NUR 205 Chapter 45 Urinary disorders

More than 10 5 colonies of bacteria per mL of urine

bacteriuria

removal of the urinary bladder

cystectomy

inflammation of the urinary bladder

cystitis

voiding more than every 3hrs

frequency

transplantation of the ureters to an disolated section of th terminal ileum with one end of the ureters brought to the abdominal wall

ileal conduit

inflammation of the bladder wall that eventually causes disintegration of the lining and loss of bladder elasticity

interstitial cystitis

voiding

micturition

bladder dysfunction that results from a disorder or dysfunction of the nervous system; may result in either urinary retention or bladder over-activity resulting in urinary urgency and urge incontinence.

neurogenic bladder

awakening at night to urinate

nocturia

involuntary urine loss associated with over-distention of the bladder do to mechanical or anatomic bladder outlet obstruction

overflow incontinence

inflammation of the prostate gland

prostatitis

inflammation of the renal pelvis

pyelonephritis

white blood cells in the urine

pyuria

urine that remains in the bladder after voiding

residual urine

transplantation of the ureters into the sigmoid colon allowing urine to flow through the colon and out the rectum.

ureterosigmoidostomy

backward flow of urine from the bladder into one or both ureters

ureterovesical or vesicoureteral reflux

inflammation of the urethra

urethritis

backward flow of urine form the urethra into the bladder

urethrovesical reflux

involuntary or uncontrolled loss of urine from the bladder sufficient to cause a social or hygienic problem.

urinary incontinence

sepsis resulting from infected urine most often a UTI

urosepsis

An example of an upper urinary tract infection is?

a. accute pyelonephritis

b. cystitis

c. prostatitis

d. urethritis

a

A sign of possible UTI is?

a. a negative urine culture

b. an out put of 200 to 900 ml with each voiding

c. cloudy urine

d. urine with a specific gravity of 1.005 to 1.022

c

The most common site of a lower UTI is the ?

a. bladder

b. kidney

c. prostate

d. urethra

a

There is an increased risk of UTI's in the presence of?

a. altered metabolic states

b. immunosuppression

c. urethral mucosa abrasion

d. all of the above.

d

The most common organism responsible fore UTI's in women and the elderly is?

a. klebsiella

b. Escherichia coli

c. Proteus

d. pseudomonas

b

A first line of fluoroquinolone antibacterial agent for UTI's that has been found to be significantly effective is?

a. bactrim

b. cipro

c. macrodantin

d. septra

b

Frequently, a urinary analgesic is prescribed for relief of burning, pain, and other symptoms of a UTI. An example would be?

a. Bactrim

b. Levaquin

c. Pyridium

d. Septra

c

Health information for a female patient diagnosed as having cystitis includes all of the following except?

a. cleanse around the perineum and urethral meatus from front to back after each bowel movement.

b. drink liberal amounts of fluid

c. shower rather than bathe in a tub.

d. void no more frequently than every 6hrs to allow urine to dilute the bacteria in the bladder

d

Complications of chronic pyelonephritis include?

a. end stage renal disease

b. hypertension

c. kidney stone formation

d. all of the above.

d

The type of incontinence that results fom a sudden increase in intra abdominal pressure is?

a. reflex incontinence

b. stress incontinence

c. overflow incontinence

d. urge incontinence

b

Incontinence or dyssyneergia is a voiding dysfunction found in the following neurogenic disorder?

a. cerebellar ataxia

b. diabetes

c. multiple sclerosis

d. parkinson disease

a

Spastic neurogenic bladder is associated with all of the following except?

a. a loss of conscious sensation and cerebral motor control

b. a lower motor neuron lesion

c. hypertrophy of the bladder walls

d. reduced bladder capacity.

b

The major complication of neurogenic bladder is?

a. hypertrophy

b. infection

c. pain

d. spasm

b

The major cause of death for patients with neurologic impairment of the bladder is?

a. myocardial infection

b. pulmonary edema

c. septicemia

d. renal failure

d

Nursing measures for the patient with neurogenic bladder include?

a. encouraging a liberal fluid intake

b. keeping the patient as mobile as possible

c. offering a diet low in calcium

d. all of the above.

d

When managing a closed urinary drainage system the nurse needs to remember not to?

a. allow the drainage bag to touch the floor

b. disconnect the bag

c. raise the drainage bag above the level of the patients bladder.

d. do any of the above.

d

A woman is taught to catheterize herself by inserting a catheter into the urethra.

a. 0.5 to 1 inch

b. 2 inches

c. 3 inches

d. 5 inches

c

A major clinical manifestation of renal stones is?

a. dysuria

b. hematuria

c. infection

d. pain

d

Patients with urolithiasis need to be encouraged to?

a. increase there fluid intake so that they can excrete 2500ml to 4000 ml every day which will help prevent additional stone formation.

b. participates in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthen to help propel calculi.

c. supplement their diet with calcium need to replace losses to renal calculi

d. limit their voiding to every 6 to 8 hrs so that increse volume can increase hydrostatic pressure which will help push stone along the urinary system.

a

A patient being prescribed a diet moderately reduced in calcium and phosphorus should be taught to avoid?

a. citrus fruits

b. milk

c. pasta

d. whole grain breads

d

the predominate cause of bladder cancer is?

a. chronic renal failure

b. cigarette smoking

c. environmental pollution

d. metastasis from another primary site.

b

The most common symptom of cancer of the bladder is?

Visible, painless hematuria

The most effective intravesical agent for transurethral resection or fulguration for bladder cancer is?

a. bacille calmette - guerin (BCG)
rubicin

b. ethoglucid

c. thoitepa

d. doxo

a

There are three natural defense to bacterial invation of the urinary tract __________ (protein) ____________ (immunoglobulin, and _______________________ which interferes with the adherence of Escherichia coli

Glycosaminoglycan (GAG); urinary immunoglobulin (IgA); normal bacteria flora of the vagina and urethral area.

Three organisms most frequently found in UTI's are __________, ___________, and ______________

Escherichia coli, pseudomonas, and enterococcus