MVU NURS 620 EXAM 3 ACTUAL
STUDY QUESTIONS AND ANSWERS
Renal disorder HPI questions to ask - ANSWER-Fever, n/v
Pain (abdominal, pelvic, back)
LMP, type of contraceptive use
New sexual partner
Vaginal discharge
Hygiene habits
Hx. Of UTIs
family history of bladder cancer
Renal Disorders: Differential Diagnosis - ANSWER-UTI
Pyelonephritis
Sexually Transmitted Infections
abdominal problems
appendicitis
cysts- ovarian or uterine
Renal Disorders: Diagnostics - ANSWER-What would we order to assist us in our
diagnosis?????
Urinalysis
Culture
Renal Disorders: Urinalysis Results - ANSWER-Color and clarity
Specific gravity
Leukocyte esterase
Nitrites: signals gram negative organism, may have false negative
Protein: 1+ to 4+ may be present
pH may be alkaline (6.5-8)
RBCs may be present
,Diagnosis: Uncomplicated UTI- clinical presentation - ANSWER-§ Dysuria
§ Urinary frequency and urgency
§ Cloudy or strong odor
§ Hematuria
§ Low back pain or suprapubic pain/tenderness
§ Elderly may present with altered mental status
Treatment for UTI's - ANSWER-Bactrim or Septra 1 DS BID x 3
Cefdinir 500 mg BID x 5
Nitrofurantoin 100 mg BID x 5
Patient education with UTI - ANSWER-•Complete the antibiotic regimen
•Proper hygiene
•Drink plenty of water (8 - 8oz glasses)
•Cotton undergarments
•Empty bladder after sexual intercourse
•Empty bladder frequently
•No tub baths or bubble baths
recurrent UTI Who should receive prophylaxis? - ANSWER-•2 or more symptomatic
UTIs w/in 6 months
•3 or > within 12 months
Management
•Prophylaxis should be initiated after previous UTI resolution is confirmed
•Daily dosing for 6 months
•Post-coital prophylaxis
•Self-medication (3-4 days of therapy when symptoms begin)
Chronic pelvic pain definition - ANSWER-Non-cyclic pain of 6 or more months duration
that is localized to the pelvis and is of sufficient severity to cause functional disability
, Chronic pelvic pain diffentials - ANSWER-endometriosis, interstitial cystitis, irritable
bowel syndrome
interstitial cystitis (IC) - ANSWER-•Chronic inflammatory condition of the bladder
clinically characterized by irritable voiding symptoms or urgency and frequency, in the
absence of objective evidence of another disease
•IC related CPP is worsened by intercourse and perimenstrual status
•90% of IC occurs in females
•Symptoms
•Pathogenesis: dysfunction of GAG layer
•Lab: diagnosis of exclusion
•Tests: GYN, U/S, IVP, Cystoscopy
•PUF Symptom Scale (>5, IC likely)
•Intravesical Potassium Sensitivity Test
Management of interstitial cystits - ANSWER-•Oral Pentosan polysulfate sodium: 100mg
TID or 200mg BID
•Course duration: 2-4 months minimum
•Intravesical DMSO bladder instillation
•Bladder training (reduce eliminations)
• Hydrodistension of bladder, low acid diet, laser, NSAIDS, antidepressants, muscle
relaxants
Male UTI - ANSWER-•Less common due to length of urethra- rule out with PSA for
prostatitis
•Clinical presentation
-Dysuria
-Urgency/ frequency
-Cloudy urine
STUDY QUESTIONS AND ANSWERS
Renal disorder HPI questions to ask - ANSWER-Fever, n/v
Pain (abdominal, pelvic, back)
LMP, type of contraceptive use
New sexual partner
Vaginal discharge
Hygiene habits
Hx. Of UTIs
family history of bladder cancer
Renal Disorders: Differential Diagnosis - ANSWER-UTI
Pyelonephritis
Sexually Transmitted Infections
abdominal problems
appendicitis
cysts- ovarian or uterine
Renal Disorders: Diagnostics - ANSWER-What would we order to assist us in our
diagnosis?????
Urinalysis
Culture
Renal Disorders: Urinalysis Results - ANSWER-Color and clarity
Specific gravity
Leukocyte esterase
Nitrites: signals gram negative organism, may have false negative
Protein: 1+ to 4+ may be present
pH may be alkaline (6.5-8)
RBCs may be present
,Diagnosis: Uncomplicated UTI- clinical presentation - ANSWER-§ Dysuria
§ Urinary frequency and urgency
§ Cloudy or strong odor
§ Hematuria
§ Low back pain or suprapubic pain/tenderness
§ Elderly may present with altered mental status
Treatment for UTI's - ANSWER-Bactrim or Septra 1 DS BID x 3
Cefdinir 500 mg BID x 5
Nitrofurantoin 100 mg BID x 5
Patient education with UTI - ANSWER-•Complete the antibiotic regimen
•Proper hygiene
•Drink plenty of water (8 - 8oz glasses)
•Cotton undergarments
•Empty bladder after sexual intercourse
•Empty bladder frequently
•No tub baths or bubble baths
recurrent UTI Who should receive prophylaxis? - ANSWER-•2 or more symptomatic
UTIs w/in 6 months
•3 or > within 12 months
Management
•Prophylaxis should be initiated after previous UTI resolution is confirmed
•Daily dosing for 6 months
•Post-coital prophylaxis
•Self-medication (3-4 days of therapy when symptoms begin)
Chronic pelvic pain definition - ANSWER-Non-cyclic pain of 6 or more months duration
that is localized to the pelvis and is of sufficient severity to cause functional disability
, Chronic pelvic pain diffentials - ANSWER-endometriosis, interstitial cystitis, irritable
bowel syndrome
interstitial cystitis (IC) - ANSWER-•Chronic inflammatory condition of the bladder
clinically characterized by irritable voiding symptoms or urgency and frequency, in the
absence of objective evidence of another disease
•IC related CPP is worsened by intercourse and perimenstrual status
•90% of IC occurs in females
•Symptoms
•Pathogenesis: dysfunction of GAG layer
•Lab: diagnosis of exclusion
•Tests: GYN, U/S, IVP, Cystoscopy
•PUF Symptom Scale (>5, IC likely)
•Intravesical Potassium Sensitivity Test
Management of interstitial cystits - ANSWER-•Oral Pentosan polysulfate sodium: 100mg
TID or 200mg BID
•Course duration: 2-4 months minimum
•Intravesical DMSO bladder instillation
•Bladder training (reduce eliminations)
• Hydrodistension of bladder, low acid diet, laser, NSAIDS, antidepressants, muscle
relaxants
Male UTI - ANSWER-•Less common due to length of urethra- rule out with PSA for
prostatitis
•Clinical presentation
-Dysuria
-Urgency/ frequency
-Cloudy urine
