MS CH 37 Nursing Care of Patients With Disorders of the Urinary System
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Questions and Answers

Which of the following are risk factors for cancer of the bladder?

  • High fiber diet, regular exercise, and low alcohol consumption
  • Frequent hand washing, vegetarian diet, and pet ownership
  • Smoking, occupational exposure to chemicals, and chronic bladder inflammation (correct)
  • Family history of lung cancer, excessive sun exposure, and obesity
  • What are the signs and symptoms of chronic kidney disease?

  • Back pain, blood in urine, and frequent fevers
  • Frequent urination, excessive thirst, and weight gain
  • Fatigue, weakness, and difficulty concentrating (correct)
  • Chest pain, rapid heartbeat, and shortness of breath
  • What is the nursing care for a patient with an ileal conduit or continent reservoir?

  • Apply direct pressure if bleeding occurs from the stoma
  • Teach the patient proper irrigation technique for the stoma (correct)
  • Limit fluid intake to prevent leakage from the reservoir
  • Encourage the patient to avoid all physical activity
  • What are the predisposing causes of urinary tract infections (UTIs)?

    <p>Poor personal hygiene, indwelling catheters, and urinary obstruction</p> Signup and view all the answers

    What is the pathophysiology of diabetic nephropathy?

    <p>High blood pressure damaging the small blood vessels in the kidneys</p> Signup and view all the answers

    What are the signs and symptoms of acute kidney injury?

    <p>Increased urine output, decreased blood pressure, and elevated heart rate</p> Signup and view all the answers

    What is the treatment for kidney stones?

    <p>Extracorporeal shock wave lithotripsy (ESWL) and increased salt intake</p> Signup and view all the answers

    How can a nurse plan nursing care for patients on peritoneal dialysis?

    <p>Teach proper technique for changing dialysis catheter dressing</p> Signup and view all the answers

    Which medication should be given with large amounts of water?

    <p>cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication is contraindicated in severe renal or liver disease?

    <p>cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication discolors urine and may have decreased absorption if given with aluminum or magnesium antacids?

    <p>cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication is an effective urinary analgesic to relieve pain associated with UTI?

    <p>phenazopyridine</p> Signup and view all the answers

    Which medication has antibacterial action in the urine but is not systemic?

    <p>phenazopyridine</p> Signup and view all the answers

    Which medication is effective against E. coli, Klebsiella spp., and other Gram-negative organisms?

    <p>Fluoroquinolones</p> Signup and view all the answers

    Which medication is used for uncomplicated UTIs and is effective against E. coli and Pseudomonas?

    <p>Sulfonamides</p> Signup and view all the answers

    Which medication is a topical analgesic that relieves pain, urgency, and frequency associated with UTI?

    <p>phenazopyridine</p> Signup and view all the answers

    Which of the following is a characteristic sign of renal disease?

    <p>Elevated red blood cell count in urine</p> Signup and view all the answers

    Which urinary condition is associated with systemic disease and sicker patients?

    <p>Pyelonephritis</p> Signup and view all the answers

    What does the presence of casts in urine indicate?

    <p>Kidney infection</p> Signup and view all the answers

    What is the treatment for severe cases of pyelonephritis?

    <p>Hospitalization for intravenous antibiotics</p> Signup and view all the answers

    What are the nursing diagnoses for a urinary tract infection patient?

    <p>Acute Pain related to inflammation of the urinary structures</p> Signup and view all the answers

    Which medication is used to treat urinary tract infections?

    <p>Fosfomycin</p> Signup and view all the answers

    What is the evidence-based practice suggestion for preventing UTIs?

    <p>Administration of cranberries or cranberry juice</p> Signup and view all the answers

    What is a possible complication of repeated kidney infections?

    <p>Scarring and loss of kidney function leading to chronic kidney disease</p> Signup and view all the answers

    What is the most common pathogen causing urinary tract infections (UTIs)?

    <p>Escherichia coli</p> Signup and view all the answers

    Which of the following is a risk factor for urinary tract infections (UTIs)?

    <p>Instrumentation such as urinary catheters</p> Signup and view all the answers

    Where can urinary tract infections (UTIs) occur resulting in cystitis?

    <p>Bladder</p> Signup and view all the answers

    What can result from incomplete bladder emptying?

    <p>Increased risk of bacterial growth</p> Signup and view all the answers

    Why are women more susceptible to urinary tract infections (UTIs)?

