Ch. 52- Test 2

Question 1

Signs and symptoms of UTI

Answer 1

Urinary frequency
Urgency
Burning on urination (associated with cystitis)
Chills, fever, flank pain (retroperitoneal), and tenderness (associated with acute pyelonephritis)

Question 2

Antiinfectives used to treat UTI

Answer 2

Nitrofurantoin
Ciprofloxacin
Levofloxacin
Trimethoprim-sulfamethoxazole

Question 3

Trimethoprim-sulfamethoxazole (Bactrim)

Answer 3

Antiinfective used to treat UTI
PO or IV; contains sulfa

Question 4

Levofloxacin (Levaquin)

Answer 4

Antiinfective used to treat UTI
can be given iv; adverse nephrotoxicity; ototoxicity

Question 5

Ciprofloxacin (Cipro)

Answer 5

Antiinfective used to treat UTI
can cause adverse liver effects jaundice etc, do liver assessment??

Question 6

Nitrofurantoin (Furadantin)

Answer 6

Antiinfective used to treat UTI
treat uti from bacterial causes; does not contain sulfa; never taken on empty stomach;

Question 7

actions for antiinfectives used for UTI

Answer 7

Act specifically within the urinary tract to destroy bacteria
They act either through direct antibiotic effect or through acidification

Question 8

indications for antiinfectives used to treat UTI

Answer 8

Chronic UTI
Adjunctive therapy in acute cystitis and pyelonephritis
Prophylaxis with urinary tract anatomical abnormalities and residual urine disorders

Question 9

Adverse effects for antiinfectives used for UTI

Answer 9

Nausea, vomiting, anorexia, bladder irritation, and dysuria
Meds will not change due to diarrhea
Pruitus, urticaria, headache, dizziness, nervousness, and confusion

Question 10

Urinary Tract Antispasmodics

Answer 10

**Oxybutynin (Ditropan XL)
**Tolterodine (Detrol)

Question 11

Contraindications for urinary tract antispasmodics

Answer 11

**Allergy
***Pyloric or **duodenal obstruction
Recent surgery
Obstructive urinary tract problems
*Glaucoma, myasthenia gravis, or acute hemorrhage

Question 12

Urinary tract Analgesic

Answer 12

Phenazopyridine (Azo-Standard, Baridium, and others) is a dye that is used to relieve urinary tract pain; can have liver side effects if combined with other drugs; liver assessment???

Pain involving the urinary tract can be very uncomfortable and lead to urinary retention and increased risk of infection

Question 13

Cautions for Antiinfectives/antispasmodics used for UTI

Answer 13

Renal Dysfunction
Pregnancy
Lactation

Question 14

Nursing Considerations for Antiinfectives

Answer 14

History and Physical Exam and known allergy
Skin, CNS function, urinary elimination patterns, including amount and episode frequency, complaints of frequency, urgency, pain, or difficulty voiding and appropriate lab values
Fluids 2-3 L/day
educate patient to take antibiotics as prescribed for full course

Question 15

Nursing Considerations for Urinary Tract Antispasmodics

Answer 15

Assess:
History and Physical Exam specifically GI and known allergy
Pyloric or duodenal obstruction or obstructions of the other GI lesions lower urinary tract
Glaucoma, pregnancy or lactation
Skin, CNS, urinary elimination pattern, including amount and frequency of episodes, and for any complaints of frequency, urgency, pain, or difficulty voiding and appropriate lab values
Focused urinary assessment

Question 16

Actions/ Indications for urinary tract analgesic

Answer 16

Actions- When phenazopyridine is excreted in urine, it exerts a direct topical analgesic effect on the urinary mucosa
Indications- Relieve symptoms related to urinary tract irritation from infection, trauma, or surgery

Question 17

adverse effects and drug-drug interactions

Answer 17

Adverse Effects- GI upset, headache, rash, reddish-orange coloring of the urine and staining of contact lenses
Renal and hepatic toxicity
Drug-Drug Interactions- Antibacterial agents

Question 18

Nursing Considerations for Urinary Tract Analgesia

Answer 18

Assess:
History and Physical Exam and known allergy
Renal insufficiency, pregnancy and lactation
Skin, sclera, GI and hepatic function urinary elimination patterns, including color, amount, and complaints of frequency, dysuria, or difficulty voiding
Appropriate lab values and assessments

Question 19

bladder protectant

Answer 19

Used to coat or adhere to the bladder mucosal wall and protect it from irritation related to solutes in urine.

Oxybutynin (cant sweat so avoid sun/heat), tolterodine(typical anticholinergic side effects), darifenacin, potassium chloride

Question 20

bladder protectant side effects and adverse effects

Answer 20

Side effects: Dry mouth and eyes, headache, dizziness, constipation
Adverse effects: Chest pain, fast or irregular heart rate, shortness of breath, swelling (edema) and rapid weight gain, confusion, hallucinations, decreased urine output