UTIs,Overactive bladder, & incontinence

Question 1

Most common sites for UTI

Answer 1

Lower urinary tract & bladder

Question 2

Are UTIs more common in women or men

Answer 2

More common IN WOMEN

(short urethra, incomplete emptying, irritation)

Question 3

what is a sign in the urine that could be concern for microorganism growth

Answer 3

Protein

Question 4

what is the most common bacteria in UTIs

Answer 4

E.coli

Question 5

Etiology of Lower UTI

Answer 5

bacteriuria

urethritis

cystitis

Question 6

bacteriuria =

Answer 6

bacteria in the urine NOT causing infection

Question 7

Urethritis =

Answer 7

infection in the urethra

Question 8

cystitis =

Answer 8

infection in the bladder

Question 9

S/S of UTI uncomplicated

Answer 9

Asymptomatic
urgency
frequency
dysuria
hematuria
cloudy/foul urine
fever/chills/fatigue

Question 10

diagnosis of UTI

Answer 10

H&P,
UA,
URINE CULTURE,
CBC

Question 11

Treatment of UTI

Answer 11

ANTIBIOTICS,
↑fluids,
avoid irritants,
loose cotton clothes, frequent urination, probiotics

Question 12

UTI: Protective Factors

Answer 12

pH = acidic

Presence of urea

Sex-specific factors:
Men = prostatic secretions
Women = urethral gland secretions

Urine flow is unidirectional
One-way valve at ureteral attachment to bladder

Immune system

Question 13

UTI: Risk Factors

Answer 13

Catheterization: “CAUTIs”= catheter associated urinary tract infection

Sex = females higher risk
Perineal irritation

Age = increases
Nursing home up to 50% have bacteriuria

Pregnancy

Sexual activity
Spermicide use with diaphragm or condom
¼ sexually active women – 1/year

Urinary obstruction or reflux

Immobility

Incontinence
Urine or stool

Decreased cognition

Bad personal hygiene

Men – more likely to have recurrent UTI’s because bacteria can hide deep in the prostate and because of BPH causing urinary retention

Question 14

LOWER UTI: Clinical Manifestations

Answer 14

Urethritis:
Dysuria = difficulty/painful urination
Most common = ASYMPTOMATIC

Cystitis:
frequency
urgency
suprapubic discomfort
dysuria

Question 15

Atypical UTI manifestations:Children

Answer 15

Fever
Irritability
Poor feeding
Vomiting
Diarrhea
Ill appearance
Old enough to verbalize?

Question 16

Atypical UTI manifestations: Elderly

Answer 16

Anxiety
Confusion
Lethargy
Anorexia
History of falling!

Question 17

most common antibiotics used for lower UTIs

Answer 17

Trimethoprim-sulfamethoxazole (Bactrim)
First-line
Don’t give with sulfa allergies

Ciprofloxacin (For sulfa allergies)
Nitrofurantoin

(Macrodanti/Macrobid)
For recurring lower UTIs

Question 18

Urinary tract analgesic med

Answer 18

phenazopyridine (Pyridium)

Question 19

Therapeutic use for phenazopyridine

Answer 19

relief of pain due to UTI

Question 20

MOA for phenazopyridine (Pyridium)

Answer 20

dye used in paint, local analgesic action

Question 21

Side/Adverse Effects of phenazopyridine

Answer 21

Well tolerated
REDDISH-ORANGE URINE

Question 22

causes of overactive bladder

Answer 22

Neurological disorders
Diabetes
UTI’s
Hormonal changes
Tumors/stones
Obstructions

Question 23

what is overactive bladder

Answer 23

Sudden urge to urinate
May experience urgency incontinence

Increased frequency
Usually 8 or more times in 24 hrs

Question 24

What is nocturia

Answer 24

Wake up more than 2 times during the night

Question 25

mirabegron(Myrbetriq) class

Answer 25

Antispasmotic (urinary)

Question 26

MOA of mirabegron(Myrbetriq)

Answer 26

selectively stimulates beta-3 adrenergic receptors, relaxing bladder smooth muscle

Question 27

Adverse reactions of mirabegron(Myrbetriq)

Answer 27

HTN*
Urinary retention
UTI
Headache

Question 28

incontinence types

Answer 28

urgency

stress

OTHERs

Question 29

what is urgency incontinence

Answer 29

Involves the involuntary leakage of urine immediately after a sudden sensation to urinate.

Question 30

causes of urgency incontinence

Answer 30

Overactive detrusor muscle that suddenly contracts
Increases with age
Bladder infection that irritate bladder lining
Bladder outlet obstruction (enlarged prostate)
CNS conditions
Drugs

Question 31

what is stress incontinence

Answer 31

Occurs when urine is involuntarily lost with increases in intraabdominal pressure

Precipitated by effort or exertion

Question 32

causes of stress incontinence

Answer 32

Loss of pelvic muscle and/or
Loss of fascial support of bladder and urethra

Question 33

risk factors of stress incontinence

Answer 33

Age
Obesity
Childbirth-related trauma
Pelvic surgery

Question 34

other types of incontinence

Answer 34

Mixed is a combination of urge and stress

Overflow is when bladder is too full

Functional is related to physical & environmental limitations and an inability to get to toilet in time

Transient is sudden onset that is reversible

Question 35

What are some problems with incontinence

Answer 35

Incontinence can cause inflammation of the skin
Redness, pain, and itching
Swelling, blisters, dryness
Damaged skin now vulnerable to infection
Damp, warm skin is breeding ground for bacteria and fungi
Areas at risk
Genitals
Between buttocks
Inner thighs

Question 36

class of Oxybutynin (Oxytrol)

Answer 36

anti-cholinergic

Question 37

MOA of oxybutynin

Answer 37

block the action of acetylcholine
Acetylcholine activates smooth muscle contractions

Question 38

Indications of oxybutynin

Answer 38

overactive bladder, incontinence

Question 39

adverse effects of oxybutynin

Answer 39

dry mouth,
constipation

Question 40

T/F oxybutynin can be in extended release forms

Answer 40

TRUE