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,A positive leukocyte esterase test results from - correct ans:the presence of white blood cells either as
whole cells or as destroyed cells. A negative leukocyte esterase test means that an infection is unlikely.
Without additional evidence there is no need for culture.
True/False: Bacteria is common in the bladder - correct ans:False
urinary tract infection (UTI) - correct ans:infection of one or more organs of the urinary tract
Pyleonephritis - correct ans:kidney infection, typically from untreated bladder infection
Very Serious - can cause sepsis
UTI infx s/s + Chills/Fever
S/S UTI - correct ans:urinary frequency, dysuria (burning sensation), and pyuria, urinary hesitancy, slow
stream, dribbling urine, nocturia, flank pain, hematuria
Most common agent that causes UTI - correct ans:E. Coli (gram negative rod)
Other agents that cause UTI - correct ans:Klebsiella
Enterobacter
Proteus
Pseudomonas
Serratia
S. Faecalis
Staph
Dx studies for UTI - correct ans:Pyuria
Bacteuria
Urine dipstick - + leukocyte esterase, +nitrates
Urine culture - most specific
,Most specific UTI test - correct ans:Urine culture
Typically on a urine dipstick there can be a positive __________ , ________ and/or __________ for UTI -
correct ans:+ leukocyte esterase
+nitrates
Hematuria
Generally, more than __________/ml of one organism reflects significant bacteriuria in urine - correct
ans:100,000
The presence of __________ ____________ on a U/A reflect contamination, or chronic UTI. - correct
ans:multiple organisms
True/False: The presence of any organism in catheterized or suprapubic tap (needle directly into the
bladder) specimens should be considered significant. - correct ans:True
If UA colony count is < 10,000 CFU - correct ans:no work up unless it is a specimen from surgery or a
catherized specimen.
If UA colony count is > 10,000 CFU but < 100,000 CFU - correct ans:work up organisms with susceptibility
if a gramnegative rod (possible contamination or inadequately refrigerated).
If UA colony count is > 100,000 CFU - correct ans:indicates significant bacteria. Work up all organisms
with susceptibility.
A positive nitrite test indicates that - correct ans:bacteria may be present in significant numbers. Gram
negative rods such as E. coli are more likely to give a positive test.
True/False: If an elderly person presents with altered cognitive status, a UTI should be suspected. -
correct ans:True
Primary Txt UTI - correct ans:Nitrofurantoin, 100 mg BID x 5 days
, If Nitrofurantoin is not appropriate for a pt with uncomplicated UTI, what is another primary txt? -
correct ans:Sulfamethoxazole/trimethoprim: 160 mg BID x 3 days
Complicated UTI (READ BOOK) - correct ans:all urinary tract infections in immunocompromised patients,
males, and those associated with fevers, stones, sepsis, urinary obstruction, catheters, or involving the
kidneys are considered complicated infections.
Uncomplicated UTI (READ BOOK) - correct ans:infection in structurally and neurologically normal urinary
tract. an acute infection of urinary bladder or kidney in premenopausal, nonpregnant women who are
not at risk for complications.
Stress incontinence - correct ans:pelvic floor muscle weakness. It is loss of small amounts of urine with
coughing, laughing, sneezing, exercising or other movements that increase intraabdominal pressure and
thus increase pressure on the bladder
Urge incontinence - correct ans:involuntary loss of urine occurring for no apparent reason while
suddenly feeling the need or urge to urinate. The most common cause of urge incontinence is
involuntary and inappropriate detrusor muscle contractions
Functional incontinence - correct ans:occurs when a person does not recognize the need to go to the
toilet, recognize where the toilet is, or get to the toilet in time
Causes - delirium, fecal incontinence, lack of manual dexterity and immobility problems
Treatment - removing barriers to effective toileting, providing edu regarding a scheduled bladder
program, bowel/bladder program, easy to undo clothing
Overflow Incontinence - correct ans:Sometimes people find that they cannot stop their bladders from
constantly dribbling, or continuing to dribble for some time after they have passed water
Oxybutynin (Ditropan) - correct ans:Incontinence medication that suppresses involuntary contractions of
the bladder's smooth muscle (spasms) by blocking the release of acetylcholine and relaxes the bladder's
detrusor muscle (out layer of muscle)