    <p>Proximity of their urethra to the anus and vagina</p> Signup and view all the answers

    What is a recommended nursing care tip to minimize the risk of catheter-related UTIs?

    <p>Discontinuing catheter use as soon as possible</p> Signup and view all the answers

    What can faulty valves in the urinary system cause?

    <p>Reflux of urine, allowing bacteria to travel from the urethra to the bladder or kidneys</p> Signup and view all the answers

    What can result from contamination in the perineal and urethral areas?

    <p>Increased risk of infection</p> Signup and view all the answers

    Which of the following urinary tract infections is characterized by symptoms such as flank pain, fever, chills, and cloudy urine?

    <p>Pyelonephritis</p> Signup and view all the answers

    What is a common cause of cystitis?

    <p>Escherichia coli</p> Signup and view all the answers

    What can prevent recurrent UTIs in postmenopausal women?

    <p>Intravaginal estrogen cream</p> Signup and view all the answers

    Which urinary tract infection can be caused by chemical irritants and STIs?

    <p>Urethritis</p> Signup and view all the answers

    What is a characteristic symptom of urethritis in males?

    <p>Urinary frequency</p> Signup and view all the answers

    What treatment is recommended for uncomplicated cases of cystitis?

    <p>Sulfa medications</p> Signup and view all the answers

    What is a risk factor for pyelonephritis?

    <p>Vesicoureteral reflux</p> Signup and view all the answers

    What diagnostic method is used for diagnosing cystitis?

    <p>Routine urinalysis only</p> Signup and view all the answers

    Which of the following is a characteristic symptom of diabetic nephropathy?

    <p>Proteinuria and edema</p> Signup and view all the answers

    What is a possible complication of chronic kidney disease?

    <p>Cardiovascular disease and pericarditis</p> Signup and view all the answers

    What is a recommended nursing care tip for patients with an ileal conduit or continent reservoir?

    <p>Monitor for signs of dehydration and electrolyte imbalance</p> Signup and view all the answers

    What are the signs and symptoms of cancer of the kidneys?

    <p>Flank pain and fever</p> Signup and view all the answers

    What is a risk factor for pyelonephritis?

    <p>Urinary stasis and catheterization</p> Signup and view all the answers

    What is the evidence-based practice suggestion for preventing urinary tract infections (UTIs)?

    <p>Use sterile technique for catheter insertion</p> Signup and view all the answers

    What is a characteristic symptom of acute kidney injury?

    <p>Anuria and elevated creatinine levels</p> Signup and view all the answers

    What is a common cause of cystitis?

    <p>Urinary tract obstruction and dehydration</p> Signup and view all the answers

    Which of the following urinary conditions is characterized by symptoms such as flank pain, fever, chills, and cloudy urine?

    <p>Pyelonephritis</p> Signup and view all the answers

    What can result from incomplete bladder emptying?

    <p>Cystitis</p> Signup and view all the answers

    What is a recommended treatment for severe cases of pyelonephritis?

    <p>Intravenous antibiotics</p> Signup and view all the answers

    What are the common risk factors for pyelonephritis?

    <p>Decreased immunity and stones</p> Signup and view all the answers

    Which medication is contraindicated in severe renal or liver disease?

    <p>Nitrofurantoin</p> Signup and view all the answers

    What is a common cause of cystitis?

    <p>Bacterial infection</p> Signup and view all the answers

    Which medication is used to treat urinary tract infections (UTIs) but is not systemic?

    <p>Phenazopyridine</p> Signup and view all the answers

    What can prevent recurrent UTIs in postmenopausal women?

    <p><strong>Estrogen</strong> used as an intravaginal cream</p> Signup and view all the answers

    Which of the following is NOT a sign or symptom of pyelonephritis?

    <p>Clear urine with no abnormal constituents</p> Signup and view all the answers

    What is the most appropriate treatment for severe cases of pyelonephritis?

    <p>Hospitalization for intravenous antibiotics</p> Signup and view all the answers

    What is a potential complication of repeated kidney infections?

    <p>Scarring and loss of kidney function</p> Signup and view all the answers

    Which diagnostic method is used for diagnosing pyelonephritis?

    <p>Urine culture and sensitivity testing</p> Signup and view all the answers

    What is a common nursing diagnosis for urinary tract infection patients?

    <p>Acute Pain related to inflammation of the urinary structures</p> Signup and view all the answers

    What evidence-based practice suggests prevention of UTIs by preventing bacteria from sticking to the bladder walls?

