RNSG 1341 Exam 1|Advanced Urinary System and Infection Nursing
Examination: Urinary Tract Infection, Pyelonephritis, Urethritis, Interstitial
Cystitis, Escherichia coli, Enterococci, Klebsiella, Proteus, Streptococci, Lower
Urinary Tract Symptoms, Dysuria, Hematuria, Nocturia, Flank Pain,
Costovertebral Angle Tenderness, Urinalysis, Urine Culture and Sensitivity,
Creatinine Clearance, Glomerular Filtration Rate, KUB X-ray, IVP, Renal
Ultrasound, Cystoscopy, Phenazopyridine, Fluoroquinolones, Nitrofurantoin,
TMP-SMZ, Urosepsis, Urinary Hygiene, Bladder Hydrodistension, Patient
Education, Dietary Modifications, Age-Related Urinary Changes Exam Questions
Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026
What is the most common organism responsible for UTIs?
E. coli, Escherichia coli is the most common pathogen causing a UTI. It causes 75% of cases without
urinary tract structural abnormalities or stones and 65% of complicated UTIs
others include: enterococci, Klebsiella, Proteus, streptococci.
What patients are at risk for UTI's?
These include debilitated persons, older adults, patients who are immunocompromised (e.g., cancer,
diabetes), and patients treated with immunosuppressive drugs or corticosteroids.
What are Signs and symptoms of a lower UTI infection?
Subjective Data
*Health history: Previous UTI. Urinary stones, reflux, strictures, or retention. Neurogenic bladder,
pregnancy, BPH, bladder cancer, sexually transmitted infection.
*Medications: Antibiotics, anticholinergics, antispasmodics
,*Surgery or other treatments: Recent urologic instrumentation (catheterization, cystoscopy)
*Cognitive-perceptual: Suprapubic or low back pain, bladder spasms, dysuria, burning on urination
*Elimination: Urinary frequency, urgency, hesitancy, dysuria, nocturia
*Health perception–health management: Urinary hygiene practices. Lassitude, malaise
*Nutritional-metabolic: Nausea, vomiting, anorexia. Chills and fever
*Sexuality-reproductive: Sexual activity, use of spermicidal agents or contraceptive diaphragm (women)
Objective Data
*Fever, chills, dysuria
*Atypical presentation in older adults: afebrile, absence of dysuria, loss of appetite, altered mental
status
*Hematuria. Cloudy, foul-smelling urine
Possible Diagnostic Findings:
*Leukocytosis. Urinalysis positive for bacteria, pyuria, RBCs, WBCs, and nitrites. Positive urine culture.
Ultrasound, CT scan, MRI, voiding cystourethrogram (VCUG), cystoscopy showing urinary tract
abnormalities
How are the symptoms for an older adult with a UTI different?
,Atypical presentation in older adults: afebrile, absence of dysuria, loss of appetite, altered mental status
the common manifestations of a UTI are often absent in older adults. Older adults tend to have general
abdominal discomfort rather than dysuria and suprapubic pain. They may have impaired cognition or
overall clinical deterioration. Because older adults are less likely to have a fever with a UTI, temperature
is an unreliable sign of a UTI.
How do you prevent an UTI?
(1) emptying the bladder regularly and completely,
(2) evacuating the bowel regularly,
(3) wiping the perineal area from front to back after voiding and defecation, and
(4) drinking an adequate amount of liquid each day.
When teaching a patient and caregiver measures to prevent a recurrence of a UTI, include:
1. Take all antibiotics as prescribed. Symptoms may improve after 1-2 days of therapy, but organisms
may still be present.
2. Practice appropriate hygiene, including:
• Carefully clean the perineal region by separating the labia in females, or in males pulling back the
foreskin if present when cleansing.
• Wipe from front to back after urinating.
• Cleanse with warm soapy water after each bowel movement.
3. Empty the bladder before and after sexual intercourse.
4. Void regularly, about every 3-4 hours during the day.
5. Maintain adequate fluid intake.
6. Avoid vaginal douches and harsh soaps, bubble baths, powders, and sprays in the perineal area.
7. Report to the HCP symptoms or signs of recurrent UTI (e.g., fever, cloudy urine, pain on urination,
urgency, frequency).
, How do you prepare a client for an IVP? What is the most important question to ask? What is the
purpose of an IVP?
IVP is used to Visualizes urinary tract after IV injection of contrast media. Evaluates size and shape of
kidneys, ureters, and bladder. Cysts, tumors, and ureteral obstructions distort normal appearance of
these structures. Patient with decreased renal function should not have IVP because contrast media can
be nephrotoxic.
Before: Cathartic or enema given night before. Assess patient for iodine sensitivity to avoid anaphylactic
reaction.
During: Warn patient that contrast injection may cause a feeling of being warm and flushed.
After: Force fluids to avoid renal problems with contrast. urine may be pink, may experience some
burning, watch for S/S of UTI
common medications to treat UTIs
Fluoroquinolones, nitrofurantoin, trimethoprim, or sulfonamides
Antibiotics used to treat urinary infections by directly killing bacteria and inhibiting bacterial
reproduction.
Penicillins and cephalosporins are administered less frequently because the medication is less effective
and tolerated.
Nitrofurantoin is an antibacterial medication where therapeutic levels are achieved in the urine only.
Nursing Actions
If a sulfonamide is prescribed, ask the client about allergy to sulfa.
