Wk 3 Pyelonephritis Flashcards
What is pyelonephritis?
A type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels to one or both of your kidneys
What is an UTI protective factor concerning pH?
Acidic
Presence of __ is a UTI protective factor
Urea
What type of secretions are protective factors against UTIs for men?
Prostatic secretions
What type of secretions are protective factors against UTIs for women?
Urethral gland secretions
Why are women at higher risk for UTIs compared to men?
Urethra is shorter, smaller and in closer proximity to the anus
Higher risk for perineal irritation
Pregnancy/sexual activity
Urine flow is __-directional
Uni-directional
As age increases…
the risk for UTI increases
Up to 50% of nursing home residents have __
bacteriuria
How do condoms increase the risk of getting a UTI?
Spermicide is irritating to the vagina
5 risk factors for a UTI
Urinary stasis Immobility Incontinence Altered LOC Bad personal hygiene
Pathogenesis of a UTI is an __ pattern
ascending
In what order does a UTI develop?
Contaminated perineum Urethra Bladder Ureter Kidneys
What is the major risk factor for an upper UTI (pyelonephritis)?
Pregnancy
What is the etiology of pyelonephritis? (2 things)
Ascending infection, typically with E. coli
Bloodstream infection
Why is pyelonephritis a problem?
Can lead to tissue damage, and down the road kidney failure
What are symptoms of pyelonephritis? (6)
Fever Chills Costovertebral angle tenderness Dysuria Nausea/Vomiting Anorexia
What is urosepsis?
Severe systemic response to pyelonephritis
Who is at high risk for urosepsis? (3)
Elderly patients
Diabetics
Immunocompromised patients
Urosepsis has a high…
mortality rate
Someone who has recurrent UTIs may receive conventional therapy which is __-__ days
7-14
A patient with an upper UTI is typically…
Admitted to the hospital to receive IV antibiotic therapy
What is first line treatment for a UTI?
Bactrim
What two drug make up bactrim?
sulfamethoxazole and trimethoprim
What is the major adverse side effect of bactrim?
anaphylaxis, otherwise well tolerated
What is another first-line antibiotic used to treat UTIs
Cirpofloxacin, works locally
What is the MOA of ciprofloxacin?
inhibits DNA replication by inhibiting bacterial DNA topoisomerase and DNA-gyrase.
What class is ciprofloxacin part of?
fluoroquinolone
What is the adverse effects of ciprofloxacin?
GI upset
What is the black box warning for ciprofloxacin?
tendinitis and tendon rupture
What drug is used for more complex cases of UTIs?
Vancomycin