    <p>Consumption of cranberries or cranberry juice</p> Signup and view all the answers

    Which medication is contraindicated in severe renal or liver disease?

    <p>Nitrofurantoin</p> Signup and view all the answers

    What is a risk factor for pyelonephritis?

    <ul> <li>Presence of urinary catheter</li> </ul> Signup and view all the answers

    Which of the following is not a risk factor for urinary tract infections (UTIs)?

    <p>Frequent voiding</p> Signup and view all the answers

    What is the most common pathogen causing urinary tract infections (UTIs)?

    <p>Escherichia coli</p> Signup and view all the answers

    Which urinary condition is associated with systemic disease and sicker patients?

    <p>Pyelonephritis</p> Signup and view all the answers

    What is a risk factor for pyelonephritis?

    <p>Incomplete bladder emptying</p> Signup and view all the answers

    What can result from contamination in the perineal and urethral areas?

    <p>Urethritis</p> Signup and view all the answers

    Where can urinary tract infections (UTIs) occur resulting in cystitis?

    <p>Bladder</p> Signup and view all the answers

    What treatment is recommended for uncomplicated cases of cystitis?

    <p>Antibiotics targeting Gram-negative organisms</p> Signup and view all the answers

    What is a possible complication of repeated kidney infections?

    <p>Glomerulonephritis</p> Signup and view all the answers

    Which medication is effective against E. coli, Klebsiella spp., and other Gram-negative organisms?

    <p>Fluoroquinolones</p> Signup and view all the answers

    Which medication has antibacterial action in the urine but is not systemic?

    <p>Cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication is contraindicated in severe renal or liver disease?

    <p>Cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication is used for uncomplicated UTIs and is effective against E. coli and Pseudomonas?

    <p>Sulfonamides</p> Signup and view all the answers

    Which medication is a topical analgesic that relieves pain, urgency, and frequency associated with UTI?

    <p>Phenazopyridine (Pyridium)</p> Signup and view all the answers

    Which medication may discolor urine and have decreased absorption if given with aluminum or magnesium antacids?

    <p>Cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication should be given with large amounts of water?

    <p>Cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication has bacterial action in the urine but is not systemic?

    <p>Cinoxacin (Cinobac)</p> Signup and view all the answers

    What is the most common pathogen responsible for urinary tract infections (UTIs)?

    <p>Escherichia coli</p> Signup and view all the answers

    What is a risk factor for urinary tract infections (UTIs)?

    <p>Incomplete bladder emptying</p> Signup and view all the answers

    What action can introduce bacteria into the urinary tract and cause infection?

    <p>Urinary catheterization</p> Signup and view all the answers

    Why are women more susceptible to urinary tract infections (UTIs)?

    <p>Longer length of the urethra</p> Signup and view all the answers

    What can result from contamination in the perineal and urethral areas?

    <p>Urinary tract infections (UTIs)</p> Signup and view all the answers

    What is a common risk factor for pyelonephritis?

    <p>Previous urinary tract infection (UTI)</p> Signup and view all the answers

    What can cause reflux of urine, allowing bacteria to travel from the urethra to the bladder or kidneys?

    <p>Faulty valves</p> Signup and view all the answers

    How can a nurse plan nursing care for patients on peritoneal dialysis?

    <p>Following infection control procedures</p> Signup and view all the answers

    What is a potential complication of repeated kidney infections?

    <p>Glomerulonephritis</p> Signup and view all the answers

    Which medication is contraindicated in severe renal or liver disease?

    <p>Nitrofurantoin</p> Signup and view all the answers

    What is a characteristic symptom of acute kidney injury?

    <p>Anuria</p> Signup and view all the answers

    Which of the following are risk factors for cancer of the bladder?

    <p>Obesity and high-fat diet</p> Signup and view all the answers

    Which medication has antibacterial action in the urine but is not systemic?

    <p>Phenazopyridine</p> Signup and view all the answers

    Where can urinary tract infections (UTIs) occur resulting in cystitis?

    <p>Urethra and bladder</p> Signup and view all the answers

    Which urinary condition is associated with systemic disease and sicker patients?

    <p>Pyelonephritis</p> Signup and view all the answers

    What urinary tract infection can be caused by chemical irritants and STIs?

    <p>Urethritis</p> Signup and view all the answers

    Which medication has bacterial action in the urine but is not systemic?

    <p>Phenazopyridine</p> Signup and view all the answers

    What is a risk factor for pyelonephritis?

    <p>Decreased immunity</p> Signup and view all the answers

    What are the common risk factors for cystitis?

