AH Ch 66 Care of Patients with Urinary
Problems ACTUAL QUESTIONS AND
CORRECT ANSWERS
Acute infections in the lower urinary tract - Correct answers✔✔Urethritis, cystitis (bladder), and
prostatitis
Upper urinary tract infection - Correct answers✔✔Pyelonephritis (kidney)
Bacteruria - Correct answers✔✔Presence of bacteria in the urine. Can be present without
manifestation of infection: called colonization or ABUTI. Can progress to infection.
Uncomplicated UTI - Correct answers✔✔No anatomic or functional abnormality of the urinary
tract
Complicated UTI - Correct answers✔✔Associated with conditions that increase the risk for
treatment failure or serious outcomes. IE obstruction, pregnancy, male gender, diabetes,
neurogenic bladder, renal insufficiency, and immunosupression.
Cystitis - Correct answers✔✔Inflammation of bladder.
Most commonly caused by bacteria moving up the urinary tract from urethra to bladder.
Catheters: high risk for cystitis
Preventing a UTI - Correct answers✔✔-Drink fluid liberally, 2-L/day unless contraindicated.
-Get enough sleep, rest, and nutrition
-If spermicides are used, consider changing contraceptives
,-Clean from front to back
-Avoid douches, perfumes, tight underwear
-Empty bladder before and after intercourse
-Do not delay urination
UTI manifestations - Correct answers✔✔Frequency, urgency, dysuria. Urine may be cloudy, foul
smelling, blood tinged.
Lab for UTI - Correct answers✔✔Urinalysis with testing for leukocute esterase and nitrate.
Clean catch specimen. Leukoesterase is an enzyme found in some white blood cells (WBCs),
especially neutrophils. When these WBCs are lysed, the urine contains leukoesterase. The
presence of leukoesterase indicates a UTI.
Urine culture - Correct answers✔✔Confirms the type of organism. Indicated when UTI is
complicated or treatment resistant.
UTI meds - Correct answers✔✔Chart 66-4
Urethritis - Correct answers✔✔Inflammation of the urethra causing symptoms similar to UTI
Most common in postmenopausal women and is probably caused by tissue changes related to
low estrogen levels. Treat with estrogen creams.
Urethritis in men - Correct answers✔✔Most commonly caused by STDs. Treat with antibiotics.
Urethral strictures - Correct answers✔✔Narrowed areas of the urethra. Most common symptom
is obstruction of urine flow.
, Stricture treatment - Correct answers✔✔-Dilation of the urethra using local anesthetic
(temporary)
-Stent placement
-Urethroplasty: best chance of long term cure. Surgical removal of affected area.
Stress incontinence - Correct answers✔✔Most common type. Loss of small amounts of urine
during coughing, sneezing, jogging, or lifting.
Stress incontinence treatment - Correct answers✔✔Journaling, behavioral interventions, diet
modification, Kegal exercises
Urge incontinence - Correct answers✔✔Urgent sensation to void as a result of bladder
contractions and unable to suppress urge to void. Aka overactive bladder
Urge incontinence treatment - Correct answers✔✔Drugs: anticholinergics, antihistamines, etc
Avoid artificial sweeteners, caffeine, and alcohol
Exercise, bladder training
Mixed incontinence - Correct answers✔✔Presence of more than one type of incontinence
Overflow incontinence - Correct answers✔✔Detrusor muscles fail to contract and bladder
becomes overdistended. Aka reflex incontinence or under active bladder. Bladder reaches full
capacity and urine must leak to avoid rupture.
Overflow incontinence treatment - Correct answers✔✔Surgery to relieve obstruction.
Intermittent catheterization, bladder compression, drug therapy, behavioral interventions.
Problems ACTUAL QUESTIONS AND
CORRECT ANSWERS
Acute infections in the lower urinary tract - Correct answers✔✔Urethritis, cystitis (bladder), and
prostatitis
Upper urinary tract infection - Correct answers✔✔Pyelonephritis (kidney)
Bacteruria - Correct answers✔✔Presence of bacteria in the urine. Can be present without
manifestation of infection: called colonization or ABUTI. Can progress to infection.
Uncomplicated UTI - Correct answers✔✔No anatomic or functional abnormality of the urinary
tract
Complicated UTI - Correct answers✔✔Associated with conditions that increase the risk for
treatment failure or serious outcomes. IE obstruction, pregnancy, male gender, diabetes,
neurogenic bladder, renal insufficiency, and immunosupression.
Cystitis - Correct answers✔✔Inflammation of bladder.
Most commonly caused by bacteria moving up the urinary tract from urethra to bladder.
Catheters: high risk for cystitis
Preventing a UTI - Correct answers✔✔-Drink fluid liberally, 2-L/day unless contraindicated.
-Get enough sleep, rest, and nutrition
-If spermicides are used, consider changing contraceptives
,-Clean from front to back
-Avoid douches, perfumes, tight underwear
-Empty bladder before and after intercourse
-Do not delay urination
UTI manifestations - Correct answers✔✔Frequency, urgency, dysuria. Urine may be cloudy, foul
smelling, blood tinged.
Lab for UTI - Correct answers✔✔Urinalysis with testing for leukocute esterase and nitrate.
Clean catch specimen. Leukoesterase is an enzyme found in some white blood cells (WBCs),
especially neutrophils. When these WBCs are lysed, the urine contains leukoesterase. The
presence of leukoesterase indicates a UTI.
Urine culture - Correct answers✔✔Confirms the type of organism. Indicated when UTI is
complicated or treatment resistant.
UTI meds - Correct answers✔✔Chart 66-4
Urethritis - Correct answers✔✔Inflammation of the urethra causing symptoms similar to UTI
Most common in postmenopausal women and is probably caused by tissue changes related to
low estrogen levels. Treat with estrogen creams.
Urethritis in men - Correct answers✔✔Most commonly caused by STDs. Treat with antibiotics.
Urethral strictures - Correct answers✔✔Narrowed areas of the urethra. Most common symptom
is obstruction of urine flow.
, Stricture treatment - Correct answers✔✔-Dilation of the urethra using local anesthetic
(temporary)
-Stent placement
-Urethroplasty: best chance of long term cure. Surgical removal of affected area.
Stress incontinence - Correct answers✔✔Most common type. Loss of small amounts of urine
during coughing, sneezing, jogging, or lifting.
Stress incontinence treatment - Correct answers✔✔Journaling, behavioral interventions, diet
modification, Kegal exercises
Urge incontinence - Correct answers✔✔Urgent sensation to void as a result of bladder
contractions and unable to suppress urge to void. Aka overactive bladder
Urge incontinence treatment - Correct answers✔✔Drugs: anticholinergics, antihistamines, etc
Avoid artificial sweeteners, caffeine, and alcohol
Exercise, bladder training
Mixed incontinence - Correct answers✔✔Presence of more than one type of incontinence
Overflow incontinence - Correct answers✔✔Detrusor muscles fail to contract and bladder
becomes overdistended. Aka reflex incontinence or under active bladder. Bladder reaches full
capacity and urine must leak to avoid rupture.
Overflow incontinence treatment - Correct answers✔✔Surgery to relieve obstruction.
Intermittent catheterization, bladder compression, drug therapy, behavioral interventions.
