NRNP 6550 Final Exam
189 Verified and Correct answer
Already best reviewed document
Secure better grades
, NRNP 6550 Final Exam
Urine culture with UTI
Correct answer
- 100.000 colonies in asymptomatic: bacteruria
10 - 10.000 colonies in symptomatic patients but also pyuria
pyuria: more than 10 leukocytes
elevated erythrocytes with
pyelonephritis WBC in urine
false positive with tumor, urethritis and poor collection technique
Repeat in pregnant women
Lower urinary tract UTI and upper urinary tract UTI
Correct answer
- bladder and urethra: cystitis/ urethritis/ prostatitis
kidney and ureters: pyelonephritis/ renal abcess
Uncomplicated and complicated uti Correct answer- Uncomplicated: in normal
working urinary tract
Complicated: defects in urinary tract or with other health problems
Common pathogens for UTI
Correct answer
- E.coli (elderly women)
Staphylococcus
proteus mirabilis (elderly men)
Klebsiella
enterecoccu
s
pseudomon
as
Providencia
(institutionalized)
Fungus: candida
Risk factors for UTI
Correct answer
- Female critically ill
elderly
catheter (caused by
,biofilm) DM
calculi, tumor,
stricture
neurogenic bladder
Women:
sexual intercourse or new sex
partner pregnancy
previous
UTI Men:
prostate
enlargement
prostatitis
lack of
circumcision gay
HIV
Findings UTI
Correct answer- Lower: Dysuria/
urgency/ frequency/ incontinence
suprapubic pain
hematuria
fever/ chills
uncommon No flank
pain
Upper:
flank pain
fever and
chills
hematuria
n/v
ams (in
elderly)
malaise
tachycardia/ tachypnea
Testing and results for UTI
Correct answer- Gold standard: urine culture and sensitivity: detection of
bacteria. Start with POC: urine analysis.
UA: pos for nitrite or leukocyte or
blood CBC: leukocyte with left shift in
pyelonephritis
For recurrent UTI in women or UTI in men rule out obstruction, calculi, or
necrosis with: xr voiding
CT
abdomen
US pelvis
MRI pelvis
, Management acute cystitis
Correct answer- First line:
- Single dose Fosfomycin (monurol)
- 3 day: sulfa: trimethoprim/ sulfa (bactrim) (do not give near delivery
of baby, give cephalexin instead) or sulfa
- 5 days: nitrofurantoin, caution in elderly
Second line:
- qiunolones: ciprofloxain or levofloxacin for 3 days (not for pregnant women!)
- B-lactams: amoxi-clav, cefdinir for 3 - 7 days
Management uncomplicated upper UTI
Correct answer- Outpt: quinolone: ciprofloxacin for 7
days or levofloxacin for 5 days Sulfa: trimethoprim/
sulfa (bactrim) for 14 days
Inpt:
Ceftriaxone or cefotaxime
Ampicillin
CAUTI:
bacterial: treat with AB for 7
days Candiduria: fluconazole
for 14 days
Discomfort: Pyridium
Management acute complicated bacterial pyelonephritis Correct answer- -
Admit
- Aminoglycosides: gentamicin/ tobramycin (not for monotherapy),
based on renal function (trough less than 2 and peak level 5-10mg/L)
and do not give for CKD
- Ampicillin
- Cefazolin
- Cefotaxime and Ceftriaxon based on obesity and pulm disease
Urine analysis: glucose and ketones Correct answer- Serum glucose at least
180mg/dl for glucose to appear in urine
Glucose in ua caused by:
- Fancone Syndrome (bad wall: caused by ahminoglycosides for example)
- DM
- Cushing's
- Vit C can give false negative
Ketones in urine:
- Alcohol
- Diabetic
- Starvation
189 Verified and Correct answer
Already best reviewed document
Secure better grades
, NRNP 6550 Final Exam
Urine culture with UTI
Correct answer
- 100.000 colonies in asymptomatic: bacteruria
10 - 10.000 colonies in symptomatic patients but also pyuria
pyuria: more than 10 leukocytes
elevated erythrocytes with
pyelonephritis WBC in urine
false positive with tumor, urethritis and poor collection technique
Repeat in pregnant women
Lower urinary tract UTI and upper urinary tract UTI
Correct answer
- bladder and urethra: cystitis/ urethritis/ prostatitis
kidney and ureters: pyelonephritis/ renal abcess
Uncomplicated and complicated uti Correct answer- Uncomplicated: in normal
working urinary tract
Complicated: defects in urinary tract or with other health problems
Common pathogens for UTI
Correct answer
- E.coli (elderly women)
Staphylococcus
proteus mirabilis (elderly men)
Klebsiella
enterecoccu
s
pseudomon
as
Providencia
(institutionalized)
Fungus: candida
Risk factors for UTI
Correct answer
- Female critically ill
elderly
catheter (caused by
,biofilm) DM
calculi, tumor,
stricture
neurogenic bladder
Women:
sexual intercourse or new sex
partner pregnancy
previous
UTI Men:
prostate
enlargement
prostatitis
lack of
circumcision gay
HIV
Findings UTI
Correct answer- Lower: Dysuria/
urgency/ frequency/ incontinence
suprapubic pain
hematuria
fever/ chills
uncommon No flank
pain
Upper:
flank pain
fever and
chills
hematuria
n/v
ams (in
elderly)
malaise
tachycardia/ tachypnea
Testing and results for UTI
Correct answer- Gold standard: urine culture and sensitivity: detection of
bacteria. Start with POC: urine analysis.
UA: pos for nitrite or leukocyte or
blood CBC: leukocyte with left shift in
pyelonephritis
For recurrent UTI in women or UTI in men rule out obstruction, calculi, or
necrosis with: xr voiding
CT
abdomen
US pelvis
MRI pelvis
, Management acute cystitis
Correct answer- First line:
- Single dose Fosfomycin (monurol)
- 3 day: sulfa: trimethoprim/ sulfa (bactrim) (do not give near delivery
of baby, give cephalexin instead) or sulfa
- 5 days: nitrofurantoin, caution in elderly
Second line:
- qiunolones: ciprofloxain or levofloxacin for 3 days (not for pregnant women!)
- B-lactams: amoxi-clav, cefdinir for 3 - 7 days
Management uncomplicated upper UTI
Correct answer- Outpt: quinolone: ciprofloxacin for 7
days or levofloxacin for 5 days Sulfa: trimethoprim/
sulfa (bactrim) for 14 days
Inpt:
Ceftriaxone or cefotaxime
Ampicillin
CAUTI:
bacterial: treat with AB for 7
days Candiduria: fluconazole
for 14 days
Discomfort: Pyridium
Management acute complicated bacterial pyelonephritis Correct answer- -
Admit
- Aminoglycosides: gentamicin/ tobramycin (not for monotherapy),
based on renal function (trough less than 2 and peak level 5-10mg/L)
and do not give for CKD
- Ampicillin
- Cefazolin
- Cefotaxime and Ceftriaxon based on obesity and pulm disease
Urine analysis: glucose and ketones Correct answer- Serum glucose at least
180mg/dl for glucose to appear in urine
Glucose in ua caused by:
- Fancone Syndrome (bad wall: caused by ahminoglycosides for example)
- DM
- Cushing's
- Vit C can give false negative
Ketones in urine:
- Alcohol
- Diabetic
- Starvation
