3/29/25, 8:02 NRNP 6550 Final |
AM
NRNP 6550 FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED
Terms in this set (188)
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
Urine culture with UTI WBC in urine
false positive with tumor, urethritis and poor collection technique
Repeat in pregnant women
Lower urinary tract UTI and upper bladder and urethra: cystitis/ urethritis/ prostatitis
urinary tract UTI kidney and ureters: pyelonephritis/ renal abcess
Uncomplicated: in normal working urinary tract
Uncomplicated and complicated uti
Complicated: defects in urinary tract or with other health problems
E.coli (elderly women)
Staphylococcus
proteus mirabilis (elderly men)
Klebsiella
Common pathogens for UTI
enterecoccus
pseudomonas
Providencia (institutionalized)
Fungus: candida
1/22
,3/29/25, 8:02 NRNP 6550 Final |
AM
Female
critically ill
elderly
catheter (caused by
biofilm) DM
calculi, tumor, stricture
neurogenic bladder
Women:
Risk factors for UTI sexual intercourse or new sex partner
pregnancy
previous UTI
Men:
prostate enlargement
prostatitis
lack of circumcision
gay
HIV
Lower:
Dysuria/ urgency/ frequency/ incontinence
suprapubic pain
hematuria
fever/ chills uncommon
No flank pain
Findings UTI Upper:
flank pain
fever and
chills
hematuria
n/v
ams (in elderly)
malaise
tachycardia/ tachypnea
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
Testing and results for UTI
with:
xr voiding
CT
abdomen
US pelvis
MRI pelvis
First line:
- Single dose Fosfomycin (monurol)
- 3 day: sulfa: trimethoprim/ sulfa (bactrim) (do not give near delivery of baby, give
cephalexin instead) or sulfa
Management acute cystitis - 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
2/22
, 3/29/25, 8:02 NRNP 6550 Final |
AM
Outpt:
quinolone: ciprofloxacin for 7 days or levofloxacin for 5 days
Sulfa: trimethoprim/ sulfa (bactrim) for 14 days
Inpt:
Ceftriaxone or cefotaxime
Management uncomplicated upper UTI Ampicillin
CAUTI:
bacterial: treat with AB for 7 days
Candiduria: fluconazole for 14 days
Discomfort: Pyridium
- Admit
- Aminoglycosides: gentamicin/ tobramycin (not for monotherapy), based on renal
Management acute complicated bacterial function (trough less than 2 and peak level 5-10mg/L) and do not give for
pyelonephritis CKD
- Ampicillin
- Cefazolin
- Cefotaxime and Ceftriaxon based on obesity and pulm disease
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
Urine analysis: glucose and ketones
- Vit C can give false negative
Ketones in urine:
- Alcohol
- Diabetic
- Starvation
-Acute renal function loss with inability to excrete metabolic waste products (urea
nitrogen and creatinine) to inability to maintain fluid and electrolyte balance.
Acute Kidney Injury
- Resolves within 3mo
- classified with RIFLE or etiology
Risk: creatinine up x 1.5 from baseline, GFR decrease more than 25% and UO less than
0.5ml/kg/hr for 6hr
Injury: creatinine up x 2 from baseline, GFR decrease more than 50% and UO less
than 0.5ml/kg/hr for 12hr
RIFLE
Failure: creatinine up x 1.5 from baseline, GFR decrease more than 25% and UO
less than 0.3ml/kg/hr for 12hr or anuria for 12hr
Loss: Complete loss of renal function for more than 4 weeks
End-stage Kidney Disease: RRT need for more than 3mo
3/22
AM
NRNP 6550 FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED
Terms in this set (188)
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
Urine culture with UTI WBC in urine
false positive with tumor, urethritis and poor collection technique
Repeat in pregnant women
Lower urinary tract UTI and upper bladder and urethra: cystitis/ urethritis/ prostatitis
urinary tract UTI kidney and ureters: pyelonephritis/ renal abcess
Uncomplicated: in normal working urinary tract
Uncomplicated and complicated uti
Complicated: defects in urinary tract or with other health problems
E.coli (elderly women)
Staphylococcus
proteus mirabilis (elderly men)
Klebsiella
Common pathogens for UTI
enterecoccus
pseudomonas
Providencia (institutionalized)
Fungus: candida
1/22
,3/29/25, 8:02 NRNP 6550 Final |
AM
Female
critically ill
elderly
catheter (caused by
biofilm) DM
calculi, tumor, stricture
neurogenic bladder
Women:
Risk factors for UTI sexual intercourse or new sex partner
pregnancy
previous UTI
Men:
prostate enlargement
prostatitis
lack of circumcision
gay
HIV
Lower:
Dysuria/ urgency/ frequency/ incontinence
suprapubic pain
hematuria
fever/ chills uncommon
No flank pain
Findings UTI Upper:
flank pain
fever and
chills
hematuria
n/v
ams (in elderly)
malaise
tachycardia/ tachypnea
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
Testing and results for UTI
with:
xr voiding
CT
abdomen
US pelvis
MRI pelvis
First line:
- Single dose Fosfomycin (monurol)
- 3 day: sulfa: trimethoprim/ sulfa (bactrim) (do not give near delivery of baby, give
cephalexin instead) or sulfa
Management acute cystitis - 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
2/22
, 3/29/25, 8:02 NRNP 6550 Final |
AM
Outpt:
quinolone: ciprofloxacin for 7 days or levofloxacin for 5 days
Sulfa: trimethoprim/ sulfa (bactrim) for 14 days
Inpt:
Ceftriaxone or cefotaxime
Management uncomplicated upper UTI Ampicillin
CAUTI:
bacterial: treat with AB for 7 days
Candiduria: fluconazole for 14 days
Discomfort: Pyridium
- Admit
- Aminoglycosides: gentamicin/ tobramycin (not for monotherapy), based on renal
Management acute complicated bacterial function (trough less than 2 and peak level 5-10mg/L) and do not give for
pyelonephritis CKD
- Ampicillin
- Cefazolin
- Cefotaxime and Ceftriaxon based on obesity and pulm disease
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
Urine analysis: glucose and ketones
- Vit C can give false negative
Ketones in urine:
- Alcohol
- Diabetic
- Starvation
-Acute renal function loss with inability to excrete metabolic waste products (urea
nitrogen and creatinine) to inability to maintain fluid and electrolyte balance.
Acute Kidney Injury
- Resolves within 3mo
- classified with RIFLE or etiology
Risk: creatinine up x 1.5 from baseline, GFR decrease more than 25% and UO less than
0.5ml/kg/hr for 6hr
Injury: creatinine up x 2 from baseline, GFR decrease more than 50% and UO less
than 0.5ml/kg/hr for 12hr
RIFLE
Failure: creatinine up x 1.5 from baseline, GFR decrease more than 25% and UO
less than 0.3ml/kg/hr for 12hr or anuria for 12hr
Loss: Complete loss of renal function for more than 4 weeks
End-stage Kidney Disease: RRT need for more than 3mo
3/22
