NURS 651 Exam 3 (Maryville) – Questions With
Answers
1). Uti: defintion
Ans: Includes bladder, (cystitis) urethera (urethritis) and kidney (pyelonephritis)
2). Signs and symptoms of uti
Ans: -Fever may be only sign infants a & young child
-Older children=urinary symptoms ( new onset incontinence, dysuria, frequency,
abdominal pain
3). Risk factors of uti
Ans: FEMALE, Uncircumcised male, GENETICS, (Anatomy), BOWEL/BLADDER
Dysfunction, Obstruction, Catheterization, SEX, Reflux
4). Exam for uti
Ans: Temp, BP, abd exam for mass, tenderness. suprapubic or costovertebral
tenderness, check external genitalia, eval lower back for signs of occult
myelomeningiocele, check other sources for fever.
5). Uti testing
Ans: -clean catch, cath, suprapubic UA
*dipstick, urine culture.
-+ leukocyte esterase=pyuria
-+nitrate=bacteria
*C/S
-+100,000 colonies for dx; may treat 50,000 or greater
UTI cal app to estimate probability of UTI (ages 2 -23 months)
6). Indications for urine sample
Ans: Girls:
2-11 months of age temp > 100.4 (non-black)
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, 2-11 months of age temp of 102.2 OR the,p 100.4 and no other fever source identified.
12-24 months of age temp 102.2 (non black)
12-24 months of age 102.2 and no other source of fever identified.
>24 months One or more of the following: dysuria, frequency, new onset incontinence,
back pain, abdominal pain, fever of 102.2 and no other acute cause.
7). Infant uti
Ans: non specific symptoms or asymptomatic
8). Uti symptom cluster
Ans: Newborn- irritability, poor feeding, diarrhea, fever, vomiting. jaundice,
hypothermia, cyanosis, lethargy
Infants//todlers/preschool: diarrhea, vomiting, fever, poor feeding, strong urine odor,
irritability, poor weight gain, diaper rash
Schoolage/adolescents; fever, vomiting, strong urine odor, urethral pain or suprapubic,
dysuria, incontinence.
9). Uti differential diagnosis
Ans: Chemical irritation (bubble bath)
vulvovaginitis
dysfunctional voiding
acute abdomen ( appe, STD)
Foreign body
Sexual abuse
Dysfunctional voiding related to constipation
10). Uti specimen collection
Ans: Clean catch urine midstream
(bagged specimen don't do it)
Straight Cath for mod to severe symptoms
Suprapubic aspiration: only when culture is urgently needed. ( + is > 1000 colonies)
_blood culture obtained for <12months and suspected sepsis
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, 11). Indications for radiology in uti
Ans: -Symptoms of pyelonephritis regardless of age and gender
-UTI in child <3 months
-males with first infection and females with second infection. even if not pyelonephritis
and child > 3 months of age.
12). Uti treatment
Ans: -IV ABX- newborns, infants, or older children with vomiting, severe symptoms
systemic illness or unable to take fluids
-ORAL- 10 day regimen, or 14 days with completed infection.
13). Uti drugs
Ans: 1. Bactrim ( infants >2 months) TMP 8-10mg/kg.BID Recommended until
sensitivities are back since most UTI are caused by E. coli.
2. Amoxicillin 30-40 mg/kg/day TID <3months
3. Augmentin 40mg/kg/day TID
4. Sulfisoxazole 150mg/kg/day QID
5. Cephalexin 50mg/kg/day TID
6. Nitrofurantin 5-7mg/kg/day in divided doses
(ideal treatment for UTI due to highly concentrated in the urine, but less effective for
systemic/renal infections as it does not concentrate well in blood)
14). Follow up urine cultures
Ans: -2nd culture at 72 hours after initiating treatment if symptoms are not rsolving
-culture 1 week after completion of treatment when test of cure is indicated.
