Renal -UTI

Acute Kidney Injury (AKI)

A sudden decrease in kidney function, often reversible; characterized by increased BUN and creatinine.

Chronic Kidney Disease (CKD)

Irreversible, progressive loss of kidney function, classified by stages based on eGFR.

Pyelonephritis

An infection of the kidney that may lead to severe complications if untreated.

Renal Calculi (Kidney Stones)

Hard accumulations of minerals and salts in the urinary tract that can cause pain and hematuria.

Fluid and Electrolyte Imbalance in CKD

Impaired kidney function leads to fluid overload, electrolyte imbalances, and uremic symptoms.

Which symptoms would the nurse expect to assess in a client diagnosed with Acute Uncomplicated Pyelonephritis? (Select All That Apply)

• A. Flank pain

• B. High fever

• C. Suprapubic pressure only

• D. Nausea and vomiting

• E. Chills

A, B, D, E. Acute pyelonephritis is an upper UTI that presents with systemic symptoms like fever and chills, along with localized flank pain.

The nurse is educating a community group about risk factors for developing a Urinary Tract Infection (UTI). Which factors should be included? (Select All That Apply)

• A. Female anatomy

• B. Persistent sexual intercourse

• C. Recent urinary catheterization

• D. High fluid intake

• E. Poor perineal hygiene

A, B, C, E. High fluid intake is generally a preventive measure, whereas the others are known risk factors for bacterial ascent.

Which of the following are contraindications or cautions for the administration of Trimethoprim/Sulfamethoxazole (TMP/SMX)? (Select All That Apply)

• A. Pregnancy

• B. Sulfa allergy

• C. History of Hypertension

• D. Currently breastfeeding

• E. Known hypersensitivity to sulfonamides

A, B, D, E. TMP/SMX is avoided in pregnancy/breastfeeding and is strictly contraindicated for anyone with a sulfa-related allergy.

A client is diagnosed with acute uncomplicated cystitis. Which clinical manifestations should the nurse expect to find? (Select All That Apply)

• A. Dysuria

• B. Urinary urgency

• C. High fever and chills

• D. Suprapubic discomfort

• E. Hematuria

A, B, D, E. Lower UTIs (cystitis) typically lack the systemic involvement of high fever and chills, which are indicative of pyelonephritis.

A client is prescribed Phenazopyridine (Pyridium) for symptomatic relief of a UTI. Which statement by the client indicates an understanding of the medication's effects?

• A. 'This medication will kill the bacteria causing my infection.'

• B. 'My urine might turn a bright orange or red color.'

• C. 'I should take this on an empty stomach for the best absorption.'

• D. 'I should stop taking my antibiotics once this makes me feel better.'

B. Phenazopyridine is a urinary analgesic that changes urine color; it provides relief for dysuria but does not treat the actual infection.

The nurse reviews a client's urinalysis results. Which finding most strongly supports a diagnosis of a UTI?

• A. Presence of glucose

• B. Absence of ketones

• C. Positive leukocyte esterase and nitrites

• D. Specific gravity of 1.025

C. Leukocyte esterase and nitrites are key markers for inflammation and the presence of nitrate-reducing bacteria like E. coli in the urine.

According to the pathophysiology of UTIs, which factors facilitate the ascent of bacteria from the perineum to the bladder? (Select All That Apply)

• A. Short female urethra

• B. Neutral pH environment of the bladder

• C. Use of spermicides

• D. Frequent voiding

• E. Turbulent urine flow

A, B, C. A short urethra and neutral pH environment favor bacterial survival and entry. Spermicides can alter normal flora. Frequent voiding actually helps flush bacteria out.

Which characteristics define a Complicated Urinary Tract Infection? (Select All That Apply)

• A. Presence of diabetes mellitus
• B. Pregnancy
• C. Structural abnormalities in the urinary tract
• D. Occurs in a healthy, non-pregnant female
• E. Presence of an indwelling catheter

A, B, C, E. Complicated UTIs occur in individuals with comorbidities, physiological changes like pregnancy, or structural/functional issues.

