Urinary Function

Question 1

Cystitis

Answer 1

Inflammation of the bladder

Can also occur without an infection present

Question 2

Interstitial Cystitis

Answer 2

Inflammation of the bladder with no known cause

Question 3

What is the most common factor placing patients at risk for UTIs in the hospital and long-term care settings?

Answer 3

Catheters

Question 4

Urosepsis

Answer 4

Spread of infection from the urinary tract to the bloodstream

Question 5

Prostatits

Answer 5

Inflammation of the prostate

Question 6

Urethritis

Answer 6

Inflammation of the urethra

Question 7

What can happen if you leave a UTI untreated?

Answer 7

Can lead to pyelonephritis and urosepsis, which can eventually lead to death

Question 8

Risk Factors for UTIs in Females

Answer 8

• Short urethra
• Sexual intercourse
• Frequent use of feminine hygiene sprays, tampons, sanitary napkins, and spermicidal jellies
• Pregnancy
• Wet bathing suits
• Frequent submersion into baths or hot tubs

Question 9

Signs and Symptoms of UTIs

Answer 9

• Lower back or lower abdominal discomfort and tenderness over the bladder area
• Nausea or Vomiting
• Urinary frequency and urgency
• Dysuria, bladder cramping, spasms
• Feeling of incomplete bladder emptying or retention of urine
• Perineal itching
• Hematuria
• Pyuria (greater than 4 WBC in urine sample)
• Fever
• Nocturia
• Voiding in small amounts
• Cloudy or foul-smelling urine

Question 10

Older Adult Clinical Manifestations of UTIs

Answer 10

• Mental confusion
• Incontinence
• Loss of appetite
• Nocturia and dysuria
• Hypotension, tachycardia, tachypnea, and fever (signs of urosepsis)

Question 11

Complications from a UTI

Answer 11

• Urethral obstruction
• Pyelonephritis
• Chronic kidney disease
• Urosepsis
• Septic shock
• Death

Question 12

A nurse is caring for a client who has a urinary tract infection. The client reports pain and a burning sensation upon urination, and cloudy urine with an odor. which of the following is the priority intervention by the nurse?

A. Offer a warm sitz bath
B. Recommend drinking cranberry juice
C. Encourage increased fluids
D. Administer an antibiotic

Answer 12

D. Administer an antibiotic

Rationale: The greatest risk to the client is injury to the renal system from the UTI. Therefore, the priority intervention is to administer antibiotics.

Question 13

A nurse is reviewing information with a female client who has frequent urinary tract infections. Which of the following information should the nurse include? (Select all that apply)

A. Avoid sitting in a wet bathing suit
B. Wipe the perineal area back to front following elimination
C. Empty the bladder when there is an urge to void
D. Wear synthetic fabric underwear
E. Take a tub bath daily

Answer 13

A and C

ATI page 593 - PN Book

Question 14

A nurse is reviewing the laboratory findings for a urinalysis (UA) of a client who reports urgency and nocturia. Which of the following findings should the nurse report to the provider?

A. Positive for casts
B. Positive for leukoctye esterase
C. Positive for epithelial cells
D. Positive for crystals

Answer 14

B. Positive leukocyte esterase

Rationale: The client who has a positive leukoctye esterase indicates 68% - 88% positive urine for URI, and the nurse should report this finding to the provider.

Question 15

Expected Findings on a UA from a Patient with a UTI

Answer 15

Bacteria, sediment, WBC, and RBC

Positive leukocyte esterase and nitrates

Question 16

Hematuria

Answer 16

Blood in the urine

Question 17

Pyuria

Answer 17

Presence of WBC (pus) in the urine

Question 18

Anuria

Answer 18

Complete lack of urine output

Scant amount

Question 19

Urethral strictures

Answer 19

Narrowed areas of the urethra

Treated surgically

Question 20

Manifestations of Urethritis

Answer 20

Burning or difficulty urinating and a discharge from the urethral meatus

Question 21

What is the most common cause of urethritis in males?

Answer 21

STDs

Question 22

Urethral Strictures

Answer 22

Narrowed areas of the urethra

Question 23

Overflow Incontinence

Answer 23

Involuntary loss of urine when the bladder is overdistended

Question 24

Continence

Answer 24

Control over the time and place of urination

Question 25

Incontinence

Answer 25

Involuntary loss of urine severe enough to cause social of hygienic problems

Question 26

Stress Incontinence

Answer 26

Loss of small amounts of urine during coughing, sneezing, jogging, or lifting. Most common type

Question 27

Urge Incontinence

Answer 27

Perception of an urgent need to urinate as a result of bladder contractions regardless of the urine volume in the bladder Also known as overactive bladder

Question 28

Mixed Incontinence

Answer 28

Presence of more than one type of incontinence - usually both urge and stress Very common in older women

Question 29

Overflow Incontinence

Answer 29

Occurs when the detrusor muscle fails to contract and the bladder becomes overdistended Also known as underactive bladder

Question 30

Functional Incontinence

Answer 30

Occurs as a result of factors other than the abnormal function of the bladder and urethra A common factor is the loss of cognitive function in patients affected by dementia.

Question 31

What exercise can you teach women when they have stress incontinence?

Answer 31

Pelvic floor (Kegel) exercises

Question 32

Pyridium

Answer 32

Analgesic It can relieve symptoms caused by urinary tract infections and other urinary problems. Makes urine a bright orange color

Question 33

Renal Calculi

Answer 33

- Too much calcium in the body - Increased risk with family history - Painful - Encourage patient to drink lots of water to decrease the chance of them reoccuring

Question 34

How do you develop bacterial cystitis? (UTI)

Answer 34

- E. coli - Improper perineal care - Catheter that may not be properly cared for - Not using the restroom when you need to go - Low estrogen count can increase risk for UTI

Question 35

If a patient is post-menopausal has complained about having two UTIs in the last 6 months, what would you explain to the patient?

Answer 35

Low estrogen levels caused by menopause can increase the risk of developing a UTI

Question 36

If someone has a fungal urinary tract infection, what would the nurse do? Select all that apply. ``` A. Get a list of medications B. Ask if they have visited any foreign places recently C. Palpate the kidney and bladder D. Look at current medical history E. Bladder scan for post void residual ```

Answer 36

A. Get a list of medications D. Look at current medical history E. Bladder scan for post void residual

Question 37

Risk Factors for Gastritis

Answer 37

- NSAIDs - H. pylori - Caffeine - Alcoho - Corticosteroids

Question 38

If a patient in a nursing home keeps having several falls, what should the nurse do first?

Answer 38

Obtain a urine sample to determine if the patient has a UTI - which can cause issues such as impaired balance, confusion, or agitation.

Question 39

For a young women of childbearing age has a UTI and a doctor gives them an antibiotic, what can happen?

Answer 39

If the patient is on an oral contraceptive, the antibiotic can make the pill ineffective which can lead to unwanted pregnancy

Question 40

What are some different reasons that an indwelling catheter might be inserted?

Answer 40

- Patient may have a neurogenic bladder - Completely incontinent (increased risk of UTI with Foley catheter) - Urinary retention - Surgery