NUR 200 9.9 UTI P/P/R/A
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The nurse is caring for a client who is diagnosed with a urinary tract infection​ (UTI). Which diagnostic test does the nurse anticipate will be ordered for the client to determine appropriate​ treatment? Pelvic examination Urine culture and sensitivity Cystoscopy Intravenous pyelography
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Urine culture and sensitivity Rationale The client suspected of having a urinary tract infection would have a urine culture and sensitivity ordered to determine the best course of pharmacological treatment. A client with renal calculi would require an intravenous pyelogram for diagnosis. A pelvic examination is useful to assess structural changes of the urinary tract. A voiding cystourethrography is useful when determining the cause of urinary inflammation.
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A client has a history of repeated urinary tract infections caused by several different factors. What clinical situation would be least likely to cause a​ UTI? Urinary stasis Blockage in the urinary tract Increase in urinary motility Trauma to the urinary tract
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Increase in urinary motility Rationale A​ decrease, not an​ increase, in urinary motility can cause a UTI. Urinary​ stasis, trauma to the urinary​ tract, and a blockage in the urinary tract can cause a UTI.
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A client is admitted to the emergency department for possible acute pyelonephritis. Which manifestations are associated with this​ disorder? ​(Select all that​ apply.) Vomiting Nocturia Urinary frequency Flank tenderness Diarrhea
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Vomiting Urinary frequency Flank tenderness Diarrhea Rationale The nurse should monitor the client for flank​ tenderness, vomiting,​ diarrhea, and urinary​ frequency; these are manifestations of acute pyelonephritis.Nocturia is a manifestation of​ cystitis, not acute pyelonephritis.
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The nurse is caring for a client diagnosed with a urinary tract infection​ (UTI). Which assessment findings support this​ diagnosis? ​(Select all that​ apply.) Hypothermia Burning sensation upon urination Abdominal pain Clear urine Flank pain
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Burning sensation upon urination Abdominal pain Flank pain Rationale Assessment findings that support the diagnosis of a UTI include abdominal​ pain, flank​ pain, and a burning sensation when urinating.​ Cloudy, dark,​ foul-smelling urine is expected with a UTI.​ Hyperthermia, or​ fever, not hypothermia supports the diagnosis of UTI.
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The client wants to know what fluids to​ avoid, in light of repeated urinary tract infections. What fluids would you educate the client​ about? ​(Select all that​ apply.) Alcoholic beverages Milk Coffee Citrus juices Cranberry juice
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Alcoholic beverages Coffee Citrus juices Rationale Avoiding citrus​ juices, alcoholic​ beverages, and coffee can help prevent urinary infections. Increasing the intake of cranberry​ juice, not avoiding​ it, can help prevent urinary infections. Milk intake has no known effect in preventing urinary infections.
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The nurse is caring for a client complaining of loss of​ appetite, feeling confused and​ lethargic, and painful urination. Based on these​ symptoms, what diagnosis does the nurse​ expect? Cystitis Urethritis Prostatitis Pyelonephritis
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Cystitis Rationale The combination of​ anorexia, confusion​ (in the​ elderly), lethargy, and dysuria are symptoms of cystitis. Symptoms are different for​ urethritis, pyelonephritis, and prostatitis.
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What physiologic changes occur with​ pyelonephritis? Scarring of the renal tubules occurs from prolonged inflammatory response. Ascending infection results in decreased renal perfusion from changes that occurred in microscopic blood vessels. Inflammation of the ascending infection causes shrinking of the renal tubules with reduction of the diameter of urine flow. An inflammatory response occurs in the pelvis and in the parenchyma within the affected kidney.
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An inflammatory response occurs in the pelvis and in the parenchyma within the affected kidney. Rationale Pyelonephritis occurs due to an inflammation of the pelvis and parenchyma of the kidney. The other choices describe other types of urinary tract infections.
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What are the causes of urinary tract​ infections? ​(Select all that​ apply.) Excessive oral fluid intake Vesicoureteral reflux Renal scaring Structural deviations Use of antibiotics
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Vesicoureteral reflux Renal scaring Structural deviations Rationale The causes of urinary tract infections include structural​ deviations, renal​ scaring, and vesicoureteral reflux. Excessive oral fluid intake or use of antibiotics does not cause urinary tract infections.