A 72-year-old client is admitted with confusion and a low-grade fever but no complaints of dysuria. What should the nurse suspect?

• A. Early-onset Alzheimer's disease
• B. Dehydration
• C. Urinary Tract Infection
• D. Normal age-related changes

C. Older adults often present with non-classic symptoms like confusion (delirium) or lethargy rather than the typical dysuria and frequency seen in younger patients.

A nurse is providing discharge teaching for a female client to prevent recurrent UTIs. Which instructions should be included? (Select All That Apply)

• A. Wipe from front to back after voiding
• B. Drink at least 2 to 3 liters of fluid daily
• C. Empty the bladder before and after sexual intercourse
• D. Wear tight-fitting synthetic underwear
• E. Avoid bubble baths and scented perineal products

A, B, C, E. Proper hygiene and fluid intake are essential; tight synthetic underwear should be avoided in favor of cotton to reduce moisture.

How is a 'Recurrent UTI' clinically defined?

• A. One infection every year
• B. Two or more infections within 6 months or three or more within 1 year
• C. An infection that never clears despite antibiotics
• D. Any infection occurring within 2 weeks of the first

B. Recurrent UTIs are specifically defined by the frequency of recurrence within a distinct timeframe (2 in 6 months or 3 in 1 year).

Which of the following is an example of a Health Care-Associated Infection (HAI) involving the urinary tract?

• A. Acute Uncomplicated Cystitis
• B. Community-acquired Pyelonephritis
• C. Catheter-Associated Urinary Tract Infection (CAUTI)
• D. Pediatric reflux-associated UTI

C. CAUTIs are a primary type of healthcare-associated infection resulting from instrumentation of the urinary tract during medical care.

A client presents with involuntary leakage of urine while coughing or laughing. Which type of incontinence is this?

• A. Urge incontinence
• B. Stress incontinence
• C. Overflow incontinence
• D. Functional incontinence

B. Stress incontinence occurs when increased abdominal pressure (coughing, laughing, lifting) overcomes the sphincter mechanism.

Urge incontinence is primarily characterized by which of the following?

• A. Constant dribbling of urine
• B. Inability to reach the toilet due to physical disability
• C. A sudden, strong desire to void followed by involuntary leakage
• D. Leakage only during heavy lifting

C. Urge incontinence results from an overactive bladder muscle that causes an intense and sudden need to urinate.

Which findings are associated with the 'DIAPPERS' mnemonic for reversible causes of urinary incontinence? (Select All That Apply)

• A. Delirium
• B. Inflammation/Infection
• C. Pharmaceuticals
• D. Excess urine output
• E. Diabetes Insipidus

A, B, C, D. DIAPPERS stands for Delirium, Infection, Atrophic changes, Pharmaceuticals, Psychological issues, Excess urine, Restricted mobility, and Stool impaction.

A client with Benign Prostatic Hyperplasia (BPH) reports difficulty starting his urine stream and a weak flow. Which symptoms are common in BPH? (Select All That Apply)

• A. Nocturia
• B. Intermittency
• C. Hematuria
• D. Post-void dribbling
• E. Urinary retention

A, B, D, E. BPH causes obstructive and irritative symptoms due to prostate enlargement pressing on the urethra.

A client is prescribed Tamsulosin (Flomax) for BPH. What is the primary mechanism of action for this drug?

• A. It shrinks the size of the prostate gland
• B. It relaxes smooth muscle in the bladder neck and prostate
• C. It increases the production of testosterone
• D. It acts as a powerful diuretic

B. Tamsulosin is an alpha-blocker that relaxes the smooth muscles to improve urine flow; it does not shrink the prostate.

The nurse is preparing to administer Finasteride (Proscar) to a client with BPH. Which information is correct regarding this medication?

