NURS 651 EXAM 3 MARYVILLE UNIVERSITY LATEST 2023-2024 ACTUAL EXAM 150 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES |ALREADY GRADED A+

NURS 651 EXAM 3 MARYVILLE UNIVERSITY LATEST 2023-

2024 ACTUAL EXAM 150 QUESTIONS AND CORRECT

DETAILED ANSWERS WITH RATIONALES |ALREADY

GRADED A+

UTI symptom cluster - ANSWER- Newborn- irritability, poor feeding,

diarrhea, fever, vomiting. jaundice, hypothermia, cyanosis, lethargy

Infants//todlers/preschool: diarrhea, vomiting, fever, poor feeding,

strong urine odor, irritability, poor weight gain, diaper rash

Schoolage/adolescents; fever, vomiting, strong urine odor, urethral pain

or suprapubic, dysuria, incontinence.

UTI differential diagnosis - ANSWER- Chemical irritation (bubble bath)

vulvovaginitis

dysfunctional voiding

acute abdomen ( appe, STD)

Foreign body

Sexual abuse

Dysfunctional voiding related to constipation

UTI specimen collection - ANSWER- Clean catch urine midstream

(bagged specimen don't do it)

Straight Cath for mod to severe symptoms

Suprapubic aspiration: only when culture is urgently needed. ( + is >

1000 colonies)

_blood culture obtained for <12months>

Indications for radiology in UTI - ANSWER- -Symptoms of

pyelonephritis regardless of age and gender

-UTI in child <3>

-males with first infection and females with second infection. even if not

pyelonephritis and child > 3 months of age.

UTI treatment - ANSWER- -IV ABX- newborns, infants, or older

children with vomiting, severe symptoms systemic illness or unable to

take fluids

-ORAL- 10 day regimen, or 14 days with completed infection.

UTI drugs - ANSWER- 1. Bactrim ( infants >2 months) TMP 8-

10mg/kg.BID Recommended until sensitivities are back since most UTI

are caused by E. coli.

2. Amoxicillin 30-40 mg/kg/day TID <3months>

3. Augmentin 40mg/kg/day TID

4. Sulfisoxazole 150mg/kg/day QID

5. Cephalexin 50mg/kg/day TID

6. Nitrofurantin 5-7mg/kg/day in divided doses

(ideal treatment for UTI due to highly concentrated in the urine, but less

effective for systemic/renal infections as it does not concentrate well in

blood)

UTI: Defintion - ANSWER- Includes bladder, (cystitis) urethera

(urethritis) and kidney (pyelonephritis)

Signs and symptoms of UTI - ANSWER- -Fever may be only sign

infants a & young child

-Older children=urinary symptoms ( new onset incontinence, dysuria,

frequency, abdominal pain

Risk factors of UTI - ANSWER- FEMALE, Uncircumcised male,

GENETICS, (Anatomy), BOWEL/BLADDER Dysfunction,

Obstruction, Catheterization, SEX, Reflux

Exam for UTI - ANSWER- Temp, BP, abd exam for mass, tenderness.

suprapubic or costovertebral tenderness, check external genitalia, eval

lower back for signs of occult myelomeningiocele, check other sources

for fever.

UTI testing - ANSWER- -clean catch, cath, suprapubic UA

*dipstick, urine culture.

-+ leukocyte esterase=pyuria

-+nitrate=bacteria

*C/S

-+100,000 colonies for dx; may treat 50,000 or greater

UTI cal app to estimate probability of UTI (ages 2 -23 months)

Indications for urine sample - ANSWER- Girls:

2-11 months of age temp > 100.4 (non-black)

2-11 months of age temp of 102.2 OR the,p 100.4 and no other fever

source identified.

12-24 months of age temp 102.2 (non black)

12-24 months of age 102.2 and no other source of fever identified.

>24 months One or more of the following: dysuria, frequency, new

onset incontinence, back pain, abdominal pain, fever of 102.2 and no

other acute cause.

Infant UTI - ANSWER- non specific symptoms or asymptomatic

Follow up Urine cultures - ANSWER- -2nd culture at 72 hours after

initiating treatment if symptoms are not rsolving

-culture 1 week after completion of treatment when test of cure is

indicated.

Tanner staging female pubic hair - ANSWER- 1. No pubic hair

(preadolescent)

2. little pigment straight hair,

3. Pigmented, straight medial border of labia sparse

4. pigment, curly, abundant but less than adult

5. lateral spread of hair, triangle

6. only occurs in 10% of women