A nurse educator is providing an in-service to nursing staff about urinary tract infections (UTP). Which statements made by the staff validate they understand the etiology and pathophysiology of UTIs? Select all that apply.
"UTI’s can be caused by urethrovesical reflux which is the backward flow of urine from the urethra to the bladder after coughing, sneezing or straining"
"UTI’s are more common in women due to their longer urethras"
Glycosaminoglycan (GAG) is a protein in the urinary tract that exerts a nonadherent protective effect against various bacteria"
The organism most often responsible for UTI's in older adults is staphylococcus."
The normal urinary tract is sterile above the urethra."
Correct Answer : A,B,C,E
A. "UTI’s can be caused by urethrovesical reflux which is the backward flow of urine from the urethra to the bladder after coughing, sneezing, or straining":
This statement is correct. Urethrovesical reflux can contribute to UTIs, especially in women, as it can introduce bacteria from the urethra back into the bladder.
B. "UTI’s are more common in women due to their longer urethras":
This statement is correct. Women have shorter urethras than men, which makes it easier for bacteria to travel into the bladder, increasing the risk of UTIs.
C. "Glycosaminoglycan (GAG) is a protein in the urinary tract that exerts a nonadherent protective effect against various bacteria":
This statement is correct. Glycosaminoglycan is a substance that lines the urinary tract and helps prevent bacterial adherence, thereby protecting against UTIs.
D. "The organism most often responsible for UTI's in older adults is staphylococcus":
This statement is incorrect. The most common bacteria responsible for UTIs are Escherichia coli (E. coli), not staphylococcus.
E. "The normal urinary tract is sterile above the urethra":
This statement is correct. Normally, the urinary tract above the urethra is sterile, devoid of bacteria. UTIs occur when bacteria enter and multiply in the urinary system, leading to infection.
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Related Questions
Correct Answer is D
Explanation
A. McBurney's point on the abdomen: McBurney's point is a location in the right lower quadrant of the abdomen that is significant in the assessment for appendicitis. It is not relevant to the assessment of pyelonephritis, which is a kidney infection.
B. Psoas sign at the knee: The psoas sign is a test for appendicitis, not pyelonephritis. It involves the patient lying on their back and lifting their right leg against resistance. If this movement causes pain in the lower right abdomen, it could indicate irritation of the psoas muscle due to an inflamed appendix.
C. Rovsing's Sign on the abdomen: Rovsing's sign is also a test for appendicitis. It involves palpating the left lower quadrant of the abdomen and observing if it causes pain in the right lower quadrant. The presence of pain in the right lower quadrant during palpation of the left lower quadrant can indicate appendicitis. This sign is not specific to pyelonephritis.
D. Costovertebral angle (CVA) on the back: The CVA is located on the back at the angle formed by the 12th rib and the spine. Percussion of the CVA is a common technique used to assess for kidney tenderness. In the case of acute pyelonephritis, infection and inflammation of the kidneys can cause tenderness and pain in the CVA area. Therefore, this area is assessed for pain related to kidney infections like pyelonephritis.
Correct Answer is C
Explanation
A. Manage bladder irrigation following the procedure. - Bladder irrigation is not typically performed after ESWL. It may be used in other urological procedures, but it is not a standard post-procedural care for ESWL.
B. Administer a bolus of 750 mL normal saline following the procedure. - While maintaining hydration is important, there is no specific requirement for a bolus of normal saline after ESWL. Hydration is usually encouraged, but the amount and method of administration are determined based on the client's overall fluid status and medical condition.
C. Strain the client's urine following the procedure.
After extracorporeal shock wave lithotripsy (ESWL), it is essential to strain the client's urine to collect any stone fragments. Straining allows healthcare providers to analyze the composition of the stones, ensuring that all fragments have been passed. This information helps in assessing the effectiveness of the procedure and guides further management.
D. Insert a urinary catheter for 24 to 48 hours after the procedure. - Inserting a urinary catheter is not a routine post-procedural measure after ESWL. Catheterization might be necessary in certain situations or for specific medical reasons, but it is not a standard practice after ESWL for all clients.
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