• A. It provides immediate relief of symptoms
• B. It should not be handled by pregnant women
• C. It is used to treat acute urinary retention
• D. It is a calcium channel blocker

B. Finasteride is a 5-alpha reductase inhibitor that can be absorbed through the skin and is hazardous to male fetuses; it also takes months to be effective.

Which diagnostic tests are appropriate for evaluating a client with urinary incontinence? (Select All That Apply)

• A. Bladder scan for post-void residual
• B. Urinalysis to rule out infection
• C. Urodynamic testing
• D. Stress test (cough test)
• E. Bone density scan

A, B, C, D. These tests assess bladder capacity, emptying, and the presence of underlying infection or structural triggers.

A client is found to have a sudden increase in serum creatinine and BUN levels, which the health care provider labels as Acute Kidney Injury (AKI). Which statement about AKI is true?

• A. It is always a permanent condition
• B. It is characterized by an eGFR of less than 15 for several years
• C. It is a sudden decrease in kidney function that is often reversible
• D. It is usually caused by eating too much protein

C. AKI is an abrupt decline in renal function. Unlike CKD, AKI has the potential for full or partial recovery depending on the cause.

Chronic Kidney Disease (CKD) is staged based on which clinical marker?

• A. Blood pressure readings
• B. Estimated Glomerular Filtration Rate (eGFR)
• C. Total daily urine volume
• D. Patient's weight

B. CKD is classified into stages 1 through 5 based on the eGFR, which measures how well the kidneys filter waste.

Which electrolyte imbalances are commonly observed in clients with advanced Chronic Kidney Disease? (Select All That Apply)

• A. Hyperkalemia
• B. Hypophosphatemia
• C. Hypermagnesemia
• D. Hypocalcemia
• E. Hypernatremia

A, C, D. In CKD, the kidneys fail to excrete potassium and magnesium, and phosphate levels rise (leading to low calcium).

A nurse is teaching a client with CKD about dietary restrictions. Which should be limited? (Select All That Apply)

• A. Sodium
• B. Potassium
• C. Phosphorus
• D. Complex carbohydrates
• E. Fluids (if restricted)

A, B, C, E. Limiting these helps prevent fluid overload, heart arrhythmias, and bone disease common in renal failure.

A client presents with sudden, severe, colicky flank pain that radiates to the groin, accompanied by nausea. What does the nurse suspect?

• A. Acute Cystitis
• B. Renal Calculi (Kidney Stones)
• C. Chronic Kidney Disease
• D. Stress Incontinence

B. Renal calculi typically cause 'renal colic,' which is sharp, severe pain that radiates as the stone moves through the ureter.

Which nursing interventions are appropriate for a client with urinary retention? (Select All That Apply)

• A. Use of a bladder scanner to assess volume
• B. Encouraging 'double voiding'
• C. Implementing a fluid restriction of 500 mL per day
• D. Administering prescribed alpha-blockers
• E. Intermittent catheterization if indicated

A, B, D, E. Fluid restriction is usually not the primary treatment for retention; instead, methods to facilitate bladder emptying are used.

What is the primary difference between Acute Uncomplicated Cystitis and Asymptomatic Bacteriuria?

Cystitis involves clinical symptoms (urgency, dysuria), whereas Asymptomatic Bacteriuria is the presence of bacteria without any symptoms.

A patient with CKD exhibits symptoms of 'Uremia.' Which findings are consistent with this condition? (Select All That Apply)

• A. Fatigue and lethargy
• B. Itching (Pruritus)
• C. Metallic taste in the mouth
• D. Increased appetite
• E. Nausea/Vomiting

A, B, C, E. Uremia is a syndrome where waste products build up in the blood, affecting almost every system in the body.

Which diagnostic finding in a urinalysis would be most indicative of an upper UTI (Pyelonephritis) rather than a lower UTI?

• A. Nitrites
• B. White blood cell (WBC) casts
• C. Hematuria
• D. High specific gravity

B. WBC casts are formed in the renal tubules and are a classic hallmark of pyelonephritis (kidney infection).

What is the primary goal of nursing management for a client with Chronic Kidney Disease?

