End-stage renal disease is signified by a GFR of:

less than 15

Diuretic therapy is used in Stage IV kidney failures to stimulate kidney function.

false

The major acid/base disturbance in renal failure is:

metabolic acidosis

Dietary management of a patient with CKD includes:

Low potassium, low sodium, and low phosphate diet.

Which of the following is true regarding a complicated urinary tract infection?

Can be caused by a structural urinary tract disorder

Which of the following is a risk factor for the development of a urinary tract 

infection (UTI)?

pregnancy

A symptom of a lower urinary tract infection includes:

urgency

Women are at a higher risk for the development of a UTI because of having a 

shorter urethra.

true

Which of the following can help to prevent a UTI?

increase water consumption

Risk factors for a UTI

pregnancy

sexually active

post-menopause

estrogen-deficiency

women (shorter urethra)

catheterization

An upper UTI is less common in men due to the longer urethra and ureter 

structures that make it more difficult for bacteria to reach the kidney.

true

complicated UTI

-A UTI that extends beyond the bladder

-Caused by structural or functional urinary tract abnormalities or untreated UTI

-Infants and older adults affected

-Associated with:indwelling cathetersrenal calculiDiabetesPregnancy

uncomplicated UTI

-Occurs in the normal urinary tract

-Responds well to a short course of antibiotic therapy

-Simple cystitis in non-pregnant women without any urologic abnormalities

Most common cause of UTI bacteria

E coli

Uncomplicated UTI

Protein +/_

Leukocyte Esterase +

Nitrites +/_

RBCs +/_

WBCs +/> 5000/hpf

Casts - None

Complicated UTI

Protein +/_

Leukocyte Esterase +

Nitrites +/_

RBCs +

WBCs +/> 100,000/hpf

Casts +

NP education

-Drink more water.

-Although there are differences of opinions, cranberry juice and vitamin C can help 

to acidify the urine.

-Urinate before and after sexual intercourse to remove bacteria from the urethral 

area.-

Encourage the female to avoid holding urine for extended periods of time

-Avoid the use of hygiene sprays and spermicides because they alter the normal 

microbial flora to enhance the risk for infection.

-Encourage the female to wipe from the front to the back after a bowel movement 

to avoid spreading bacteria to the urethra

-Encourages showers rather than bathing to avoid the spread of bacteria.

A 25 year- old female presents to the primary care office with urinary burning and 

frequency for the last 3 days. She denies any fever, chills, back pain. Her 

gynecological history is negative and reports no vaginal discharge. The only new 

information reported is that she recently had sexual intercourse with a new male 

partner.

The NP obtains a urinalysis and determines that the urine contains leukocytes, 

RBCs, nitrites, and WBCs. No casts are identified. Based on symptom presentation 

and UA results, the patient can be diagnosed with:

cystitis

J.S. is an 80 -year-old patient who resides in a local nursing home. He recently 

became confused and then fell while ambulating to the bathroom three days ago. 

Because of his confusion and fall, he was transferred to the acute care facility for 

evaluation and treatment. Lab work revealed that the patient was very dehydrated 

with hypernatremia identified and appropriate intravenous fluids started. Cystitis 

was also identified from the urinalysis. He was also noted to have red and 

excoriated skin between the buttocks and inner thighs due to urinary frequency and 

dribbling. To help with skin healing and to prevent further urine leakage, an

indwelling catheter was inserted. Two days after the catheter was placed, the 

patient spiked a fever of 102 degrees Fahrenheit associated with shaking chills. An 

intense, foul odor was noted in the urine. On examination of the flank area, the 

patient yelled out when touched. A urine culture was obtained and came back 

positive for nitrites and RBCs. Urine microscopy revealed >100,000 WBC/hpf and 

casts.

Based on the information provided in the case, the patient can most likely be 

diagnosed with:

pyelonephritis

Identify the major risk factor J.S. has that is associated with pyelonephritis:

indwelling foley catheter

The urinalysis of a patient with a complicated UTI will show WBCs and casts

true