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44 Cards in this Set

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What is the name of an upper uti:

Name of lower UTI is?
pyelonephritis
cystitis
urethritis
prostatitis
Urinary antiseptics/antiinfectives have _______- effect when given in lower dasages.
bacteriostatic
Urinary antiseptics/antiinfectives have ___________ effect when given in higher dosages.
bacteriacidal (think suicidal)
What is acute cystitis commonly caused by:
Escherichia coli, saprophyticus and gram-negative Klebsiella, Porteus and Pseudomonas.
Symptoms of cystitis:
pain, burning on urination and urinary frequency and urgency.
Which bacteria most commonly causes Pyelonephritis.
E Coli
Symptoms of Pyelonephritis
chills, high fever, flank pain, pain during urination, urinary frequency and urgency and pyuria
What is the typical bacterial count in pyelonephritis
100,000 bacteria/ml.
What antibiotics might the pt receive to tx pyelonephritis in severe cases when pt has actually been hospitalized and receives thru IV
amnioglycoside, ticarcillin/clavulanic acid or piperacillin/tazobactam.
Drugs to tx UTI's
nitrofurantoin
Bactrim
Amoxillin
Cephalosporins
What are the groups of urinary antiseptics/antiinfectives
Nitrofuranoin
Methenamine
Trimethoprim
Fluoroquinolones
Nitrofurantoin (bacteriostatic and bactericida)
Effective against which bacteria
gram - and gram + (especially e-coli). Used to tx acute and chronic UTIs. Absorbion is decreased with antacids.
When is peak action with Nitrofurantoin
30 minutes post absorbtion.
Methenamine (Hiprex, Mandelamine) produces a bacteriocidal effect when the urinary ph is < what?
5.5
Methenamine is used for which kind of UTI
chronic
Do not take Methenamine with what?
sulfonamides
Trimethoprin can be used in conjunction with what to tx UTIs?
sulfanamide
What is the half-life of Trimethoprin
9 to 11 hours. Although longer in pts with renal disease.
What is the half-life of Fluoroquinolones
2-4 hours (but prolonged in pts with renal dysfunction).
What are the side effects of Nitrofurantoin (urinary antiseptic)
GI disturbances such as anorexia, nausea, vomiting, diarrhea, ab. pain and pulmonary reactions such as dyspnea, chest pain, fever and cough.
Methenamine side effects:
GI including nausea, vomiting, diarrhea. Some allergic reactions to the dye in Hiprex. Bladder irritation and crystalluria (when taken in large doses may occur).
Trimethoprim side effects:
GI symptoms including nausea and vomiting, and skin problems such as rash and pruritus.
Fluoroquinolones side-effects:
headaches, dizziness, syncope (fainting), peripheral neuritis, visual disturbances and rash. Nausea, vomiting and diarrhea, headaches and visual disturbances can occur with cinoxacin and norfloxacin use. Photosensitivity.
(drug to drug interation) Which med decreases nitrofurantoin absorption
Antacids
(drug to drug interation)
What inhibits the action of Methenamine.
Sodium bicarbonate
If a pt takes methenamine with sulfonamides what might they increase the risk of
crystalluria
Nalidixic acid enhances the effects of which anticoagulant
Warfarin
What type of drug is Phenazopyridine
Urinary analgesic
What does Phenazopyridine tx
(urinary analgesic)
used to relieve pain, burning sensation and the frequency and urgency of urination that are symptomatic of lower UTIs.
Side effects of Phenazopyrindine (urinary alalgesic)
GI disturbances, hemolytic anemia, nephrotoxicity and hepatotoxicity. Urine becomes reddish/orange. Glucose levels need to be monitored because Phenazopyridine can alter the glucose urine test.
What is a parasympathomimetic
Drug used to stimulate micturition.
Which parasympathomimetic drug is the drug of choice to stimulate micturiation
Bethanechol chloride (Urecholine) also known as direct-acting parasympathomimetic.
How does the parasympathomimetic drug Bethanechol chloride stimulate micturiation
By increasing tone of the detrusor urinal muscle, which produces a contraction strong enough to stimulate urination.
If a UT spasms are the result of infection or injury, which class of drug can help
antispasmodics which have a direct action on the smooth muscles of the urinary tract.
When are antispasmodics contraindicated
if Gi obstruction is present or if the client has glaucoma.
antispasmodics aka: dimethyl sulfoxide (aka DMSO), oxybutynin and flavoate is contraindicated with pts suffering from
glaucoma and GI obstruction.
antispasmodics/antimuscarinicsside effects are
dry mouth
increased HR
dizziness
intestinal distention
constipation
What other info. should the health care provide obtain from the client?
Firstly, this drug is an antibacterial agent. Increased fluids highly recommended to prevent crystallization in the urine.
Nurse: check renal func. by checking urinary output should be >600ml/d, bun (8-25 mg/dl), creatinine (0.5 - 1.5 mg/d)
If she has renal dysfunction she couldn't take sulfanomides.
Oral antidiabetic drugs can increase likelyhood of hypoglycemic effect.
Obtain CBC.
WHAT ELSE SHOULD THE HC PROVIDER DISCUSS WITH CLIENT IN REGARD TO TAKING THIS DRUG
Side effects are anorexia, nausea, vomiting and diarrhea, stomatitis, crystalluria and photosensitivity.
Tell client to take drug with full glas of water. Urine output shoiuld be at least 1200 ml/d to decrease risk of crystallluria.
Tell client not to take antacids because antacids decrease the absorbtion rate.
WHAT PREVENTATIVE MEASURES SHOULD BE TAKEN TO PREVENT FURTHER EPISODES OF UTIs
xx
xx
xx
WHAT IS THE RECOMMENDED FOLLOW UP CARE FOR F.I.
Instruct client to report bruising or bleeding that could be a result of a drug-induced blood disorder. Advise client to have blood cell count monitored on a regular basis.
Avoid direct sunlight and wear sunblock due to photosensitivity.
xx
xx
R.M. TAKES COUMADIN 7.5 MG PER DAY. WHAT EFFECT DOES CO-TRIMOXAZOLE HAVE ON WARFARIN AND WHAT IS THE NURSING RESPONSIBILITY.
It increases the anticoagulant effect. Meaning that the blood could get really thin. The nurse needs to obtain a full list of current drugs to find out if on Warfarin in particular.