• A. To reverse the damage to the nephrons
• B. To slow the progression of the disease and manage complications
• C. To increase protein intake to 2.0 g/kg
• D. To prevent the patient from ever needing dialysis

B. CKD is irreversible and progressive; nursing care focuses on monitoring, slowing damage, and managing fluid/electrolyte balances.

Which interventions help manage Urge Incontinence? (Select All That Apply)

• A. Bladder retraining (scheduled voiding)
• B. Pelvic floor muscle exercises (Kegels)
• C. Reducing caffeine and alcohol intake
• D. Increasing caffeine to stimulate the bladder
• E. Anticholinergic medications as prescribed

A, B, C, E. Caffeine and alcohol are bladder irritants that worsen urgency. Training and exercises help strengthen control and capacity.

A client has an indwelling urinary catheter. Which nursing action is most effective in preventing a CAUTI?

• A. Cleaning the meatus with antiseptic every hour
• B. Keeping the drainage bag above the level of the bladder
• C. Maintaining a closed drainage system and removing the catheter as soon as possible
• D. Giving prophylactic antibiotics to all catheterized clients

C. Maintaining a closed system and early removal are the gold standards for preventing catheter-associated infections.

What does a positive 'Leukocyte Esterase' test on a urine dipstick signify?

• A. The presence of glucose in the urine
• B. The presence of white blood cells, indicating inflammation or infection
• C. The breakdown of red blood cells
• D. The presence of kidney stones

B. Leukocyte esterase is an enzyme produced by neutrophils, signifying pyuria (white cells in urine) and suggesting a UTI.

A client with Overflow Incontinence is likely to experience which of the following? (Select All That Apply)

• A. Frequent dribbling of urine
• B. Bladder distention
• C. High post-void residual (PVR) volumes
• D. Sudden large volume loss while running
• E. Feeling of incomplete emptying

A, B, C, E. Overflow incontinence is caused by an overfull bladder that cannot empty, leading to distention and constant leakage.

Why is 'Neutral pH' mentioned in the pathophysiology of UTIs?

• A. Acidic urine helps bacteria grow faster
• B. Bacteria such as E. coli thrive in neutral environments and are inhibited by acidic urine
• C. Neutral pH prevents the formation of kidney stones
• D. It makes the urine appear clear

B. Normal urine is slightly acidic, which is a defense mechanism. A neutral or alkaline pH provides a more hospitable environment for bacterial growth.

A nurse is assessing a client for BPH. Which diagnostic result would support the diagnosis of urinary obstruction related to BPH?

• A. Decreased Serum Creatinine
• B. High urinary flow rate
• C. Enlarged prostate on digital rectal exam (DRE)
• D. Low Prostate-Specific Antigen (PSA) levels

C. A digital rectal exam allows the provider to feel the size and consistency of the prostate; enlargement is a classic sign of BPH.

A nurse is caring for a client with a suspected lower urinary tract infection (UTI). Which microorganism is most frequently identified as the causative agent in uncomplicated UTIs?

A) Staphylococcus saprophyticus
B) Uropathogenic E. : coli (UPEC)
C) Proteus mirabilis
D) Klebsiella pneumoniae

The correct answer is B) Uropathogenic E. : coli (UPEC). This gram-negative bacterium is responsible for approximately 80-85\% of community-acquired UTIs. It originates from the gastrointestinal flora and migrates to the urinary tract, utilizing specialized fimbriae to adhere to the bladder wall and resist being flushed out during urination.

Which of the following client factors would lead a nurse to classify a urinary tract infection as 'Complicated' rather than 'Uncomplicated'? (Select All That Apply)

1. Pregnancy: High levels of progesterone cause ureteral dilation and stone-like stagnation, increasing the risk of upper tract involvement.

2. Diabetes Mellitus: Chronic hyperglycemia leads to glycosuria, which serves as a nutrient medium for bacteria and impairs neutrophil function.

3. Renal Calculi (Kidney Stones): These cause mechanical obstruction and provide a location where bacteria can evade antibiotics.