    <p>Obstruction and strictures</p> Signup and view all the answers

    Which medication discolors urine and may have decreased absorption if given with aluminum or magnesium antacids?

    <p>Nitrofurantoin</p> Signup and view all the answers

    What is the evidence-based practice suggestion for preventing recurrent UTIs in postmenopausal women?

    <p>Estrogen used as an intravaginal cream</p> Signup and view all the answers

    Which of the following is a characteristic symptom of cystitis?

    <p>Cloudy urine</p> Signup and view all the answers

    Which of the following is a characteristic symptom of pyelonephritis?

    <p>Flank pain, fever, chills, and cloudy urine</p> Signup and view all the answers

    What is a possible complication of repeated kidney infections?

    <p>Chronic kidney disease</p> Signup and view all the answers

    Which medication is used to treat urinary tract infections (UTIs) but is not systemic?

    <p>Fosfomycin</p> Signup and view all the answers

    What is a common nursing diagnosis for a urinary tract infection patient?

    <p>Acute Pain related to inflammation of the urinary structures</p> Signup and view all the answers

    Which medication has antibacterial action in the urine but is not systemic?

    <p>Nitrofurantoin</p> Signup and view all the answers

    What evidence-based practice suggests prevention of UTIs by preventing bacteria from sticking to the bladder walls?

    <p>Cranberries or cranberry juice</p> Signup and view all the answers

    What are the predisposing causes of urinary tract infections (UTIs)?

    <p>Use of urinary catheters and incomplete bladder emptying</p> Signup and view all the answers

    What medication is contraindicated in severe renal or liver disease?

    <p>Cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication should be given with large amounts of water?

    <p>Sulfonamides</p> Signup and view all the answers

    Which medication may discolor urine and has decreased absorption if given with aluminum or magnesium antacids?

    <p>Cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication has topical analgesic properties and relieves pain associated with urinary tract infections?

    <p>Phenazopyridine (Pyridium)</p> Signup and view all the answers

    Which medication is effective against E. coli, Klebsiella spp., and other Gram-negative organisms, but is not systemic?

    <p>Cinoxacin (Cinobac)</p> Signup and view all the answers

    Which medication is used for uncomplicated UTIs and is effective against E. coli and Pseudomonas?

    <p>Sulfonamides</p> Signup and view all the answers

    Urinary antiseptics have systemic antibacterial action

    <p>False</p> Signup and view all the answers

    Cinoxacin (Cinobac) may decrease absorption if given within 2 hours of aluminum or magnesium antacids

    <p>True</p> Signup and view all the answers

    Sulfonamides are not effective against E. coli

    <p>False</p> Signup and view all the answers

    Phenazopyridine (Pyridium) is contraindicated in renal insufficiency

    <p>True</p> Signup and view all the answers

    Urinary analgesics relieve pain urgency and frequency associated with urinary tract infections

    <p>True</p> Signup and view all the answers

    Impaired urinary elimination is related to frequency, nocturia, dysuria, and incontinence

    <p>True</p> Signup and view all the answers

    The urine color changes to red-orange in sepsis

    <p>False</p> Signup and view all the answers

    Urinary antiseptics are effective against Gram-positive organisms

    <p>False</p> Signup and view all the answers

    Urinary antiseptics have systemic antibacterial action

    <p>False</p> Signup and view all the answers

    Phenazopyridine (Pyridium) changes urine glucose testing

    <p>True</p> Signup and view all the answers

    Study Notes

    • Urethritis: inflammation of the urethra, can be caused by chemical irritants, bacterial infection, trauma, or STIs. Symptoms: urinary frequency, urgency, dysuria, and discharge in males. Diagnosed through urinalysis or culture. Treatment: based on cause, can include antibiotics, phenazopyridine, and avoidance of irritants.

    • Cystitis: inflammation and infection of the bladder wall, usually caused by Escherichia coli. Symptoms: dysuria, frequency, urgency, and cloudy urine. Diagnosed through urinalysis. Treatment: sulfa medications or nitrofurantoin for uncomplicated cases, ciprofloxacin for complicated cases.

    • Pyelonephritis: infection of the kidneys, usually begins with infection of the lower urinary tract and ascends. Symptoms: flank pain, fever, chills, and cloudy urine. Diagnosed through urinalysis and culture. Treatment: antibiotics based on sensitivity test, hospitalization for severe cases.