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What are the clinical manifestations of​ pyelonephritis? ​(Select all that​ apply.) Flank pain Vomiting Fever Enuresis Dysuria
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Flank pain Vomiting Fever Rationale Clinical manifestations that occur with pyelonephritis include​ fever, vomiting, and flank pain. Enuresiss and dysuria occur with cystitis.
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Which topics are important to include in the home care teaching for a client with a urinary tract infection​ (UTI)? (Select all that ​apply.) Adequate fluid consumption Void every 5 to 6 hours Good hygiene methods Proper nutrition Wear polyester underwear
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Adequate fluid consumption Good hygiene methods Proper nutrition Rationale Home care teaching for a client with a UTI includes good hygiene​ methods, proper​ nutrition, and adequate fluid consumption.​ Cotton, not​ polyester, underwear is recommended for clients prone to UTIs. Frequent voiding is encouraged.
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Which nursing intervention is appropriate for a client with the nursing diagnosis of impaired urinary​ elimination? Measuring intake and output Administering analgesics Assessing pain Recommending warm sitz baths
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Measuring intake and output Rationale The client experiencing the nursing diagnosis of impaired urinary elimination would benefit most from the nurse measuring intake and output. The client with the nursing diagnosis of pain would benefit from a pain​ assessment, analgesic​ administration, and recommending a warm sitz bath.
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Ms. Boyer is an​ 82-year-old woman who had a total knee replacement yesterday. Although her pain has been adequately managed during​ rest, when she gets up to use the bedside​ commode, she rates her pain very high.​ Consequently, she is reluctant to drink and holds her urine so she does not have to get up often. Her daughter explains her​ mother's situation, states her surprise that her mother does not have a urinary catheter in​ place, and asks why this is so. What is your best response to Ms.​ Boyer's daughter? ​\"Although having a urinary catheter in place would reduce your​ mother's discomfort when​ moving, movement is encouraged so additional complications will not​ occur.\" ​\"Infections from urinary catheters often result in kidney​ infections, which could result in renal failure. It is a big​ risk, and movement is encouraged​ postoperatively.\" ​\"The urinary catheter could reduce your​ mother's need to​ void, which could be a bigger problem later on.​ Typically, urinary catheters are not inserted for a​ client's comfort.\" ​\"Having a urinary catheter in place would increase your​ mother's risk of developing a urinary tract infection. Bacteria could enter the bladder from the catheter and from urine in the drainage bag and​ tubing.\"
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​\"Having a urinary catheter in place would increase your​ mother's risk of developing a urinary tract infection. Bacteria could enter the bladder from the catheter and from urine in the drainage bag and​ tubing.\" Rationale Insertion of a urinary catheter increases the risk of developing a urinary tract infection. This occurs because the flushing action of the voiding process is no longer​ present, and bacteria from the perineal area can ascend on the catheter sides farther up the urethra and closer to the bladder. Although client movement is encouraged​ postoperatively, it is important to offer the most specific response when teaching clients and family members. Referencing the potential development of complications is very general. Insertion of a urinary catheter does not reduce the​ client's need to​ void; it may contribute to urinary retention over a prolonged period because the bladder muscle is not contracting when a urinary catheter is in place. Having a urinary catheter in place increases the risk for​ cystitis; this could ascend and develop into a kidney infection but is a less frequent occurrence.
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Ms. Rodriquez is a​ 20-year-old woman who has had several urinary tract infections during the past 2 years. She returned to the healthcare​ provider's office for a​ follow-up visit and is speaking to you regarding treatment. She tells you that she realizes that she must complete the prescribed course of antibiotics. She is concerned that because she has taken antibiotics several times during the past few​ years, she will develop problems. Ms. Rodriguez is asking if there are foods that she can avoid to prevent the urinary tract infections from recurring. What is your best​ response? ​\"You should avoid foods high in sugar as these cause​ UTIs.\" ​\"Cranberry juice should be avoided as this is a causative factor for​ UTIs.\" ​\"You should avoid alcoholic​ beverages, as consumption has been linked to increasing the risk for​ UTIs.\" ​\"Research does not support the restriction of foods in order to avoid​ UTIs.\"
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​\"You should avoid alcoholic​ beverages, as consumption has been linked to increasing the risk for​ UTIs.\" Rationale The nurse would educate the client to avoid alcoholic beverages as these have been linked to UTIs. The client would be encouraged to drink cranberry juice and to avoid artificial sweeteners as part of the teaching associated with decreasing the risk for UTIs.
