Urinary Tract Infections (UTI) Risk Factors
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Questions and Answers

What is the primary reason cells are damaged in shock?

  • Excessive blood supply and oxygenation
  • Infection and sepsis
  • Malnutrition and chronic illness
  • Inadequate blood supply and oxygenation (correct)

    • What is the definition of severe sepsis?

  • Dysfunction of one of the major organ systems or unexplained metabolic acidosis (correct)
  • Dysfunction of two or more major organ systems
  • Chronic illness such as diabetes or kidney disease
  • Infection with antibiotic-resistant microorganisms

    • What is the benefit of early interventions in shock?

  • Shorter hospital stay
  • Increased risk of organ failure
  • Greater chance of patient survival (correct)
  • Reduced risk of sepsis

    • What is a risk factor for septic shock?

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

    Why are older adult patients at particular risk for sepsis?

    <p>Aging immune system and comorbid conditions</p> Signup and view all the answers

    What is a common symptom of sepsis in the early stage?

    <p>Fever, chills, and warm skin</p> Signup and view all the answers

    What is the last stage of shock?

    <p>Irreversible stage</p> Signup and view all the answers

    What is a consequence of sepsis if not recognized and treated early?

    <p>Life-threatening organ dysfunction</p> Signup and view all the answers

    What is the primary goal of administering vasopressors in a patient with hypotension?

    <p>To maintain arterial pressure greater than or equal to 65 mm Hg</p> Signup and view all the answers

    Which of the following is a criteria for a poor outcome in the Q-SOFA screening tool?

    <p>Altered mental status</p> Signup and view all the answers

    What is the purpose of the Glasgow Scale?

    <p>To measure level of consciousness</p> Signup and view all the answers

    What is the primary diagnostic test for COVID-19?

    <p>Polymerase chain reaction (PCR) test</p> Signup and view all the answers

    What is the goal of mechanical ventilation in COVID-19 management?

    <p>To support failing respiratory function</p> Signup and view all the answers

    What is the purpose of drawing blood cultures?

    <p>To obtain an unaltered sample for diagnosis</p> Signup and view all the answers

    What is the goal of interprofessional management of sepsis?

    <p>To support failing organs and maintain tissue oxygenation</p> Signup and view all the answers

    What is the medication of choice for treating COVID-19?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the reflux of urine from the urethra into the bladder?

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

    Which of the following is a risk factor for obstructed urinary flow?

    <p>Congenital abnormalities</p> Signup and view all the answers

    What is the most common route of infection in the urinary tract?

    <p>Transurethral route</p> Signup and view all the answers

    What is the term for the backward flow of urine from the bladder into one or both ureters?

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

    Which of the following symptoms is less common in older adults?

    <p>Back pain</p> Signup and view all the answers

    What is the term for the spread of infection from the urinary tract to the bloodstream?

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

    Which of the following is a risk factor for urinary tract infection?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the inability or failure to empty the bladder completely?

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

    What is essential to include in the client's discharge teaching plan?

    <p>Drink 8 to 10 eight-oz glasses of water daily</p> Signup and view all the answers

    What is a potential source of sepsis?

    <p>All of the above</p> Signup and view all the answers

    What is urosepsis?

    <p>The spread of infection from the urinary tract to the bloodstream</p> Signup and view all the answers

    Which of the following is NOT a sign of sepsis?

    <p>Slow heart rate</p> Signup and view all the answers

    What is a critical component of the plan of care to ensure early intervention for shock?

    <p>All of the above</p> Signup and view all the answers

    What is the primary mode of COVID-19 transmission?

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

    What laboratory test is most indicative of sepsis?

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

    What test(s) would the nurse review to assess the client's cellular immune system function?

    <p>Total Lymphocyte Count and Delayed Hypersensitivity Skin Test</p> Signup and view all the answers

    What is the primary goal of the 1 hour sepsis bundle?

    <p>To initiate treatment for patients in early sepsis within 1 hour</p> Signup and view all the answers

    What type of agents are started when the infecting organism is unknown?

    <p>Broad-spectrum antibiotic agents</p> Signup and view all the answers

    What is the recommended amount of crystalloids to be infused over 30 minutes for fluid resuscitation?

    <p>30 mL/kg</p> Signup and view all the answers

    What is monitored to assess the effectiveness of fluid resuscitation?

    <p>BP, patient mentation, respiratory rate, fluid responsiveness after PLR, urine output, and serum lactate levels</p> Signup and view all the answers

    What is the recommended amount of crystalloids to be infused over 30 minutes for fluid resuscitation?

    <p>30 mL/kg</p> Signup and view all the answers

    What is the recommended timeframe for initiating aggressive nutritional supplementation in septic shock patients?