    • UTIs (urinary tract infections) are common and can cause dysuria, urinary frequency, urgency, and cloudy urine. In older adults, fatigue is a common symptom.

    • Urethritis can be caused by chemical irritants, bacterial infection, trauma, or STIs. Bubble bath and bath salts are common irritants, and spermicidal agents can also cause urethritis.

    • Cystitis is usually caused by Escherichia coli and diagnosed with a routine urinalysis. Symptoms include dysuria, frequency, and cloudy urine. Complicated cases may require a urine culture and sensitivity test.

    • Pyelonephritis is caused by ascending infection from the lower urinary tract and can lead to sepsis and kidney damage. Risk factors include obstruction, strictures, stones, vesicoureteral reflux, and decreased immunity.

    • Treatment for UTIs includes antibiotics, fluid intake, and follow-up urinalysis to ensure infection has been resolved. Pyelonephritis may require hospitalization and intravenous antibiotics.

    • Estrogen used as an intravaginal cream can prevent recurrent UTIs in postmenopausal women.

    • Acute pyelonephritis can cause small abscesses and gross enlargement of the kidney. Risk factors for pyelonephritis include urological surgery, lymphatic infection, urinary stasis, and decreased immunity.

    • Disorders of the urinary system encompass issues with the kidneys, ureters, bladder, and urethra, with potential causes including infection, obstructions, cancer, hereditary disorders, and metabolic, traumatic, or chronic diseases.

    • Urinary tract infections (UTIs) are caused by bacterial invasion of the urinary tract, with Escherichia coli being the most common pathogen. UTIs affect around 150 million people annually.

    • UTIs can occur in the urethra, resulting in urethritis; in the bladder, resulting in cystitis; or in the kidneys, leading to pyelonephritis.

    • Risk factors for UTIs include: incomplete bladder emptying, contamination in perineal and urethral areas, instrumentation, faulty valves, previous UTIs, female anatomic and genetic differences, pregnancy, and aging.

    • Incomplete bladder emptying can result from obstruction or infrequent voiding, leading to urine stasis and bacterial growth.

    • Contamination in the perineal and urethral areas can originate from sexual intercourse, fecal soiling, or infections such as vaginitis, epididymitis, or prostatitis.

    • Instrumentation, such as urinary catheters, can cause infection by introducing bacteria into the urinary tract.

    • Faulty valves can cause reflux of urine, allowing bacteria to travel from the urethra to the bladder or kidneys.

    • Previous UTIs can serve as a reservoir for persistent bacteria, increasing the risk of reinfection.

    • Women are more susceptible to UTIs due to the shorter length of their urethra and its proximity to the anus and vagina. Pregnant women and older adults are also at increased risk.

    • Nursing care tips include limiting the use of urinary catheters, employing infection control procedures, and discontinuing catheter use as soon as possible to minimize the risk of catheter-related UTIs. Catheter-related UTIs are considered a "never event" in healthcare.

    • Costovertebral tenderness, a sign of renal disease, is noted when striking the area where the rib and vertebrae join.

    • Urine in pyelonephritis is cloudy with increased white blood cells (WBCs), bacteria, casts, red blood cells (RBCs), and positive nitrites.

    • Pyelonephritis patients are sicker than those with cystitis and show signs of systemic disease.

    • Urinalysis in kidney infection shows casts, microscopic particles formed from abnormal constituents in urine.

    • The urine specimen has more than 100,000 colonies of bacteria per milliliter, and the presence of casts always indicates a kidney problem.

    • CBC count will show an elevated white blood cell count and an increase in sedimentation rate.

    • Treatment for pyelonephritis includes administration of antibiotics based on culture and sensitivity results. Severe cases may require hospitalization for intravenous antibiotics.

    • Complications of repeated kidney infections include scarring and loss of kidney function, leading to chronic kidney disease (CKD).

    • During data collection for a urinary tract infection patient, concerns, symptoms, voiding patterns, presence of pain, and catheter status are documented.

    • Nursing diagnoses include Acute Pain related to inflammation of the urinary structures, with expected outcomes of pain relief.

    • Evidence-based practice suggests cranberries or cranberry juice may prevent UTIs by preventing bacteria from sticking to the bladder walls.

    • Medications used to treat urinary tract infections include antibiotics, fosfomycin, nitrofurantoin, ciprofloxacin, and levofloxacin, with varying nursing considerations.

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    Test your knowledge of medical terminology related to urinary system disorders by identifying the word components and their meanings in the given examples of urethritis, cystitis, and pyelonephritis.

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