15). Tanner staging female pubic hair
Ans: 1. No pubic hair (preadolescent)
2. little pigment straight hair,
3. Pigmented, straight medial border of labia sparse
4. pigment, curly, abundant but less than adult
5. lateral spread of hair, triangle
6. only occurs in 10% of women
16). Tanner staging female breast development
Ans: 1. Preadolescent nipple elevation
2. Breast buds with areolar enlargement
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Answers
1). Uti: defintion
Ans: Includes bladder, (cystitis) urethera (urethritis) and kidney (pyelonephritis)
2). Signs and symptoms of uti
Ans: -Fever may be only sign infants a & young child
-Older children=urinary symptoms ( new onset incontinence, dysuria, frequency,
abdominal pain
3). Risk factors of uti
Ans: FEMALE, Uncircumcised male, GENETICS, (Anatomy), BOWEL/BLADDER
Dysfunction, Obstruction, Catheterization, SEX, Reflux
4). Exam for uti
Ans: Temp, BP, abd exam for mass, tenderness. suprapubic or costovertebral
tenderness, check external genitalia, eval lower back for signs of occult
myelomeningiocele, check other sources for fever.
5). Uti testing
Ans: -clean catch, cath, suprapubic UA
*dipstick, urine culture.
-+ leukocyte esterase=pyuria
-+nitrate=bacteria
*C/S
-+100,000 colonies for dx; may treat 50,000 or greater
UTI cal app to estimate probability of UTI (ages 2 -23 months)
6). Indications for urine sample
Ans: Girls:
2-11 months of age temp > 100.4 (non-black)
PaperStoc.com Page 1 of 28
, 2-11 months of age temp of 102.2 OR the,p 100.4 and no other fever source identified.
12-24 months of age temp 102.2 (non black)
12-24 months of age 102.2 and no other source of fever identified.
>24 months One or more of the following: dysuria, frequency, new onset incontinence,
back pain, abdominal pain, fever of 102.2 and no other acute cause.
7). Infant uti
Ans: non specific symptoms or asymptomatic
8). Uti symptom cluster
Ans: Newborn- irritability, poor feeding, diarrhea, fever, vomiting. jaundice,
hypothermia, cyanosis, lethargy
Infants//todlers/preschool: diarrhea, vomiting, fever, poor feeding, strong urine odor,
irritability, poor weight gain, diaper rash
Schoolage/adolescents; fever, vomiting, strong urine odor, urethral pain or suprapubic,
dysuria, incontinence.
9). Uti differential diagnosis
Ans: Chemical irritation (bubble bath)
vulvovaginitis
dysfunctional voiding
acute abdomen ( appe, STD)
Foreign body
Sexual abuse
Dysfunctional voiding related to constipation
10). Uti specimen collection
Ans: Clean catch urine midstream
(bagged specimen don't do it)
Straight Cath for mod to severe symptoms
Suprapubic aspiration: only when culture is urgently needed. ( + is > 1000 colonies)
_blood culture obtained for <12months and suspected sepsis
PaperStoc.com Page 2 of 28
, 11). Indications for radiology in uti
Ans: -Symptoms of pyelonephritis regardless of age and gender
-UTI in child <3 months
-males with first infection and females with second infection. even if not pyelonephritis
and child > 3 months of age.
12). Uti treatment
Ans: -IV ABX- newborns, infants, or older children with vomiting, severe symptoms
systemic illness or unable to take fluids
-ORAL- 10 day regimen, or 14 days with completed infection.
13). Uti drugs
Ans: 1. Bactrim ( infants >2 months) TMP 8-10mg/kg.BID Recommended until
sensitivities are back since most UTI are caused by E. coli.
2. Amoxicillin 30-40 mg/kg/day TID <3months
3. Augmentin 40mg/kg/day TID
4. Sulfisoxazole 150mg/kg/day QID
5. Cephalexin 50mg/kg/day TID
6. Nitrofurantin 5-7mg/kg/day in divided doses
(ideal treatment for UTI due to highly concentrated in the urine, but less effective for
systemic/renal infections as it does not concentrate well in blood)
14). Follow up urine cultures
Ans: -2nd culture at 72 hours after initiating treatment if symptoms are not rsolving
-culture 1 week after completion of treatment when test of cure is indicated.
15). Tanner staging female pubic hair
Ans: 1. No pubic hair (preadolescent)
2. little pigment straight hair,
3. Pigmented, straight medial border of labia sparse
4. pigment, curly, abundant but less than adult
5. lateral spread of hair, triangle
6. only occurs in 10% of women
16). Tanner staging female breast development
Ans: 1. Preadolescent nipple elevation
2. Breast buds with areolar enlargement
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