - ANSWhat are possible differential diagnosis of dysuria?
UA - ANSWhat is the easiest, most noninvasive, and most economical way to identify UTI
and/or other renal problems?
Lower urinary tract infection - ANSInfection 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 - ANSName the types of lower urinary tract infections.
,Onset of UTI in a previously symptom-free individual. - ANSAcute lower urinary tract infections
are characterized by what?
UA C&S - ANSWhat 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 - ANSWhat results would make you suspect UTI?
-2 or more symptomatic UTIs w/in 6 months
-3 or > within 12 months - ANSWho should receive prophylaxis for recurrent UTI?
After previous UTI resolution is confirmed - ANSWhen 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 - ANSAntibiotic regimin for
recurrent UTI prophylaxis.
-Dysuria
-urinary frequency & urgency
-hematuria
-low back or suprapubic pain/tenderness
-elderly=AMS - ANSWhat 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 - ANSWHat 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 - ANSPatient education for uncomplicated UTI
Chronic Pelvic Pain - ANSNon-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 - ANS3 most common disorders causing Chronic pelvic pain?
Interstitial cystitis (IC) - ANSChronic 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. - ANSWhat worsens IC related CPP?
Dysfunction of the GAG layer - ANSPathogenesis of IC
-diagnosis of exclusion
-gyn
-ultrasound
-IVP
-cystoscopy
-PUF scale (>5, likely IC)
-intravesical potassium sensitivity test - ANSWhat 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 -
ANSManagement of Interstitial cystitis.
sexually active adults
very young children
frail older adults - ANSWhich populations are lower UTIs most common in?
Suppressed immune system
pregnancy
urinary obstruction
catheter dependency
neurogenic bladder
DM - ANSWhat predisposing conditions put the patient at more risk for lower UTI?
fecal contamination secondary to poor perineal hygeine. - ANSMost common cause of lower
UTI?
unprotected sexual intercourse
anatomically shortened urethra in women
spermicide
-obstructions
-antibiotic-resistant bacteria ---- presence of multiple strains of bacteria - ANSWhat 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 - ANSWhat 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 - ANSWhat are possible differential diagnosis of dysuria?
UA - ANSWhat is the easiest, most noninvasive, and most economical way to identify UTI
and/or other renal problems?
Lower urinary tract infection - ANSInfection 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 - ANSName the types of lower urinary tract infections.
,Onset of UTI in a previously symptom-free individual. - ANSAcute lower urinary tract infections
are characterized by what?
UA C&S - ANSWhat 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 - ANSWhat results would make you suspect UTI?
-2 or more symptomatic UTIs w/in 6 months
-3 or > within 12 months - ANSWho should receive prophylaxis for recurrent UTI?
After previous UTI resolution is confirmed - ANSWhen 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 - ANSAntibiotic regimin for
recurrent UTI prophylaxis.
-Dysuria
-urinary frequency & urgency
-hematuria
-low back or suprapubic pain/tenderness
-elderly=AMS - ANSWhat 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 - ANSWHat 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 - ANSPatient education for uncomplicated UTI
Chronic Pelvic Pain - ANSNon-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 - ANS3 most common disorders causing Chronic pelvic pain?
Interstitial cystitis (IC) - ANSChronic 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. - ANSWhat worsens IC related CPP?
Dysfunction of the GAG layer - ANSPathogenesis of IC
-diagnosis of exclusion
-gyn
-ultrasound
-IVP
-cystoscopy
-PUF scale (>5, likely IC)
-intravesical potassium sensitivity test - ANSWhat 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 -
ANSManagement of Interstitial cystitis.
sexually active adults
very young children
frail older adults - ANSWhich populations are lower UTIs most common in?
Suppressed immune system
pregnancy
urinary obstruction
catheter dependency
neurogenic bladder
DM - ANSWhat predisposing conditions put the patient at more risk for lower UTI?
fecal contamination secondary to poor perineal hygeine. - ANSMost common cause of lower
UTI?
unprotected sexual intercourse
anatomically shortened urethra in women
spermicide
