NURS 536 Final Exam questions with correct answers

NURS 536 Final Exam questions with correct|\ |\ |\ |\ |\ |\ |\




answers

Risk factors for UTI - CORRECT ANSWERS ✔✔•Sexually active
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•Postmenopausal
•Woman who uses birth control methods such as diaphragms or
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spermicide
•Those individuals who have trouble emptying your bladder
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completely, such as spinal cord injury or those with nerve damage
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around the bladder |\ |\




•Urinary tract obstruction such as urinary stricture, enlarged
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prostate or renal calculi |\ |\ |\




•Abnormality of the urinary tract, such as vesicoureteral reflux
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(VUR)
•DM, immunocompromised
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•Recent instrumentation |\




•Prior UTI |\




Bacterial causes of UTI - CORRECT ANSWERS ✔✔E. coli
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Klebsiella pneumoniae |\




P. aeruginosa
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UTI Symptoms - CORRECT ANSWERS ✔✔-pain/burning when
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urinating
-frequent urination |\

,-kidney pain |\




UTI symptoms in the elderly - CORRECT ANSWERS ✔✔Falls,
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changes in mental status
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Asymptomatic bacteriuria - CORRECT ANSWERS ✔✔•Cloudy or|\ |\ |\ |\ |\ |\ |\



malodorous urine may be associated with bacteriuria
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•Color and odor of urine can be influenced by ingestion of certain
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foods, dehydration and other noninfectious factors
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UTI Diagnosis - CORRECT ANSWERS ✔✔UA:
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•Abnormal result: Leukocyte esterase, nitrites, white blood cells
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•Hematuria is not a predictor for complicated infection and does
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not alter the approach to therapy
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•White blood cell casts in the urine, although rare, are indicative of
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upper tract infection rather than simple cystitis
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Differential Diagnosis for UTI - CORRECT ANSWERS ✔✔•Vaginitis
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•Urethritis
•Interstitial cystitis |\




•PID
•Epididymitis (men) |\

,•Prostatitis (men) |\




Complicated UTI - CORRECT ANSWERS ✔✔•Fever |\ |\ |\ |\ |\ |\



(>99.9°F/37.7°C), signs of sepsis |\ |\ |\




•Chills, rigors, marked fatigue or malaise
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•Flank pain or costovertebral angle tenderness
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UTI Treatments - Low Risk - CORRECT ANSWERS ✔✔Low risk
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patients:


•Macrobid, Bactrim, fosfomycin, pivmecillinam
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•Alternative: fluoroquinolone, Augmentin, cefpodoxime, cefdinir,
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cefadroxil


UTI Treatments - High risk - CORRECT ANSWERS ✔✔High risk
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patients:


*obtain culture
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Outpatient management of complicated infection
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+/-Following the dose of the parenteral agent, options include the
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following:


•Cipro 500mg BID or 1000mg ER once daily or Levaquin 750mg
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once daily 7 to 10 days
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, •Trimethoprim-sulfamethoxazole - one double-strength (160 |\ |\ |\ |\



mg/800 mg) tablet orally twice daily for 7 to 10 days
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•Amoxicillin-clavulanate - 875 mg orally twice daily for 10 to 14 |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



days


•Cefpodoxime - 200 mg orally twice daily for 10 to 14 days |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\




•Cefdinir - 300 mg orally twice daily for 10 to 14 days
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•Cefadroxil - 1 g orally twice daily for 10 to 14 days |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\




Pyelonephritis - CORRECT ANSWERS ✔✔inflammation of the |\ |\ |\ |\ |\ |\ |\



kidney and renal pelvis
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Pyleonephritis - Who? - CORRECT ANSWERS ✔✔•In females: An |\ |\ |\ |\ |\ |\ |\ |\ |\



elevated incidence in girls aged 0-4 years, a peak in women 15-35
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years of age, and a gradual increase after age 50 years to another
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peak at 80 years of age.
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Pyelonephritis Symptoms - CORRECT ANSWERS ✔✔•Fever - This is |\ |\ |\ |\ |\ |\ |\ |\ |\



not always present, 103°F (39.4°C)
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•Costovertebral angle pain |\ |\ |\




•Nausea and/or vomiting - Vary in frequency and intensity, from
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absent to severe; anorexia is common in patients with acute
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pyelonephritis