Chapter 45 - Renal and Urologic Problems

Question 1

UTI Risk Factors

Answer 1

Pregnancy, menopause, habitual delay of urination, instrumentation, and sexual intercourse

Question 2

Catheter-associated urinary tract infections

Answer 2

• Most common HAI
• Most common pathogen is E. coli
• 2nd most common pathogen is C. albicans

Question 3

UTI Symptoms

Answer 3

Dysuria, frequency, urgency, and suprapubic discomfort or pressure

Question 4

UTI Diagnosis

Answer 4

Urinalysis

• Presence of nitrites, WBCs, and leukocyte esterase
• Midstream sample

Question 5

UTI Drugs

Answer 5

• Trimethoprim/Sulfamethoxazole (TMP-SMX)
• Nitrofurantoin
• Cephalexin
• Fosfomycin

Question 6

UTI Health Promotion

Answer 6

• Prevention
• Emptying bowel and bladder regularly
• Wipe front to back
• Drink adequate water

Question 7

Pyelonephritis

Answer 7

• Inflammation of the renal parenchyma and collecting system, including the renal pelvis
• Most common cause is lower UTI
• Reoccuring infection can cause chronic pyelonephritis

Question 8

Pyelonephritis Clinical Manifestations

Answer 8

Sudden onset of chills, fever, vomiting, malaise, flank pain, and lower UTI symptoms

Question 9

Pyelonephritis Interventions

Answer 9

• Take antibiotics
• Follow-up urine culture
• Identification of risks for reccurence or relapse

Question 10

Urethritis

Answer 10

Inflammation of the urethra, most often from STIs

Question 11

Urethritis Manifestations

Answer 11

• Discharge
• Dysuria
• Urgency
• Frequency

Question 12

Urethral Diverticula

Answer 12

• Outpouchings in the urethra that result from obstruction and rupture of the periurethral glands
• Associated with childbearing, urethral instrumentation, dilation, and infections
• Surgery is the best treatment option, but stress incontinence is a common complication

Question 13

Urethral Diverticula Symptoms

Answer 13

Dysuria, postvoid dribbling, frequency, urgency, and dyspareunia (pain with sexual activities)

Question 14

Interstitial Cystitis

Answer 14

Chronic, painful inflammatory disease of the bladder

Question 15

Interstitial Cystititis Symptoms

Answer 15

Urgency/frequency and pain in the bladder or pelvis

Question 16

Interstitial Cystitis Drugs

Answer 16

Pentosan - Enhances the protective effects of the glycosaminoglycan layer of the bladder and relieves pain by reducing the irritative effects of urine on the bladder wall
-Short term: antihistamine therapy and opioid analgesics

Question 17

Genitourinary TB

Answer 17

Usually a result of TB of the lung
Usually 5-8 years after primary infection
Can result in full blown renal failure if treatment is not started soon

Question 18

Genitourinary TB Diagnostics

Answer 18

Myobacterium tuberculosis found in urine
X-rays
CT scan
IV pyelography
VCUG
to see extent of disease