Examination: Urinary Tract Infection, Pyelonephritis, Urethritis, Interstitial
Cystitis, Escherichia coli, Enterococci, Klebsiella, Proteus, Streptococci, Lower
Urinary Tract Symptoms, Dysuria, Hematuria, Nocturia, Flank Pain,
Costovertebral Angle Tenderness, Urinalysis, Urine Culture and Sensitivity,
Creatinine Clearance, Glomerular Filtration Rate, KUB X-ray, IVP, Renal
Ultrasound, Cystoscopy, Phenazopyridine, Fluoroquinolones, Nitrofurantoin,
TMP-SMZ, Urosepsis, Urinary Hygiene, Bladder Hydrodistension, Patient
Education, Dietary Modifications, Age-Related Urinary Changes Exam Questions
Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026
What is the most common organism responsible for UTIs?
E. coli, Escherichia coli is the most common pathogen causing a UTI. It causes 75% of cases without
urinary tract structural abnormalities or stones and 65% of complicated UTIs
others include: enterococci, Klebsiella, Proteus, streptococci.
What patients are at risk for UTI's?
These include debilitated persons, older adults, patients who are immunocompromised (e.g., cancer,
diabetes), and patients treated with immunosuppressive drugs or corticosteroids.
What are Signs and symptoms of a lower UTI infection?
Subjective Data
*Health history: Previous UTI. Urinary stones, reflux, strictures, or retention. Neurogenic bladder,
pregnancy, BPH, bladder cancer, sexually transmitted infection.
*Medications: Antibiotics, anticholinergics, antispasmodics
,*Surgery or other treatments: Recent urologic instrumentation (catheterization, cystoscopy)
*Cognitive-perceptual: Suprapubic or low back pain, bladder spasms, dysuria, burning on urination
*Elimination: Urinary frequency, urgency, hesitancy, dysuria, nocturia
*Health perception–health management: Urinary hygiene practices. Lassitude, malaise
*Nutritional-metabolic: Nausea, vomiting, anorexia. Chills and fever
*Sexuality-reproductive: Sexual activity, use of spermicidal agents or contraceptive diaphragm (women)
Objective Data
*Fever, chills, dysuria
*Atypical presentation in older adults: afebrile, absence of dysuria, loss of appetite, altered mental
status
*Hematuria. Cloudy, foul-smelling urine
Possible Diagnostic Findings:
*Leukocytosis. Urinalysis positive for bacteria, pyuria, RBCs, WBCs, and nitrites. Positive urine culture.
Ultrasound, CT scan, MRI, voiding cystourethrogram (VCUG), cystoscopy showing urinary tract
abnormalities
How are the symptoms for an older adult with a UTI different?
,Atypical presentation in older adults: afebrile, absence of dysuria, loss of appetite, altered mental status
the common manifestations of a UTI are often absent in older adults. Older adults tend to have general
abdominal discomfort rather than dysuria and suprapubic pain. They may have impaired cognition or
overall clinical deterioration. Because older adults are less likely to have a fever with a UTI, temperature
is an unreliable sign of a UTI.
How do you prevent an UTI?
(1) emptying the bladder regularly and completely,
(2) evacuating the bowel regularly,
(3) wiping the perineal area from front to back after voiding and defecation, and
(4) drinking an adequate amount of liquid each day.
When teaching a patient and caregiver measures to prevent a recurrence of a UTI, include:
1. Take all antibiotics as prescribed. Symptoms may improve after 1-2 days of therapy, but organisms
may still be present.
2. Practice appropriate hygiene, including:
• Carefully clean the perineal region by separating the labia in females, or in males pulling back the
foreskin if present when cleansing.
• Wipe from front to back after urinating.
• Cleanse with warm soapy water after each bowel movement.
3. Empty the bladder before and after sexual intercourse.
4. Void regularly, about every 3-4 hours during the day.
5. Maintain adequate fluid intake.
6. Avoid vaginal douches and harsh soaps, bubble baths, powders, and sprays in the perineal area.
7. Report to the HCP symptoms or signs of recurrent UTI (e.g., fever, cloudy urine, pain on urination,
urgency, frequency).
, How do you prepare a client for an IVP? What is the most important question to ask? What is the
purpose of an IVP?
IVP is used to Visualizes urinary tract after IV injection of contrast media. Evaluates size and shape of
kidneys, ureters, and bladder. Cysts, tumors, and ureteral obstructions distort normal appearance of
these structures. Patient with decreased renal function should not have IVP because contrast media can
be nephrotoxic.
Before: Cathartic or enema given night before. Assess patient for iodine sensitivity to avoid anaphylactic
reaction.
During: Warn patient that contrast injection may cause a feeling of being warm and flushed.
After: Force fluids to avoid renal problems with contrast. urine may be pink, may experience some
burning, watch for S/S of UTI
common medications to treat UTIs
Fluoroquinolones, nitrofurantoin, trimethoprim, or sulfonamides
Antibiotics used to treat urinary infections by directly killing bacteria and inhibiting bacterial
reproduction.
Penicillins and cephalosporins are administered less frequently because the medication is less effective
and tolerated.
Nitrofurantoin is an antibacterial medication where therapeutic levels are achieved in the urine only.
Nursing Actions
If a sulfonamide is prescribed, ask the client about allergy to sulfa.