4. Male Gender: Due to the protective length of the male urethra and prostate, any infection is considered complex until proven otherwise.

5. Indwelling Catheterization: The presence of foreign material allows for the formation of biofilms and facilitates bacterial entry.

When assessing a client for a lower urinary tract infection (cystitis), which clinical manifestations should the nurse expect to find? (Select All That Apply)

1. Dysuria: A sharp, burning, or painful sensation during the act of voiding.

2. Urinary Frequency: The need to urinate more than every 2 hours despite low volume output.

3. Urinary Urgency: A sudden, compelling, and often painful desire to urinate.

4. Suprapubic Pain: Pressure or discomfort specifically located in the lower abdomen over the bladder area.

5. Pyuria: Cloudy urine caused by the presence of white blood cells (WBCs) and debris.

1. Dysuria: A sharp, burning, or painful sensation during the act of voiding.

2. Urinary Frequency: The need to urinate more than every 2 hours despite low volume output.

3. Urinary Urgency: A sudden, compelling, and often painful desire to urinate.

4. Suprapubic Pain: Pressure or discomfort specifically located in the lower abdomen over the bladder area.

5. Pyuria: Cloudy urine caused by the presence of white blood cells (WBCs) and debris.

How should the nurse best define the clinical term 'Dysuria' to a patient who says they feel 'stinging' during urination?

A) Difficulty initiating the urinary stream
B) Pain or discomfort occurring during the act of urination
C) The involuntary loss of urine during coughing
D) Excessive urination during the nighttime hours

The correct answer is B) Pain or discomfort occurring during the act of urination. Dysuria is a hallmark symptom of bladder neck or urethral irritation. It is typically a localized inflammatory response to infection, trauma, or chemical irritants (like soaps or spermicides) affecting the inner lining of the lower urinary tract.

A nurse is assessing a client with Benign Prostatic Hyperplasia (BPH) who presents with constant dribbling and a feeling of fullness. Which findings are characteristic of 'Overflow Incontinence'? (Select All That Apply)

1. Bladdr distention

2. Constant dribbling

3. High post-void residual

4. Weak urinary stream

1. Bladder Distention: The bladder becomes palpably enlarged because it cannot be completely emptied.

2. Constant Dribbling: Small amounts of urine leak out once the intravesical pressure exceeds the sphincter's closing pressure.

3. High Post-Void Residual (PVR): A bladder scanner indicates a volume remaining in the bladder after voiding, typically > 100-200 : mL.

4. Weak Urinary Stream: The flow of urine is diminished in force and caliber due to urethral compression.

What is the primary pathophysiological mechanism that leads to urinary retention in a male client with Benign Prostatic Hyperplasia (BPH)?

A) Immune-mediated damage to the renal parenchyma
B) Inflammation of the kidneys leading to decreased glomerular filtration
C) Mechanical compression of the prostatic urethra by the enlarged gland
D) Overactivity of the detrusor muscle causing bladder spasms

The correct answer is C) Mechanical compression of the prostatic urethra by the enlarged gland. In BPH, the noncancerous hyperplasia of the transition zone of the prostate narrows the urethral lumen. This raises resistance to urine outflow, requiring the bladder to generate higher pressures and eventually leading to incomplete emptying and urinary stasis.

Which of the following are considered 'irritative' or 'obstructive' symptoms associated with Benign Prostatic Hyperplasia (BPH)? (Select All That Apply)

1. Nocturia

2. Urinary hesitancy

3. Intermittency

4. Straining

5. Incomplete emptying

1. Nocturia: Waking at night to void due to incomplete emptying and increased bladder sensitivity.

2. Urinary Hesitancy: Difficulty or delay in initiating the urinary stream.

3. Intermittency: The urinary stream starts and stops involuntarily during the act of voiding.

4. Straining: The need to utilize abdominal muscles to force urine out past the obstruction.

5. Incomplete Emptying: The sensation that the bladder is not empty immediately after voiding.

A nurse suspects a client's infection has progressed from the bladder to the kidneys (Pyelonephritis). Which systemic findings would support this change? (Select All That Apply)