    <p>Within 24 to 48 hours of ICU admission</p> Signup and view all the answers

    What is the purpose of collecting specimens of blood, sputum, urine, wound drainage, and tips of invasive catheters?

    <p>To identify the infecting organism</p> Signup and view all the answers

    What is the recommended next step after recognizing signs and symptoms of sepsis or septic shock?

    <p>Measure lactate levels and obtain blood cultures</p> Signup and view all the answers

    What is the purpose of administering low-dose unfractionated heparin or low-molecular-weight heparin?

    <p>To prevent deep vein thrombosis (DVT)</p> Signup and view all the answers

    Study Notes

    Urinary Tract Infections (UTIs)

    • Risk factors: neurologic disorders, gout, altered states caused by incomplete emptying of the bladder and urinary stasis, decreased natural host defenses or immunosuppression, inability or failure to empty the bladder completely, inflammation or abrasion of the urethral mucosa, instrumentation of the urinary tract (e.g., catheterization, cystoscopic procedures)
    • Obstructed urinary flow caused by: congenital abnormalities, urethral strictures, contracture of the bladder neck, bladder tumors, calculi (stones) in the ureters or kidneys, and compression of the ureters
    • Urethrovesical reflux: reflux of urine from the urethra into the bladder
    • Ureterovesical or vesicoureteral reflux: backward flow of urine from the bladder into one or both ureters
    • Bacteria enter the urinary tract in three ways: ascending infection, hematogenous spread, and direct extension
    • Most common route of infection is transurethral

    Signs and Symptoms of UTIs

    • Burning on urination
    • Urinary frequency (voiding more than every 3 hours)
    • Urgency
    • Nocturia (awakening at night to urinate)
    • Incontinence
    • Suprapubic or pelvic pain
    • Hematuria and back pain may also be present

    Sepsis and Shock

    • Pathophysiology of shock: cellular changes, vascular responses, and changes in blood pressure
    • Sepsis: response to infection becomes generalized and involves normal tissues remote from the site of injury or infection
    • Stages of shock: compensatory (stage 1), progressive (stage 2), and irreversible (stage 3)
    • Risk factors for septic shock: immunosuppression, extremes of age, chronic conditions, malnourishment, chronic illness, invasive procedures, emergent and/or multiple surgeries, increased use of invasive procedures and indwelling medical devices, and the aging population

    Sepsis Signs and Symptoms

    • Evolving process that may result in septic shock and life-threatening organ dysfunction if not recognized and treated early
    • Early stage: BP may remain within normal limits, or patient may be hypotensive but responsive to fluids
    • Heart rate increases, progressing to tachycardia
    • Hyperthermia and fever, chills, feeling cold, with warm, pale, flushed skin and bounding pulses
    • Respiratory rate is elevated, with SOB

    Treatments and Interventions for Sepsis

    • Rapid identification and elimination of the cause of infection
    • Fluid replacement: initial fluid challenge, which includes an IV infusion of at least 30 mL/kg of crystalloids over 30 minutes
    • Broad-spectrum antibiotic agents started until culture and sensitivity reports are received
    • Vasopressors, inotropic agents, packed red blood cells, neuromuscular blockade agents, and sedation agents
    • DVT prophylaxis with low-dose unfractionated heparin or low-molecular-weight heparin
    • Ulcer prophylaxis
    • Aggressive nutritional supplementation should be initiated within 24 to 48 hours of ICU admission

    1-Hour Sepsis Bundle

    • Recognize signs and symptoms of sepsis or septic shock
    • Measure lactate levels (remeasure if greater than 2 mmol)
    • Blood cultures before giving antibiotics
    • Broad-spectrum antibiotics
    • 30 mL/kg rapid IV crystalloid fluids
    • Vasopressors if hypotensive during or after fluid resuscitation

    Q-SOFA Screening Tool

    • Q-SOFA: non-ICU patient
    • SOFA: ICU patient
    • Greater than or equal to 2 greater risk for a poor outcome, altered mental status, tachypnea greater than 22, systolic less than 100
    • Glasgow Scale: lower the score, lower level of consciousness

    COVID-19

    • Risk factors: unknown
    • Signs and symptoms: fever, chills, SOB, fatigue, loss of smell or taste, sore throat, congestion, runny nose, headache, muscle aches, N/V/D
    • Complications: unknown
    • Management: oxygen, cardiorespiratory monitoring, endotracheal intubation, oral or nasal intubation, mechanical ventilation, ECMO, suctioning
    • Diagnostics: PCR test, nasopharynx, blood, bronchoscopy
    • Treatment: medications (Remdesivir, Corticosteroids, Bamlanivimab), clinical trials

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    Description

    This quiz covers the risk factors for Urinary Tract Infections (UTIs), including neurological disorders, anatomical abnormalities, and instrumentation of the urinary tract. Test your knowledge of the causes of UTIs and how to prevent them.

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