NR507 Week 4 edapt Urinary System
Pathologies questions and answers with
solutions
NR507 Week 4 edapt: Urinary System Pathologies: Common Diseases and
Disorders Urinary Tract Infections/ Benign Prostatic Hypertrophy/ Renal
Calculi/ Urinary Incontinence/ Acute Kidney Injury/ Chronic Kidney Disease
Urinary Tract Infections
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Upper UTIs occur in organs that are above the urinary bladder and include ureter infections and
pyelonephritis (kidney infection).
Cystitis (bladder infection), urethritis (infection of the urethra), and prostatitis (infection of the
prostate) occur in the lower urinary tract.
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Pathophysiology of Urinary Tract Infections
The most common organisms that cause urinary tract infection (UTI) are Escherichia coli ( E.
coli ), Staphylococcus saprophyticus , Proteus mirabilis , and Klebsiella . E. coli causes
approximately 80% of the cases of UTI as it is the most common organism contained in fecal
matter that is easily accessible from the anus to the urethra.
???The sequence of events starts with the bacteria entering the urethra and end with the client
having symptoms of infection. The correct order is:
1. Bacteria enter the lower urinary tract
2. An inflammatory response is triggered
3. Neutrophils arrive
4. Bacteria continue to multiply
5. Biofilm forms
6. Bacteria adhere to the bladder wall
7. Client experiences pain with urination
Urinary Tract Infection Clinical Manifestations
1. Frequent Urination: Increased urge to urinate, often with the feeling of incomplete emptying is associated with a
bladder infection due to inflammation of the bladder and urethra.
2. Painful Urination: Discomfort or a burning sensation during urination is associated with inflammation of the bladder
and urethra (lower UTI).
3. Urgency: A sudden and intense need to urinate is associated with inflammation of the bladder and urethra (lower
UTI).
4. Lower Abdominal Discomfort: Pain or pressure in the lower abdomen can be caused by an infection anywhere in the
urinary tract.
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5. Pelvic Pain: Pain in the pelvic area is associated with a bladder infection, especially in women with a bladder infection.
6. Cloudy or Strong-Smelling Urine: Changes in the appearance or odor of urine can be caused by an infection anywhere
in the urinary tract.
7. Blood in Urine (Hematuria): The presence of blood, giving the urine a pink or reddish color can be caused by an
infection anywhere in the urinary tract.
8. Fever: In some cases, a UTI can be accompanied by a systemic fever.
9. Back Pain: Pain in the lower back is associated with an infection in the kidneys. Assessment for pain or tenderness at
the costovertebral angle (CVA) can increase both pain and inflammation and should be part of a routine assessment.
10. Fatigue: Feeling tired or generally unwell can be caused by an infection anywhere in the urinary tract.
11. Discomfort or Pain During Sex: Women with bladder or urethra infections may experience pain or discomfort during
sexual activity.
Symptoms of infection, including fatigue, bacteria in the urine, and an elevated temperature,
may be present for any infection, including lower UTI, upper UTI, and STI. Note: The presence of
bacteria in the urine from an STI may indicate contamination of the urine sample.
Foul smelling urine and painful urination can be present with both lower and upper UTI.
Pelvic pain is more likely to be present in a female with a lower UTI or STI.
An urgency to void is associated with lower UTI.
Urinary Tract Infection Diagnosis
Client History: The nurse practitioner (NP) will conduct a focused health history, inquiring about previous UTIs,
chronic conditions, medications, and relevant lifestyle factors.
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