1. Costovertebral Angle (CVA) Tenderness

2. Fever chills

3. flank pain

4. N/V

5. Leukocytosis(^WBC)

1. Costovertebral Angle (CVA) Tenderness: Pain or sensitivity elicited by percussion over the flank area.

2. Fever and Chills: Systemic inflammatory markers indicating the infection is no longer localized to the lower tract.

3. Flank Pain: Sharp or dull pain located in the side or back between the hip and the ribs.

4. Nausea and Vomiting: Systemic symptoms of illness common in upper urinary tract infections.

5. Leukocytosis: An elevated White Blood Cell (WBC) count in the blood, indicating a systemic response.

An elderly client is brought to the Emergency Department for a sudden onset of delirium. Why should the nurse prioritize a urine culture in this patient population? (Select All That Apply)

1.Atypical Presentation

2. mental status change

3. increase risk for sepsis

4. bladder hypotonicity

5. ALL

1. Atypical Presentation: The elderly often do not present with classic symptoms like frequency or fever.

2. Mental Status Changes: Confusion, agitation, or delirium are frequently the first (and sometimes only) indicators of a UTI in older adults.

3. Increased Risk of Sepsis: Due to decreased immune function, UTIs in the elderly can rapidly progress to life-threatening urosepsis.

4. Bladder Hypotonicity: Age-related changes can lead to incomplete emptying, providing a reservoir for bacterial growth.

A nurse is teaching a female client how to prevent recurrent urinary tract infections. Which instructions should be included in the teaching plan? (Select All That Apply)

1. Wipe from front to back: This prevents the introduction of fecal enteric bacteria (like E. : coli) to the urethral meatus.

2. Increase fluid intake: Drinking approximately 2-3 liters of water daily helps dilute urine and mechanically flushes out bacteria.

3. Void after sexual intercourse: This helps clear any bacteria that may have been pushed into the urethra during activity.

4. Avoid irritants: Bubble baths, scented pads, and harsh soaps can disrupt the normal flora and irritate the urethral opening.

5. Choose cotton underwear: This allows for better airflow and prevents the moisture buildup that encourages bacterial growth.

6. All

1. Wipe from front to back: This prevents the introduction of fecal enteric bacteria (like E. : coli) to the urethral meatus.

2. Increase fluid intake: Drinking approximately 2-3 liters of water daily helps dilute urine and mechanically flushes out bacteria.

3. Void after sexual intercourse: This helps clear any bacteria that may have been pushed into the urethra during activity.

4. Avoid irritants: Bubble baths, scented pads, and harsh soaps can disrupt the normal flora and irritate the urethral opening.

5. Choose cotton underwear: This allows for better airflow and prevents the moisture buildup that encourages bacterial growth.

The nurse is interpreting a urinalysis (UA) for a client with urinary frequency. Which findings are specifically indicative of a UTI? (Select All That Apply)

1. Positive Nitrites: Bacteria such as E. : coli convert nitrates into nitrites; this finding is highly specific for a gram-negative infection.

2. Positive Leukocyte Esterase: This enzyme is released by neutrophils, indicating the presence of white blood cells (pyuria) related to infection.

3. Presence of WBCs (> 5-10/hpf): Confirms an inflammatory white cell response to an irritant or pathogen in the urinary tract.

4. Bacteria on Microscopic Exam: Visual identification of bacteria in the urine sample.

5. All

1. Positive Nitrites: Bacteria such as E. : coli convert nitrates into nitrites; this finding is highly specific for a gram-negative infection.

2. Positive Leukocyte Esterase: This enzyme is released by neutrophils, indicating the presence of white blood cells (pyuria) related to infection.

3. Presence of WBCs (> 5-10/hpf): Confirms an inflammatory white cell response to an irritant or pathogen in the urinary tract.

