NR507 Pathophysiology Final EXAM 2019 TEST BANK WITH QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) | ALREADY GRADED A+

NR507 Pathophysiology Final EXAM 2019 TEST BANK WITH QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) | ALREADY GRADED A+ Why does pregnancy increase the risk of UTI? - ANSWER- Pregnancy results in increased progesterone which relaxes smooth muscle leading to urine stasis. Why are post-menopausal individuals at an increased risk of UTI? - ANSWER- Post-menopause results in a lower amount of estrogen resulting in urethral dryness. What are factors that would make a UTI "complicated"? - ANSWER- infants, older adults, structural abnormalities, indwelling catheter, immunocompromised, males, UTIs with fever/sepsis, stones What might the NP need to counsel a sexually active female patient n regarding UTI prevention? - ANSWER- Urinating before and after intercourse, discouraging the use of spermicide, avoid holding urine for long periods, encourage showers instead of baths, increase water intake Define a simple UTI - ANSWER- A simple or uncomplicated UTI is in an afebrile non-pregnant immune-competent female patient Define an upper UTI and its risks - ANSWER- An upper UTI is in the kidneys, this infection has the potential to move through the renal veins causing bacteremia which then can lead to septic shock Define cystitis - ANSWER- Lower UTI with bladder infection Define pyelonephritis and S/S - ANSWER- infection of the kidney, S/S: vomiting, flank pain, fever What is the most common bacteria that causes UTI? - ANSWER- Escherichia coli, this usually comes from fecal matter What abnormal lab values in a urinalysis would indicate UTI? (5) - ANSWER- increased RBCs, increased WBCs, presence of bacteria, presence of large crystals, presence of casts What is the main difference in UA results between a uncomplicated and a complicated UTI? - ANSWER- In an uncomplicated UTI, the WBC count will be 5,000. In a complicated UTI, the WBC count will be 100,000. Casts will only be present in complicated UTIs. What does the presence of nitrates in a UA indicate? - ANSWER- Positive nitrates indicates gram negative bacteria True or false, BPH causes cancerous growth. - ANSWER- False. What is the effect of BPH on the bladder? - ANSWER- BPH can lead to bladder hypertrophy d/t increased bladder contractions as the individual will strain to urinate d/t constriction of the prostatic urethra. What are the irritative symptoms of BPH? - ANSWER- Irritative symptoms are related to the storage of urine. Symptoms include: nocturia, frequency, urgency, bladder pain, urge incontinence What are the obstructive symptoms of BPH? - ANSWER- Obstructive symptoms are related to voiding. Symptoms include: hesitancy, straining, weak flow, dribbling, retention, and overflow incontinence What is the cause of BPH? - ANSWER- Normal cells response to dihydrotestosterone which causes the cells to proliferate and live longer. Dihydrotestosterone is a hormone that stimulates the development of male characteristics (an androgen). It is made through conversion of the more commonly known androgen, testosterone. What does BPH stand for? - ANSWER- benign prostatic hypertrophy or hyperplasia What is the pharmacotherapy for BPH? - ANSWER- 5-alpha-reductase inhibitors (Finasteride, Proscar) inhibit testosterone from becoming dihydrotestosterone and therefore shrink the prostate. What is the function of prostate specific antigen? - ANSWER- PSA is an enzyme that liquifies semen post-ejaculation to allow the sperm to "swim" aka dissolution of the seminal fluid coagulum True or false, BPH increases risk of UTI. - ANSWER- True, increases risk of UTI d/t stagnation of urine. What is the largest zone of the prostate? - ANSWER- Peripheral zone Which zone of the prostate has the highest risk for development of BPH? - ANSWER- The transitional zone Which zone of the prostate contains the prostatic urethra? - ANSWER- The transitional zone. Where are hyperplastic nodules usually found in BPH? - ANSWER- The peripheral zone What is the gold standard for Dx of renal calculi? - ANSWER- CT scan. Other diagnostic methods include x-ray and CT What is the cause of calcium stones? - ANSWER- idiopathic, hypercalcemia, hypercalciuria. Form when Calcium and oxalate in urine combine. Possible cause is hyperparathyroidism Treatment for calcium stones? - ANSWER- thiazide diuretics to excrete Ca What is the cause of Struvite stone - ANSWER- Caused by UTI, bacteria produce urease which makes urine alkaline and causes stones to form. "Staghorn stone". What is the cause of Uric acid stone (2 causes) - ANSWER- Gout causes an increase in uric acid. Chemotherapy causes the destruction of cells resulting in increased purine which results in increased uric acid which causes stones. What is the treatment of uric acid stone? - ANSWER- Water, allopurinol, Potassium bicarb to increase alkalinity What is the cause of a cystine stone? - ANSWER- Rare, occurs in children with a renal tubule defect where cystine is not reabsorbed. Staghorn shape. What are the signs and symptoms of renal calculi? - ANSWER- Renal colic S/S are flank or costovertebral angle pain that radiates to the groin as the stone passes. Hematuria. N/V What procedure is the treatment for renal calculi? - ANSWER- Lithotripsy, non-invasive, breaks down stone. True or false, Renal calculi have a low rate of recurrence? - ANSWER- False, renal calculi have a high rate of recurrence When the bladder is empty, what muscle relaxes and which muscles contract? - ANSWER- Detrusor muscle relaxes and the internal and external sphincters constrict. What is micturition? - ANSWER- urination What part of the brain controls micturition? - ANSWER- pontine micturition center in the brain stem