Exam#3

Question 1

What are UTI’s caused by?

Answer 1

-Pathogenic microorganisms in the urinary tract
-Can be uncomplicated of complicated depending on patient complications

Question 2

Lower UTI’s

Answer 2

Bacterial cystitis
Prostatitis
Urethritis

Question 3

Upper UTI’s

Answer 3

Acute and chronic pyelonephritis
Interstitial nephritis
Renal nephritis

Question 4

Uncomplicated Lower or Upper UTI’s

Answer 4

Common in young women but not usually recurrent

Question 5

Complicated Lower and Upper UTI’s

Answer 5

Usually occur in people with urologic abnormalities or recent catheterization
Often acquired during hospitalization

Question 6

Access method of UTI

Answer 6

Occurs first when the bacteria gains access inside the urinary tract

Question 7

Attachment method of UTI

Answer 7

Bacteria attach to the epithelium of the urinary tract and colonize to avoid being washed out

Question 8

Inflammation method of UTI

Answer 8

As a defense mechanism to the bacteria, inflammation starts to set along with other signs of infection

Question 9

What does UTI cause

Answer 9

Inability or failure to empty bladder
Catheterization or cystoscopy
Obstructed urinary flow
Immunosuppression

Question 10

Clinical manifestations of UTI

Answer 10

Dysuria (painful urination)
Frequency (more than Q3hrs)
Nocturia
Suprapubic/Pelvic pain
Urgency

Question 11

How to prevent UTI’s

Answer 11

Avoid bath tubs
Perineal hygiene
Increase fluid intake
Voiding habit
Medications
Avoid urinary tract irritants

Question 12

Complications of UTI’s

Answer 12

Renal failure
Urosepsis

Question 13

How to diagnose UTI’s

Answer 13

Urine cultures
STD tests
CT scan
Ultrasonography

Question 14

Medical management of UTI’s

Answer 14

Acute pharmacologic therapy- antibacterial agent that eradicates bacteria from the urinary tract with minimal effects on fecal and vaginal flora
Long-term pharmacologic therapy- Re-infection with new bacteria is the reason for recurrence; patients are instructed to self treat when symptoms occur

Question 15

Nursing assessments of UTI’s

Answer 15

Assess for frequency, urgency, or hesitancy
Assess patients knowledge about antimicrobials and preventative care
Assess urine color, odor, concentration, volume, and cloudiness

Question 16

Nursing diagnosis of UTI’s

Answer 16

Acute pain related to infection within urinary tract
Deficient knowledge related to factors and preventions of disease

Question 17

Nursing interventions of UTI’s

Answer 17

Relieve pain- Analgesics and heat help relieve pain and spasm
Fluids- increased fluids promotes renal blood flow to flush bacteria
Voiding- Q2-3hrs
Irritants- avoid coffee, tea, colas, and alcohol

Question 18

What is Pyelonephritis?

Answer 18

Infection in the kidneys and is caused by a bacterial infection of the lower urinary tract
Can be acute or chronic

Question 19

Most common organism causing pyelonephritis

Answer 19

Escherichia coli

Question 20

Signs and Symptoms of Pyelonephritis

Answer 20

Flank pain
Dysuria
Polyuria
Urinary urgency
Urinary frequency
Malaise
Fever
Nausea
Vomiting

Question 21

Complications of Pyelonephritis

Answer 21

Kidney failure
Renal scarring
Sepsis

Question 22

What to assess in pyelonephritis

Answer 22

Symptoms
Description of pain
CVA
Labs (UA, CX, Ultrasound, CT)

Question 23

Nursing interventions for pyelonephritis

Answer 23

Mangage pain
Mangage fever
Give meds
Increase fluids
Encourage avoidance of soda, tea, alcohol, coffee, spices
Encourage voiding frequently
Assist in non-pharmacologic techniques for pain
Educate

Question 24

What is Urolithiasis (Renal Calculi)

Answer 24

Stones in the urinary tract
Are formed when calcium oxalate, calcium phosphate, and uric acid increase
Vary in size
Increases risk of infection, urinary stasis, and immobility

Question 25

What is nephrolithiasis

Answer 25

Stones forming in the kidney

Question 26

What is ureterolithiasis

Answer 26

Stones formed in the ureters

Question 27

Clinical manifestations of stones in renal pelvis

Answer 27

Hematuria Polyuria Pain that radiates toward bladder(female), testicles(male) Acute pain Nausea Vomiting Abdominal discomfort Diarrhea Pain in costovertebral region

Question 28

Clinical manifestations of ureteral colic (stones in ureter)

Answer 28

Acute, excruciating wavelike pain that radiates down thigh and pelvic region Frequent desire to void Usually contains blood

Question 29

Clinical manifestations of stones in bladder

Answer 29

Irritation Urinary retention Possible urosepsis

Question 30

How to diagnose urolithiasis

Answer 30

KUB Ultrasound IVP CT (non-contrast) UA BUN CBC PTH

Question 31

Nursing priorities for urolithiasis

Answer 31

Alleviate pain Maintain adequate renal functioning Prevent complications Educate

Question 32

Medical management of urolithiasis

Answer 32

Increase fluids Increase calcium for calcium stones HCTZ for calcium stones Low purine and low protein for uric acid Allopurinol for uric acid

Question 33

Medical management for urolithiasis

Answer 33

Stone removal Ureteroscopy- stones fragmented with use of laser, ultrasound, and electrohydraulicn lithotripsy Extracorporeal shock wave lithotripsy Electrohydraulic lithotripsy Chemolysis- alternative for those at risk with other therapies Surgical removal

Question 34

Nursing assessment

Answer 34

Assess for pain (severity, location, radiation) Associated symptoms (abdominal pain, NVD) Observe, for (hematuria, strain, urine for stones.)

Question 35

Complications of urolithiasis

Answer 35

Infection Urinary tract obstruction Acute renal failure Hydronephrosis

Question 36

Nursing interventions for urolithiasis

Answer 36

Administer opioid analgesics Encourage positions of comfort Assist with ambulation Monitor pain Encourage increased fluids Begin IV fluids Monitor output Strain urine

Question 37

Nursing interventions

Answer 37

Instruct patient to report, decreased volume, bloody or cloudy urine, fever, pain Monitor vital signs for infection

Question 38

What is glomerulonephritis?

Answer 38

Auto immune condition that triggers inflammation and proliferation of globular tissue that can result in damage to the basement membrane or capillary endothelium Most often caused by group a beta hemolytic streptococcal infection