4. Bacteria on Microscopic Exam: Visual identification of bacteria in the urine sample.

A client is prescribed Phenazopyridine (Pyridium) for symptoms of a UTI. Which educational points are essential for the nurse to cover? (Select All That Apply)

1. Urine Coloration: The medication will turn the urine a bright reddish-orange; this is a normal drug effect.

2. Staining Risk: Orange urine can permanently stain clothing and soft contact lenses.

3. Analgesic Only: It provides local anesthesia to the urinary mucosa but has no antibacterial activity.

4. Short-Term Use: Should only be used for 2 days to prevent masking the worsening of the actual infection.

5. All

1. Urine Coloration: The medication will turn the urine a bright reddish-orange; this is a normal drug effect.

2. Staining Risk: Orange urine can permanently stain clothing and soft contact lenses.

3. Analgesic Only: It provides local anesthesia to the urinary mucosa but has no antibacterial activity.

4. Short-Term Use: Should only be used for 2 days to prevent masking the worsening of the actual infection.

To prevent Catheter-Associated Urinary Tract Infections (CAUTI), which evidence-based nursing interventions must be implemented? (Select All That Apply)

1. Maintain a Closed Drainage System: Do not disconnect the catheter from the tubing to avoid introducing pathogens.

2. Maintain Unobstructed Flow: Keep the drainage bag and tubing free of kinks and below the level of the bladder.

3. Daily Perineal Hygiene: Clean the urethral meatus and the catheter tubing with mild soap and water daily.

4. Secure the Catheter: Use a securement device (stat-lock) to prevent mechanical trauma and movement-induced bacterial entry.

5. Review Need Daily: Encourage removal as soon as the clinical indication for the catheter is resolved.

6. ALL

1. Maintain a Closed Drainage System: Do not disconnect the catheter from the tubing to avoid introducing pathogens.

2. Maintain Unobstructed Flow: Keep the drainage bag and tubing free of kinks and below the level of the bladder.

3. Daily Perineal Hygiene: Clean the urethral meatus and the catheter tubing with mild soap and water daily.

4. Secure the Catheter: Use a securement device (stat-lock) to prevent mechanical trauma and movement-induced bacterial entry.

5. Review Need Daily: Encourage removal as soon as the clinical indication for the catheter is resolved.

A patient with a spinal cord injury has a 'neurogenic bladder' and requires intermittent catheterization. If the bladder is allowed to overfill due to lack of sensation, what type of urinary incontinence occurs?

A) Stress Incontinence
B) Urge Incontinence
C) Overflow Incontinence
D) Functional Incontinence

The correct answer is C) Overflow Incontinence. In a neurogenic bladder, the normal coordination between the detrusor muscle and the sphincter is lost. When the bladder becomes over-extended because it cannot empty on its own, small volumes of urine leak out uncontrollably once the pressure threshold is reached.

Which of the following patients are at a higher physiological risk for developing a Urinary Tract Infection? (Select All That Apply)

1. Post-menopausal women: Decreased estrogen levels lead to vaginal atrophy and a change in the pH, which favors the growth of pathogens over healthy lactobacilli.

2. Clients with Neurogenic Bladder: Poor emptying results in urinary stasis, providing a stagnant pool for bacterial colonization.

3. Males with BPH: Prostatic enlargement causes obstruction and incomplete voiding.

4. Females (General): The female urethra is significantly shorter (3-4 : cm) than the male urethra, providing a shorter path for bacteria to reach the bladder.

5. ALL

1. Post-menopausal women: Decreased estrogen levels lead to vaginal atrophy and a change in the pH, which favors the growth of pathogens over healthy lactobacilli.

2. Clients with Neurogenic Bladder: Poor emptying results in urinary stasis, providing a stagnant pool for bacterial colonization.

3. Males with BPH: Prostatic enlargement causes obstruction and incomplete voiding.

4. Females (General): The female urethra is significantly shorter (3-4 : cm) than the male urethra, providing a shorter path for bacteria to reach the bladder.