NURS 640 FINAL EXAM QUESTIONS AND
ANSWERS
BPH treatment
Alpha Blockade:
Tamsulosin (FLomax)
Doxazosin (Cardura)
Prazosin (Minipress)
Most common urologic emergency
Acute urinary retention
Urinary retention volume
> 300 cc ; Overflow incontinence when chronic
When to leave urinary catheter in or str8 catheter
> 400 cc
Gender acute cystitis occurs in the most
Women
Acute cystitis risk factors
Female gender
sexually active women
,DM in women (UTI risk increase 2-3x)
incontinent women
Acute cystitis infective organism
Enteric gram negative rods: E. Coli is the most common
Uncomplicated Cystitis treatment
Can resolve on own.
if pharm needed: Empiric Antibiotics 1st line: Cephalexin-Nitrofurantin or Trimethoprim-
Sulfamethoxazole
If Acute cystitis and have sulfa allergy treat with:
Ciprofloxacin
Acute cystitis is typically non-systemic until:
7-10 days infection when it becomes complicated - may progress to UTI
Treatment for complicated Acute cystitis:
Urinary analgesia: Phenazopyridine - LIMIT TO 2 DAYS treatment; as this will mask Cystitis
symptoms
If acute pyelonephritis & acute prostatitis patients have sulfa allergy treat with:
Bactrim or Bata Lactam
1f acute pyelonephritis & acute prostatitis patients are inpatient setting treat with:
IV Ampicillin + Aminoglycoside
,Do not force hydration in:
Urinary Stone Disease: Only till Euvolemic
When to use suprapubic catheter instead of urethral catheters?
Acute Bacterial Prostatitis
Prostate precautions
Do not message if tender to tough
Urine Dipstick limitations:
Pair with clinical history and findings - negative dipstick findings do not rule out infection
Urine incubation time for bacterial growth:
2 hrs
Significant dipstick findings when:
Leukocyte Esterase
Nitrates
>1 cell blood
>3 cells protein
UA; Urine microscopic significant findings:
Pyuria: WBC-PUS
WBC: > 5 per HPF or 8-10 per uL
Bacteria
RBC: > 5 per HPF (High power field in urine)
, - Same findings for UTI and Inflammation!
Urine culture in uncomplicated Cystitis?
NOT NEEDED
Clean catch specimen for uncomplicated bacteriuria:
Significant for > 100,000 CFU/mL bacteria
Women need 2 specimens for significance
Men need 1 specimen for significance
Catheter catch specimen for uncomplicated bacteriuria:
Significant for > 100 CFU/mL bacteria
1 specimen for significance in male or female
Colony count does not correlate severity level in:
Acute cystitis
Age Keys to Acute Epididymitis
< 40yrs = STD (Chlamydia / Gonorrhea) consideration
> 40yrs = UTI / Prostatitis / gram (-) rods consideration
Treatment for UTI with Multi-drug resistance (MDR) considerations:
LOW MDR risk: Cefriaxone - Zosyn or Fluoroquinolones
HIGH MDR risk: Antipseudomonal Carbapenem -w- MRSA coverage
ANSWERS
BPH treatment
Alpha Blockade:
Tamsulosin (FLomax)
Doxazosin (Cardura)
Prazosin (Minipress)
Most common urologic emergency
Acute urinary retention
Urinary retention volume
> 300 cc ; Overflow incontinence when chronic
When to leave urinary catheter in or str8 catheter
> 400 cc
Gender acute cystitis occurs in the most
Women
Acute cystitis risk factors
Female gender
sexually active women
,DM in women (UTI risk increase 2-3x)
incontinent women
Acute cystitis infective organism
Enteric gram negative rods: E. Coli is the most common
Uncomplicated Cystitis treatment
Can resolve on own.
if pharm needed: Empiric Antibiotics 1st line: Cephalexin-Nitrofurantin or Trimethoprim-
Sulfamethoxazole
If Acute cystitis and have sulfa allergy treat with:
Ciprofloxacin
Acute cystitis is typically non-systemic until:
7-10 days infection when it becomes complicated - may progress to UTI
Treatment for complicated Acute cystitis:
Urinary analgesia: Phenazopyridine - LIMIT TO 2 DAYS treatment; as this will mask Cystitis
symptoms
If acute pyelonephritis & acute prostatitis patients have sulfa allergy treat with:
Bactrim or Bata Lactam
1f acute pyelonephritis & acute prostatitis patients are inpatient setting treat with:
IV Ampicillin + Aminoglycoside
,Do not force hydration in:
Urinary Stone Disease: Only till Euvolemic
When to use suprapubic catheter instead of urethral catheters?
Acute Bacterial Prostatitis
Prostate precautions
Do not message if tender to tough
Urine Dipstick limitations:
Pair with clinical history and findings - negative dipstick findings do not rule out infection
Urine incubation time for bacterial growth:
2 hrs
Significant dipstick findings when:
Leukocyte Esterase
Nitrates
>1 cell blood
>3 cells protein
UA; Urine microscopic significant findings:
Pyuria: WBC-PUS
WBC: > 5 per HPF or 8-10 per uL
Bacteria
RBC: > 5 per HPF (High power field in urine)
, - Same findings for UTI and Inflammation!
Urine culture in uncomplicated Cystitis?
NOT NEEDED
Clean catch specimen for uncomplicated bacteriuria:
Significant for > 100,000 CFU/mL bacteria
Women need 2 specimens for significance
Men need 1 specimen for significance
Catheter catch specimen for uncomplicated bacteriuria:
Significant for > 100 CFU/mL bacteria
1 specimen for significance in male or female
Colony count does not correlate severity level in:
Acute cystitis
Age Keys to Acute Epididymitis
< 40yrs = STD (Chlamydia / Gonorrhea) consideration
> 40yrs = UTI / Prostatitis / gram (-) rods consideration
Treatment for UTI with Multi-drug resistance (MDR) considerations:
LOW MDR risk: Cefriaxone - Zosyn or Fluoroquinolones
HIGH MDR risk: Antipseudomonal Carbapenem -w- MRSA coverage