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The student health center nurse is talking to a college student who had symptoms of a urinary tract infection​ (UTI). The student bought​ over-the-counter Pyridium and no longer has symptoms. The student feels​ \"cured.\" What is the​ nurse's best​ response? ​\"Keep taking the​ Pyridium, since it seems to be working well by​ itself.\" ​\"Since you no longer have​ pain, you no longer have a urinary tract​ infection.\" ​\"Come back after you stop taking the​ Pyridium, if you have any​ symptoms.\" ​\"Pyridium is an​ analgesic, so it helps the​ pain, but it does not treat the infection. An antibiotic is​ needed.\"
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​\"Pyridium is an​ analgesic, so it helps the​ pain, but it does not treat the infection. An antibiotic is​ needed.\" Rationale Pyridium is an​ analgesic, so it helps the​ pain, but it does not treat the infection. An antibiotic is needed to treat the infection. Easing the pain is​ worthwhile, but not if it delays active treatment of the infection. The client does not need to stop the​ analgesic; the client does not need to make a return visit for treatment. The client needs a prescription for an antibiotic to treat the infection.
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A nurse is caring for a client diagnosed with a urinary tract infection. When providing education to this​ client, which topic should not be included as a bladder​ irritant? Citrus juices Alcohol Smoking Caffeinated beverages
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Smoking Rationale Caffeinated​ beverages, citrus​ juices, alcohol, and artificial sweeteners are considered bladder​ irritants; therefore, the client should be educated to avoid them. Smoking is not considered a bladder irritant.
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The client asks the​ nurse, \"How did I get this urinary tract infection​ (UTI)?\" The nurse bases the response on which common causative​ factor? Congenital strictures in the urethra An ascending infection from the urethra Urinary stasis in the urinary bladder An infection elsewhere in the body
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An ascending infection from the urethra Rationale The most common cause of a UTI is an ascending infection from the urethra. Congenital strictures and urinary retention can lead to​ infection, but these are not the most common causes. Systemic infections are rarely causes of UTIs.
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The nurse is caring for a client in the emergency department​ (ED) who has been diagnosed with a urinary tract infection​ (UTI) and is complaining of pain. The nurse teaches the client to expect which medication for the treatment of​ pain? ​Sulfamethoxazole-trimethoprim Amoxicillin clavulante Vancomycin Pyridium
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Pyridium Rationale Pyridium is a medication that is used to treat the painful spasms that are associated with UTIs.​ Sulfamethoxazole-trimethoprim and amoxicillin clavulante are antibiotics that are commonly used in the treatment of​ UTIs, but they would not be prescribed for the treatment of pain. Vancomycin is an antibiotic and would not be appropriate in the treatment of pain.
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A​ 5-year-old client arrives at the community health clinic exhibiting signs of a urinary tract infection​ (UTI), including fever of 101 ​º​F, ​strong-smelling urine, and irritability. A urine culture and sensitivity have been ordered. Which causative agent does the nurse​ expect, based on this diagnostic​ test? Protein A​ gram-negative enteric bacterium Ketones Glucose
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A​ gram-negative enteric bacterium Rationale The majority of UTIs are caused by​ gram-negative enteric bacterium such as Escherichia coli. The culture and sensitivity will verify the causative agent and allow the healthcare provider to prescribe the most appropriate treatment.​ Glucose, protein, and ketones are tested by a urine​ dipstick, not a urine culture.
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The parent of a child with repeated urinary tract infections​ (UTIs) is worried because her child has not been progressing like other children of the same age. Which nursing diagnosis would be the most appropriate for this​ client? Increased risk for knowledge deficit Potential for growth retardation Alteration in urinary elimination Increased risk for fear
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Potential for growth retardation Rationale While all these diagnoses are appropriate for clients with a history of​ UTIs, the most appropriate for this client based on the concern of the parent is potential for growth retardation.
